ABDOMINAL SONOGRAPHY ARDMS EXAM
2024 WITH ACTUAL CORRECT QUESTIONS
AND VERIFIED DETAILED ANSWERS
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what is the sonographic appearance of an intussusception?
an intussusception usually presents as an oval, pseudokidney mass, with central echoes on longitudinal
imaging, and a sonolucent doughnut or target configuration on cross-sectional imaging
name the four zones of the prostate
peripheral zone
transition zone
central zone
fibromuscular stroma
what zone of the prostate is the source of most prostate cancers?
the peripheral zone is the location for approx. 70% of all prostate cancers. the classic appearance of
prostate cancer on ultrasound is a hypoechoic, peripherally-oriented lesion
what zone of the prostate is not affected by cancer?
the fibromuscular stroma is a non-glandular, anterior portion of the prostate. therefore, it is not
affected by cancer, prostatitis, or hyperplasia
describe benign prostatic hyperplasia (BPH)
enlargement of the inner gland. BPH priginates exclusively from the inner gland. 95% of all BPH arises in
the transition zone, and only 5% form the periurethral glands or tissue
the ejaculatory ducts pass through the _____ and empties into the urethra
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,central zone
seminal vesicles are two sac-like out-pouchings of the vas deferens situated adjacent to the ____ aspect
of the prostate between the urinary bladder and rectum.
superior/posterior
the base of the prostate is the _____ portion of the gland
superior
the apex of the prostate is the ____ portion of the gland
inferior
the demarcation between the inner gland and the outer gland is called the _____
surgical capsule
the prostate is situated in the retroperitoneum and is bordered:
1. anteriorly by the ____
2. posteriorly by the ___
3. superiorly by the ____
4. inferiorly by the _____
1. pubic bone
2. rectum
3. bladder
4. urogenital diaphragm
describe prostate-specific antigen (PSA).
PSA is produced exclusively by prostatic acinar cells, and rises in relationship to the amount of benign
and/or malignant tissue
when do PSA levels rise?
PSA will rise with patient age, prostate volume, benign prostatic hyperplasia, and or prostate cancer.
prostate cancer will elevate the PSA level approximately 10x that of benign prostatic hyperplasia.
what is the name of the anatomical point where the posterior sheath of the rectus muscle ends?
arcuate line
describe the sonographic appearance of an abscess
abscesses are complex collections containing cystic and solid componenets. in most cases, debris,
septations, and gas are seen within the abscess. the borders of an abscess are typically irregular, and
may be quite thick. depending on their cystic component, abscesses typically demonstrate posterior
enhancement. clinically, patients with abscesses should present with fever and leukocytosis
what is the etiology of a lymphocele?
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,complications of renal transplantation and gynecologic, vascular, or urological surgery. the etiology is
leakage of lymph due to surgical disruption of lymphatic channels.
what are some possible causes of urinomas?
renal trauma, renal surgery, or an obstructing lesion
what two conditions are commonly associated with urinomas?
most commonly associated with renal transplantation and posterior urethral valve obstruction.
sonographically similar to lymphoceles
describe the sonographic appearance of a hematoma
variable, depends on age of collection. most hematomas are initially seen as echogenic collections
because of rapid fibrin invasion. gradual hemolysis eventually creates an anechoic appearance.
calcifications are often associated with long-standing hematomas
define hematocrit
the percentage of red blood cells per volume of blood. normal range = 40-50%
what is the significance of a low hematocrit level?
a low hematocrit level, indicates red blood cell loss. low hematocrit can be caused by many factors
including internal bleeding, iron deficiency and external blood loss
what is a Baker's cyst?
a collection of synovial fluid which is found in the popliteal fossa. although it can be found from the
popliteal fossa to the ankle, it is commonly located in the medial aspect of the popliteal fossa.
may be caused by trauma or rheumatoid arthritis. The synovial fluid is very inflammatory and can cause
a great deal of pain. complications include infection, venous thrombosis or compression of venous
structures causing calf swelling
what is pseudomyxoma peritonei?
relatively rare condition described as the filling of the peritoneal cavity with mucinous material and
gelatinous ascites. this is a result of rupture of the mucinous cystadenocarcinoma of the ovary,
appendix, or other sources. adhesions are present, producing matting of mesentery and bowel
posteriorly in the abdominal cavity.
what are the most common causes of pseudomyxoma peritonei?
rupture of a mucinous cystadenocarcinoma of the appendix and
rupture of a mucinous cystadenocarcinoma of the ovary
what is the most common cause of a neonatal adrenal mass?
adrenal hemorrhage is the most common cause of neonatal adrenal mass. it generally occurs during the
first week of life, either as an asymptomatic abdominal mass or as a mass in the presence of jaundice
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, and/or anemia. the sonographic appearance of adrenal hemorrhage is variable depending on the age of
the hematoma
what does the presence of portal venous gas indicate?
portal venous gas in an indication of bowel infarction, as seen in ulcerative colitis or necrotizing
enterocolitis
what is the sonogrpahic appearance of portal venous gas?
the sono appearance of portal venous gas is that of linear echogenic branches in the periphery of the
liver. echogenic foci within the lumen of the portal vein is also seen
does the sonographic portal venous gas differ from that of biliary gas?
yes, the sono appearance of portal venous gas differs from that of biliary gas. portal venous gas is seen
within the periphery of the liver, while biliary gas is located closer to the liver hilum
what is nutcracker syndrome?
Nutcracker syndrome is compression of the left renal vein between the superior mesenteric artery and
the aorta. it is evident by the markedly dilated left renal vein as compared to the right renal vein.
associated symptoms include : left-sided hematuria, abd pain, varicocele formation, and possibly
infertility.
what pathology is described by the terms mantle sign and sandwich sign?
Diffuse lymphadenopathy of the abd will create a layered or mantle appearance around vessels of the
abd. lymphadenopathy is visualized anterior and posterior to vessels of the abd, thus creating the
sandwich sign
what are the symptoms of Graves Disease?
thyroid hyperfunctioning, causing diffuse glandular hyperplasia. Patients with Graves disease may
present with exophthalmos, palpable lymph nodes, muscle atrophy, localized myxedema, weight loss,
tremors, and nervousness.
describe the sono features of Graves disease
sonographically, the thyroid is diffusely enlarged and appears identical to a multinodular goiter. color
flow Doppler will show increased vascularity due to hyperfunctioning of the gland
a 6-year old patient presents with a lateral neck mass. the mass is anterior to the SCM muscle and
lateral to the thyroid near the angle of the mandible. the mass is predominantly cystic, with enhanced
through-transmission. what is the most likely diagnosis for this mass?
this mass is a branchial cleft cyst. a branchial cleft cyst arises in the lateral aspect of the neck, commonly
from epithelial remnants of the second branchial cleft. this is the most common explanation for a cyst in
the lateral aspect of the neck
a patient presents with hypoglycemia and a hypoechoic mass in the tail of the pancreas. what is the
mass in the pancreas?
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