Which is the most common pancreatic cancer?
Answer(s): C
Pancreatic ductal adenocarcinoma is by far the most common pancreatic malignancy, accounting for approximately 8590% of pancreatic cancers. It typically arises from the exocrine portion of the pancreas, most frequently in the pancreatic head. Islet cell (neuroendocrine) tumors and cystic neoplasms (e.g., mucinous cystadenocarcinoma) are far less common.According to Rumack's Diagnostic Ultrasound:"Adenocarcinoma is the most common malignant neoplasm of the pancreas, representing the vast majority of pancreatic cancers."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.WHO Classification of Digestive System Tumors, 5th ed., IARC, 2019.
Which area of the spleen is not covered by visceral peritoneum?
Answer(s): D
The spleen is almost entirely covered by visceral peritoneum, except at the hilum where vessels, nerves, and lymphatics enter and exit. This area lacks peritoneal covering to allow vascular connection to the splenic artery and vein.According to Moore's Clinically Oriented Anatomy:"The spleen is entirely covered by visceral peritoneum except at its hilum where the vascular structures enter."
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 8th ed. Wolters Kluwer, 2018.Gray's Anatomy for Students, 4th ed., Elsevier, 2019.
Which complication is of greatest concern with undescended testis?
Answer(s): B
The most serious long-term complication of undescended testis (cryptorchidism) is an increased risk of testicular malignancy, especially seminoma. Although torsion and hernia may also occur, seminoma is the most concerning complication due to its life-threatening potential.According to Rumack's Diagnostic Ultrasound:"Cryptorchidism is associated with a significantly increased risk of seminoma, the most common malignancy in undescended testes."
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.American Urological Association (AUA) Guidelines, 2019.
Which action should a sonographer take if the abdominal aorta measures 5.5 centimeters in the anteroposterior diameter?
Answer(s): A
An abdominal aortic aneurysm (AAA) measuring 5.5 cm represents a significantly increased risk of rupture and often requires surgical evaluation. The sonographer must report this critical finding immediately to the interpreting physician. The sonographer should never disclose a diagnosis directly to the patient.According to AIUM and SRU Guidelines:"An aortic diameter of 5.5 cm or greater should be promptly reported to the interpreting physician due to the high risk of rupture."
AIUM Practice Parameter for Abdominal Aortic Ultrasound, 2020.Society of Radiologists in Ultrasound (SRU) Consensus Statement, 2003.
Which foreign body is better visualized with sonography than computed tomography (CT)?
Wooden foreign bodies are often difficult to detect on CT because of their low radiodensity, but they are highly echogenic with posterior shadowing or reverberation on ultrasound, making ultrasound superior for detecting retained wooden objects. Glass, metal, and stones are better visualized with CT due to their high radiodensity.According to AIUM and musculoskeletal ultrasound literature:"Wood is poorly visualized on CT but demonstrates high reflectivity and acoustic shadowing on ultrasound."
Bianchi S, Martinoli C. Ultrasound of the Musculoskeletal System. Springer, 2007.AIUM Practice Parameter for Musculoskeletal Ultrasound, 2020.
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