Verified AB-Abdomen dumps Q&As 100% Pass in First Attempt Guaranteed Updated Dump from ValidExam [Q93-Q107]

The image shows a transverse view of the left lobe of the liver with the portal triads clearly visible. The
“parallel channel” or “double barrel” sign is observed-where dilated intrahepatic bile ducts run alongside the portal veins, creating a characteristic sonographic pattern of paired anechoic (black) tubular structures.
This sonographic feature is diagnostic for dilated intrahepatic bile ducts and is typically seen in obstructive jaundice or biliary obstruction from conditions such as:
* Choledocholithiasis (stone in the common bile duct)
* Stricture or mass compressing the bile ducts
* Cholangiocarcinoma
The intrahepatic bile ducts normally are too small to visualize clearly unless dilated. Their dilation gives the liver a “too many tubes” appearance, where bile ducts become as prominent as the portal veins.
Comparison of answer choices:
* A. Normal intrahepatic ducts are not usually seen this clearly or prominently on ultrasound.
* B. Dilated intrahepatic – Correct. The parallel channel sign supports this diagnosis.
* C. Dilated common bile duct would be visualized extrahepatically, typically anterior to the portal vein near the head of the pancreas.
* D. Dilated common hepatic duct is also extrahepatic and seen in the porta hepatis, not within the liver parenchyma.
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.
Taylor KJW, Burns PN, Wells PNT. Clinical Applications of Doppler Ultrasound. Raven Press; 1990.

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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Caput medusae refers to dilated paraumbilical veins due to portal hypertension. When portal venous pressure rises, collateral channels may open along the ligamentum teres and recanalized paraumbilical vein, resulting in visible dilated veins radiating from the umbilicus.
* Esophageal varices (B) are gastroesophageal collaterals.
* Coronary vein varices (C) involve gastric veins.
* Splenic vein varices (D) are typically localized to the splenic hilum.
Reference Extracts:
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
* Gore RM, Levine MS. Textbook of Gastrointestinal Radiology. 4th ed. Saunders, 2015.
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The ultrasound image shows a transverse section through the upper abdomen. The arrow is pointing to a vascular structure running posterior to the pancreas and anterior to the left kidney. This vessel is the splenic vein.
Anatomically:
* The splenic vein runs along the posterior border of the pancreas.
* It courses medially to join the superior mesenteric vein (SMV) and form the portal vein.
* It receives tributaries from the spleen, short gastric veins (draining the stomach), and the inferior mesenteric vein.
In this case, the question asks which organ is primarily drained via the vessel marked by the arrow. The splenic vein’s main tributary is from the spleen.
Comparison of answer choices:
* A. Spleen – Correct. The splenic vein is the primary drainage vessel for the spleen.
* B. Stomach – Some gastric veins drain into the splenic vein, but the primary drainage is via left and right gastric veins into the portal system.
* C. Left kidney – Drains into the left renal vein, not the splenic vein.
* D. Duodenum – Drains mainly into the superior mesenteric vein (SMV).
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.
Netter FH. Atlas of Human Anatomy, 7th ed. Elsevier; 2018.

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.

Urinomas are collections of urine in the retroperitoneum that result from trauma, surgery, or obstruction causing urine leakage. Trauma is a frequent cause of urinoma formation due to disruption of the urinary tract.
According to Rumack’s Diagnostic Ultrasound:
“Urinomas may develop as a complication of trauma, surgery, or obstructive uropathy with urinary extravasation into the retroperitoneum.” Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Renal Ultrasound, 2020.
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The ultrasound image labeled “SAG RUQ KIDNEY” demonstrates a midline sagittal view showing a renal parenchymal structure that extends across the midline anterior to the aorta and vertebral bodies, suggesting the presence of a horseshoe kidney.
A horseshoe kidney is a congenital renal anomaly in which the lower poles of both kidneys are fused across the midline by a parenchymal or fibrous isthmus. This isthmus typically lies anterior to the aorta and inferior vena cava and can be seen as a hypoechoic band of tissue crossing the midline on ultrasound.
Ultrasound findings characteristic of a horseshoe kidney:
* Abnormally low position of the kidneys in the abdomen
* Renal tissue (isthmus) bridging the lower poles anterior to the great vessels
* Renal axes may be more horizontal than usual
* Kidneys may appear closer together or “kissing” the spine anteriorly
Differentiation from other options:
* A. Duplicated collecting system: Manifests as two separate collecting systems within one kidney, often with a central renal sinus split into two – not typically midline bridging.
* B. Crossed renal ectopia: Involves one kidney crossing midline and fusing with the other on the opposite side, but they do not form a midline isthmus.
* D. Pelvic kidney: A single kidney located in the pelvis due to failed ascent – it does not appear as midline fusion of two kidneys.
References:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th Edition. Elsevier, 2018.
Chapter: Urinary Tract, pp. 215-218.
American Institute of Ultrasound in Medicine (AIUM). Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen and/or Retroperitoneum. 2020.
Radiopaedia.org. Horseshoe kidney: https://radiopaedia.org/articles/horseshoe-kidney

The transverse ultrasound image of the liver shows a solid, hypoechoic mass located in the posterior aspect of the right lobe of the liver. In this view:
* The anterior aspect of the liver is at the top of the image (near the transducer).
* The posterior aspect is at the bottom (deeper).
* The right lobe occupies the majority of the screen on transverse imaging when the probe is placed in the epigastrium or right upper quadrant.
Anatomically, the right lobe of the liver is divided into anterior and posterior segments by the right hepatic vein in the coronal plane. In transverse imaging:
* The right anterior segment lies closer to the anterior abdominal wall.
* The right posterior segment lies deeper (posteriorly).
Given that the mass is seen deep within the liver on the right side of the image, it is best localized to the right posterior segment (Segment VI or VII depending on the exact craniocaudal level).
Comparison of answer choices:
* A. Left lateral is located far to the left of the image and typically appears higher and more anterior on transverse scans.
* B. Left medial lies near the midline and would appear adjacent to the ligamentum teres or falciform ligament.
* C. Right anterior lies closer to the transducer (top of the image), not posteriorly.
* D. Right posterior – Correct. This is the segment shown deep in the right lobe of the liver.
References:
Couinaud C. Liver anatomy: portal (and hepatic) segmentation. Trans Assoc Am Physicians. 1957.
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.

Exudative ascites is characterized by high protein content and cellular debris, typically resulting from infections (e.g., peritonitis, tuberculosis), malignancy, or inflammatory conditions. Transudative ascites is more commonly seen in conditions such as liver failure, renal failure, and hypoproteinemia due to changes in hydrostatic or oncotic pressure.
According to Light’s Criteria:
“Infection and malignancy are common causes of exudative ascites, distinguished by high protein content and elevated LDH.” Reference:
Light RW. Pleural Diseases. 6th ed. Lippincott Williams & Wilkins, 2013.
AASLD Guidelines for the Evaluation of Ascites, 2021.
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Budd-Chiari syndrome is caused by hepatic venous outflow obstruction, resulting in hepatomegaly, ascites, right upper quadrant pain, and liver dysfunction. It may be due to thrombosis or compression of the hepatic veins or IVC.
According to Rumack’s Diagnostic Ultrasound:
“Budd-Chiari syndrome results from hepatic venous outflow obstruction and presents with hepatomegaly, ascites, and right upper quadrant pain.” Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Liver Ultrasound, 2020.
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Power Doppler measures the amplitude (strength) of Doppler signals rather than frequency shift, making it more sensitive to low-velocity and small-vessel blood flow. Its primary advantage is an improved signal-to- noise ratio, allowing for better visualization of slow or weak flow.
* A: Power Doppler is more sensitive to motion artifacts, not less.
* B: It is still angle dependent, though somewhat less so than color Doppler.
* D: Power Doppler does not display flow direction (a limitation).
Reference Extracts:
* Kremkau FW. Sonography Principles and Instruments. 9th ed. Elsevier, 2015.
* Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.

The most common symptom of cholelithiasis (gallstones) is biliary colic, characterized by intermittent right upper quadrant or epigastric pain often triggered by fatty meals. Jaundice occurs in complications such as choledocholithiasis.
According to Rumack’s Diagnostic Ultrasound:
“Gallstones may cause biliary colic – episodic upper abdominal pain often related to food intake.” Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
American College of Gastroenterology (ACG) Guidelines for Gallstone Disease, 2013.
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In mild acute pancreatitis, the pancreas often appears diffusely enlarged and slightly hypoechoic due to edema and inflammation. However, in very early or mild cases, the pancreas may still appear normal. Heterogeneous echotexture may develop in more severe or necrotizing pancreatitis.
According to Rumack’s Diagnostic Ultrasound:
“In mild pancreatitis, the pancreas is commonly enlarged and hypoechoic due to inflammatory edema.” Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Abdomen, 2020.
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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.” Reference:
American College of Emergency Physicians (ACEP) Ultrasound Guidelines, 2016.
AIUM Practice Parameter for the Performance of the FAST Examination, 2020.
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Portal veins course horizontally within the liver and have echogenic walls due to their fibrous sheath. In contrast, hepatic veins course vertically toward the IVC and lack echogenic walls. Hepatic veins also demonstrate a triphasic waveform.
According to Rumack’s Diagnostic Ultrasound:
“Portal veins course horizontally within the liver and are easily recognized by their echogenic walls.” Reference:
Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.
AIUM Practice Parameter for Liver Ultrasound, 2020.
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