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ARDMS Abdomen Sonography Examination Sample Questions (Q72-Q77):

NEW QUESTION # 72
Which condition is most consistent with the findings in this image?

A. Medullary sponge kidney
B. Renal cell carcinoma
C. Acute pyelonephritis
D. Fungal balls

Answer: A

Explanation:
The ultrasound image demonstrates a longitudinal view of the right kidney. Within the renal pyramids, there are multiple echogenic foci, some showing posterior acoustic shadowing-findings characteristic of medullary nephrocalcinosis. This sonographic appearance is strongly associated with medullary sponge kidney (MSK).
Medullary sponge kidney is a congenital disorder of the renal tubules that results in ectatic (dilated) collecting ducts in the renal medulla. The dilated ducts frequently become calcified, leading to the "paintbrush" or
"bouquet of flowers" appearance seen in the renal pyramids on ultrasound. These calcifications are most often bilateral and symmetrical, further aiding the diagnosis.
Comparison of answer choices:
* A. Fungal balls (mycetomas) typically appear as mobile, non-shadowing echogenic masses within the collecting system, often in immunocompromised patients.
* B. Renal cell carcinoma usually presents as a solid mass with irregular borders and variable echogenicity-this image does not show a mass.
* C. Acute pyelonephritis may show renal enlargement, decreased echogenicity, or loss of corticomedullary differentiation-but not calcification of the pyramids.
* D. Medullary sponge kidney is correct due to the punctate echogenic foci within the medullary pyramids, consistent with nephrocalcinosis.
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.
Babcock DS. Sonographic findings in medullary sponge kidney. AJR Am J Roentgenol. 1981;137(6):1239-
1243.

NEW QUESTION # 73
Hepatitis is classified into groups. Which of these four types are transmitted by fecal-oral route?

A. Hepatitis B
B. Hepatitis A
C. Hepatitis D
D. Hepatitis C

Answer: B

Explanation:
Hepatitis A is primarily transmitted via the fecal-oral route, often through contaminated food or water.
Hepatitis B, C, and D are transmitted through blood and body fluids.
According to CDC and WHO guidelines:
"Hepatitis A virus (HAV) is transmitted primarily by the fecal-oral route via ingestion of contaminated food or water." Reference:
CDC. Viral Hepatitis Surveillance - United States, 2020.
WHO. Hepatitis A Fact Sheet, 2022.

NEW QUESTION # 74
What is the adrenal disorder that produces excessive secretion of aldosterone?

A. Conn syndrome
B. Cushing disease
C. Waterhouse-Friderichsen syndrome
D. Addison disease

Answer: A

Explanation:
Conn syndrome (primary hyperaldosteronism) results from excessive aldosterone secretion, often due to an adrenal adenoma, leading to hypertension, hypokalemia, and metabolic alkalosis. Cushing disease involves cortisol, Addison disease involves adrenal insufficiency, and Waterhouse-Friderichsen is associated with adrenal hemorrhage.
According to Rumack's Diagnostic Ultrasound:
"Conn syndrome is due to excessive secretion of aldosterone, often secondary to adrenal cortical adenoma." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Adrenal Ultrasound, 2020.
-

NEW QUESTION # 75
Which of the following would optimize visualization of a bladder mass?

A. Compression technique to move bowel gas
B. Utilize a high-frequency linear transducer
C. Have patient fill bladder
D. Have patient empty bladder

Answer: C

Explanation:
A full bladder provides an acoustic window that displaces bowel gas and distends the bladder walls, allowing optimal visualization of any bladder masses or lesions. An empty bladder may collapse, obscuring masses.
According to Rumack's Diagnostic Ultrasound:
"Bladder evaluation should be performed with the bladder optimally distended to visualize its walls and any intraluminal 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 # 76
Elevation of alpha-fetoprotein levels is a characteristic finding in which tumor?

A. Hepatoma
B. Adenoma
C. Focal nodular hyperplasia
D. Cholangiocarcinoma

Answer: A

Explanation:
Alpha-fetoprotein (AFP) is commonly elevated in patients with hepatocellular carcinoma (hepatoma), particularly in those with underlying cirrhosis or chronic hepatitis B/C. AFP is not typically elevated in adenomas, cholangiocarcinoma, or FNH.
According to Rumack's Diagnostic Ultrasound:
"Serum AFP levels are elevated in 50-70% of patients with hepatocellular carcinoma." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AASLD Guidelines for HCC Surveillance, 2018.
-

NEW QUESTION # 77
......

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