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實用AB-Abdomen熱門認證和資格考試中的領先材料提供者＆頂尖的ARDMS Abdomen Sonography Examination

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最新的 ARDMS RDMS AB-Abdomen 免費考試真題 (Q17-Q22):

問題 #17
A 60-year-old man presents to the emergency room, complaining of tearing pain in the chest and abdomen.
Blood pressure readings from the two arms show a difference of more than 20 mm. Which ultrasound finding is most likely associated with this presentation?

• A. Thickened gallbladder wall
• B. Intimal flap in the aorta
• C. Pericardial fluid
• D. Echogenic material in the inferior vena cava

答案：B

解題說明：
An intimal flap in the aorta is a hallmark ultrasound finding of aortic dissection, which can present with tearing chest/abdominal pain and differential blood pressures between arms. The flap represents separation of the intimal and medial layers of the aortic wall.
According to Rumack's Diagnostic Ultrasound:
"An intimal flap visualized within the aorta is diagnostic of an aortic dissection." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
American Heart Association (AHA) Guidelines for Aortic Disease, 2020.
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問題 #18
What is the most common cause of nutcracker syndrome?

• A. Compression of left renal vein between inferior vena cava and aorta
• B. Compression of right renal vein between inferior vena cava and aorta
• C. Compression of right renal vein between superior mesenteric artery and aorta
• D. Compression of left renal vein between superior mesenteric artery and aorta

答案：D

解題說明：
Nutcracker syndrome results from compression of the left renal vein between the superior mesenteric artery (SMA) and the aorta. This can cause hematuria, flank pain, and pelvic congestion due to impaired venous drainage.
According to Zwiebel's Introduction to Vascular Ultrasound:
"In nutcracker syndrome, the left renal vein is compressed between the aorta and SMA, resulting in venous hypertension." Reference:
Zwiebel WJ, Pellerito JS. Introduction to Vascular Ultrasound. 6th ed. Elsevier, 2019.
AIUM Practice Parameter for Abdominal Vascular Ultrasound, 2020.
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問題 #19
Which of the following must be sterile for a percutaneous procedure?

• A. Machine controls
• B. Transducer
• C. Gel within transducer cover
• D. Transducer cover

答案：C

解題說明：
In percutaneous procedures such as biopsies or drainages, maintaining a sterile field is critical to avoid introducing infection. While the transducer is covered by a sterile cover, the gel placed inside this cover (between the probe and the cover) must also be sterile, as it contacts the sterile field. The transducer itself and machine controls are not sterile but are handled appropriately to avoid field contamination.
According to the AIUM Guidelines:
"Sterile coupling gel must be used inside the sterile probe cover during all invasive or percutaneous procedures." (AIUM Guidelines for Cleaning and Preparing Ultrasound Transducers, 2021).
Reference:
AIUM Guidelines for Cleaning and Preparing Ultrasound Transducers and Equipment for Reuse, 2021.
ACR Practice Parameter for Performing Ultrasound-Guided Procedures, 2020.
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問題 #20
Based on this image, which congenital anomaly should be suspected?

• A. Supernumerary kidney
• B. Horseshoe kidney
• C. Annular pancreas
• D. Pancreas divisum

答案：C

解題說明：
The ultrasound image demonstrates a dilated duodenum with a hypoechoic soft tissue structure encircling it.
This is a classic sonographic appearance suggestive of an annular pancreas. In annular pancreas, pancreatic tissue completely or partially encircles the second portion of the duodenum, which can lead to duodenal narrowing or obstruction.
Annular pancreas is a congenital anomaly that results from failure of the ventral pancreatic bud to rotate properly during embryologic development. As a result, pancreatic tissue encircles the duodenum. It may present in neonates with symptoms of duodenal obstruction or in adults with abdominal pain, pancreatitis, or vomiting.
Ultrasound Findings:
* Hypoechoic pancreatic tissue encircling the duodenum
* Evidence of duodenal dilatation proximal to the obstruction
* "Double bubble" sign may be seen in neonates
Differentiation from other options:
* A. Supernumerary kidney: Refers to an accessory kidney. It would be seen in the retroperitoneum and is unrelated to the duodenum or pancreas.
* B. Pancreas divisum: A ductal anomaly best diagnosed on MRCP or ERCP. It is not typically visible on conventional ultrasound.
* D. Horseshoe kidney: A renal fusion anomaly where the lower poles of the kidneys are fused. It is seen in the pelvis or lower abdomen and does not involve the duodenum or pancreas.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Pancreas, pp. 269-272.
Radiopaedia.org. Annular pancreas: https://radiopaedia.org/articles/annular-pancreas AIUM Practice Parameter for the Performance of Abdominal and Retroperitoneal Ultrasound Examinations,
2020.

問題 #21
Which disease process may cause numerous shadowing calcifications to form within the spleen?

• A. Sickle cell anemia
• B. Non-Hodgkin lymphoma
• C. Thalassemia
• D. Histoplasmosis

答案：D

解題說明：
Histoplasmosis is a fungal infection that can lead to granulomatous disease. Chronic granulomatous infections may result in multiple splenic calcifications that appear as small echogenic foci with shadowing on ultrasound. Other infectious granulomas (e.g., tuberculosis) may present similarly.
According to Rumack's Diagnostic Ultrasound:
"Granulomatous infections such as histoplasmosis and tuberculosis may produce multiple splenic calcifications, often with shadowing." Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for the Performance of Abdominal Ultrasound Examinations, 2020.
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問題 #22
......

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