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ARDMS Abdomen Sonography Examination Sample Questions (Q84-Q89):
NEW QUESTION # 84
Which clinical finding is most likely associated with the splenic pathology demonstrated in this image?
Answer: A
Explanation:
The ultrasound image demonstrates a heterogeneous and echogenic spleen with evidence of atrophy and multiple areas of calcification-consistent with autosplenectomy. This appearance is classically associated with chronic sickle cell anemia.
In sickle cell disease, repeated vaso-occlusive episodes result in infarctions, fibrosis, and progressive calcification of the spleen. Over time, this leads to functional asplenia or complete autosplenectomy (involution and shrinkage of the spleen). The hallmark sonographic features include:
* A small, echogenic spleen
* Multiple coarse calcifications
* Irregular contour or atrophic appearance
These findings are not typically seen in other conditions:
* A. Trauma may cause subcapsular hematomas or lacerations, but not chronic atrophy with calcifications.
* C. Immunocompromised patients may develop abscesses or infections but not the classic features of autosplenectomy.
* D. Portal hypertension typically causes splenomegaly and varices, not atrophic and calcified spleens.
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.
Kellenberger CJ. Imaging of the spleen in children. Eur Radiol. 2004;14(5):92-102.
NEW QUESTION # 85
Which sonographic finding is most consistent with this image of the abdominal aorta?
Answer: B
Explanation:
The ultrasound image provided shows a transverse view of the abdominal aorta, with a clearly measured aortic diameter of 5.71 cm. A normal adult abdominal aorta should measure less than 3.0 cm in anterior- posterior diameter. Any measurement exceeding this threshold is defined as an abdominal aortic aneurysm (AAA).
In this case, the dilation is well beyond the 3.0 cm threshold, confirming the presence of an aneurysm. The rounded, anechoic/heterogeneous central lumen surrounded by echogenic arterial wall layers further supports this diagnosis.
Comparison of answer choices:
* A. Stenosis: Would show a narrowed lumen with turbulent, aliasing flow on Doppler, not a dilated aorta.
* B. Dissection: Typically shows an echogenic intimal flap separating true and false lumens; no flap is visible here.
* C. Aneurysm: Correct. The aorta's transverse diameter (5.71 cm) confirms the presence of an aneurysm.
* D. Occlusion: Would appear as a lack of flow with thrombus or echogenic content filling the lumen, not dilation.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.
Society for Vascular Surgery Guidelines: Management of Abdominal Aortic Aneurysms (Chaikof et al., J Vasc Surg, 2018).
Hagen-Ansert SL. Textbook of Diagnostic Sonography, 8th ed. Elsevier; 2017.
NEW QUESTION # 86
Which structures are located within the testes?
Answer: A
Explanation:
The seminiferous tubules are coiled structures located within the testes where spermatogenesis (sperm production) occurs. They are surrounded by Sertoli and Leydig cells that support spermatogenesis and testosterone production.
* Gubernacula (A) are fetal structures involved in testicular descent.
* Efferent ductules (B) connect the rete testis to the epididymis but are not located within the testicular parenchyma.
* Aberrant ductules (C) are accessory ducts found outside the testis.
Reference Extracts:
* Moore KL, Dalley AF, Agur AM. Clinically Oriented Anatomy. 7th ed. Lippincott Williams & Wilkins, 2013.
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
NEW QUESTION # 87
Which malignancy most commonly metastasizes to the testes?
Answer: D
Explanation:
Testicular metastases are rare and usually identified in older patients. The most frequent primary site of malignancies metastasizing to the testes is theprostate. Studies (Ulbright and Young, 2008; Mosharafa et al.,
2003) indicate that prostatic adenocarcinoma accounts for the highest number of testicular metastases, with lung and gastrointestinal tract malignancies also contributing less frequently. These metastases can be unilateral or bilateral and are often discovered incidentally during surgical intervention for prostate cancer.
The metastatic route involves retrograde venous extension, arterial embolism, or lymphatic dissemination.
Histologically, prostatic adenocarcinoma in the testis can be confirmed viaimmunohistochemical markers like prostate-specific antigen (PSA), supporting its prostatic origin.
References:
Ulbright TM, Young RH. Tumors of the Testis, Adnexa, Spermatic Cord, and Scrotum. AFIP Atlas of Tumor Pathology, 4th Series, Fascicle 18. Armed Forces Institute of Pathology, 2008.
Mosharafa AA, Foster RS, Bihrle R, et al. Clinical and pathologic features of testicular metastases from solid tumors: a 40-year review. Urology. 2003;61(5): 1064-1068.
NEW QUESTION # 88
Which renal condition is commonly associated with pyuria and leukocytosis?
Answer: C
Explanation:
Acute pyelonephritis is a bacterial infection of the renal parenchyma and collecting system. Classic clinical findings include fever, flank pain, leukocytosis (elevated white blood cells), and pyuria (white blood cells in urine). Ultrasound may demonstrate renal enlargement, decreased echogenicity, and loss of corticomedullary differentiation.
* Nephrocalcinosis (A) involves calcium deposition without infection.
* Staghorn calculus (B) may lead to infection but is primarily characterized by obstructive uropathy.
* Renal cell carcinoma (C) presents with hematuria and mass formation rather than infection symptoms.
Reference Extracts:
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
Chapter: Kidneys.
* Middleton WD, Kurtz AB, Hertzberg BS.Ultrasound: The Requisites. 3rd ed. Elsevier, 2015.
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NEW QUESTION # 89
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