Important ARDMS AB-Abdomen Exam Questions

Answer: D

Explanation:

Littoral cell angioma is a rare, benign vascular tumor of the spleen, arising from the littoral cells lining the splenic sinusoids. In contrast, lymphoma, metastasis, and angiosarcoma are malignant splenic neoplasms.

According to WHO Classification and Rumack's Diagnostic Ultrasound:

''Littoral cell angioma is a rare benign vascular neoplasm of the spleen with characteristic imaging findings.''

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.

WHO Classification of Tumours of the Digestive System, 5th ed., IARC, 2019.

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Answer: C

Explanation:

The ultrasound image shown is a transverse endorectal (transrectal) ultrasound, commonly used to evaluate the prostate and adjacent structures. The two hypoechoic (dark) oval-shaped structures seen superior and posterior to the prostate are characteristic of the seminal vesicles.

The seminal vesicles are paired, elongated glands located superior and posterior to the base of the prostate and are best visualized in transverse planes on endorectal imaging. They appear as hypoechoic or anechoic structures with internal septations, depending on the degree of fluid content.

In contrast:

The urethra appears as a central echogenic linear structure within the prostate.

The prostate base is more inferior in the scan and is visualized just above the urethra.

The ejaculatory ducts are usually not as prominently visualized and are located medial to the seminal vesicles, entering the prostate near the verumontanum.

This image most clearly demonstrates the bilateral seminal vesicles.

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound, 5th ed. Elsevier; 2017.

ACR--AIUM--SRU Practice Parameter for the Performance of an Ultrasound Examination of the Prostate (2021).

Hagen-Ansert SL. Textbook of Diagnostic Sonography, 8th ed. Elsevier; 2017.

Answer: D

Explanation:

Adrenal adenomas are the most common adrenal tumors in adults. They are often discovered incidentally (adrenal incidentalomas) and are usually nonfunctioning, though some may secrete cortisol or aldosterone. Neuroblastoma is common in children, pheochromocytomas are rarer catecholamine-producing tumors, and adrenal cortical carcinoma is malignant but much less common than adenomas.

According to Rumack's Diagnostic Ultrasound:

''Adrenal adenomas are the most common adrenal masses in adults, frequently identified incidentally on imaging studies.''

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.

ACR Incidental Findings Committee Guidelines for Adrenal Masses, 2017.

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Answer: C

Explanation:

Fine needle aspiration (FNA) uses a thin needle to aspirate cells, which are then packed into the lumen of the needle for cytological evaluation. It is distinct from core biopsy, which uses cutting needles to obtain tissue cores.

According to AIUM Practice Parameters:

''Fine needle aspiration involves insertion of a thin needle into a lesion to aspirate cells for cytologic analysis. The cells are collected inside the needle lumen.''

AIUM Practice Parameter for the Performance of Ultrasound-Guided Percutaneous Needle Biopsy, 2020.

Rumack CM, Diagnostic Ultrasound, 5th ed. Elsevier, 2017.

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Answer: A

Explanation:

The FAST exam is primarily used to detect free intraperitoneal or pericardial fluid in trauma patients, serving as a rapid, bedside assessment tool. While organ injuries may be suspected, the FAST exam is not primarily designed to assess for solid organ lacerations.

According to AIUM and ACEP guidelines:

''The primary goal of the FAST exam is to detect the presence of free fluid suggestive of hemorrhage in trauma patients.''

American College of Emergency Physicians (ACEP) Ultrasound Guidelines, 2016.

AIUM Practice Parameter for the Performance of the FAST Examination, 2020.

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