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ARDMS ABD REVIEW > Physics > Flashcards

Physics Flashcards

1
Q

Which of the following will increase the amount of color displayed in the abdominal AO?

increase frame rate
decrease color gain
decrease color threshold
increase wall filter

A

increase frame rate

**changing to a smaller sample size will increase frame rates

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2
Q

What type of transducer produced the image?

sector phased array
linear sequential array
curvilinear phased array
vector phased array

A

sector phased array

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3
Q

You are evaluating an obese patient with a known AAA. While using color Doppler to assess flow within the aneurysm, minimal flow is detected in the anechoic lumen. You decrease the color scale and increase the color gain but there is no improvement. Which of the following adjustments will most improve the color display on this exam?

decrease the color threshold
switch from a 4MHz curved array to a 4MHz linear array
increase color sample size
increase the color threshold

A

increase the color threshold

**increasing the color threshold will increase the amount of color displayed

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4
Q

What determines the transducer frequency used for the evaluation of a foreign body?

composition of the foreign body
depth of the foreign body
the radiologist reading the exam
age of the foreign body

A

depth of the foreign body

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5
Q

What acoustic artifact is demonstrated by the red arrow?

reverberation
refractive shadowing
mirror imaging
ringdown

A

refractive shadowing

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6
Q

The primary factor that determines transducer selection for a biopsy is:

physician preference
thickness of the sterile cover
depth of the mass
composition of the mass

A

depth of the mass

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7
Q

Which of the following would cause artifactual debris within a simple cyst?

increased rejection settings
short distance from the transducer
activation of spatial compounding
reduced gain settings

A

short distance from the transducer

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8
Q

Which of the following best describes the areas indicated by the yellow arrows?

reverberation artifact
refractive shadowing
PE element damage
posterior shadowing

A

PE element damage

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9
Q

A large angiomyolipoma in the right kidney is most commonly associated with what acoustic artifact?

mirror image
reverberation
comet tail artifact
propagation speed artifact

A

propagation speed artifact

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10
Q

What is the BEST way to evaluate the indicated vessel for the presence of blood flow?

color Doppler
PW Doppler
power Doppler
B-color

A

power Doppler

**preferred for smaller vessels and those coursing perpendicular to the US beam

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11
Q

Which of the following will reduce ansiotropy artifact?

dual screen imaging
turn of harmonic imaging
reduce color Doppler gain
rocking the transducer

A

rocking the transducer

**ansiotropy artifact refers to falsely hypoechoic areas of a tendon that occur when the transducer is not completely parallel to the tendon

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12
Q

Which of the following acoustic artifacts is identified on the image?

reverberation
lobe artifact
mirror image
misregistration

A

reverberation

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13
Q

Overgaining on an US exam can cause ___.

blood to appear anechoic
underestimation of arterial stenosis
overestimation of Doppler velocity
increased posterior shadowing

A

overestimation of Doppler velocity

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14
Q

You are scanning the GB and there appears to be sludge within the lumen. Which of the following will aid in differentiating the sludge from artifact?

ask the patient to perform the Valsalva maneuver
increase the transducer frequency
apply color Doppler
ask the patient to fast for 3-4 more hours and rescan

A

increase the transducer frequency

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15
Q

____ occurs posterior to highly attenuating structures.

enhancement
speckle
shadowing
refraction

A

shadowing

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16
Q

Acoustic Radiation Forced Impulse (AFRI) evaluation of the liver:

is performed with a subcostal midline window
is helpful in cases of suspected abscess formation
should be performed with the patient in the prone position
should be performed in the right lobe

A

should be performed in the right lobe

**used to assess the liver for signs of chronic disease

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17
Q

All of the following are characteristics of Power Doppler, EXCEPT:

demonstrates presence or absence of flow
demonstrates organ perfusion better than color Doppler
more sensitive to slow flow than color Doppler
demonstrates velocity of flow within the organ

A

demonstrates velocity of flow within the organ

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18
Q

When evaluating a liver transplant, you must use angle correction during Doppler evaluation of:

PVs only
HAs only
HAs and PVs
HAs and HVs

A

HAs and PVs

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19
Q

What system control should be turned off when trying to differentiate a small stone in the GB from a sludge ball?

compound imaging
harmonic imaging
focal zone
time gain compensation

A

compound imaging

** turning this feature off can improve visualization of posterior shadowing and enhancement

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20
Q

If there is no diastolic flow demonstrated on a Doppler tracing of the interlobar artery of the upper pole of the right kidney, what will the RI be?

unable to calculate RI, not enough information
0
1.0
0.5

A

1.0

(PSV - EDV)/PSV

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21
Q

Which type of transducer would be used to evaluate a patient with increased LFTs and height 5’3” and weight 275lbs?

10MHz vector array
5MHz linear phased array
5MHz sector phased array
3MHz curvilinear phased array

A

3MHz curvilinear phased array

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22
Q

Harmonic imaging leads to:

increased image noise
reduced signal to noise ratio
reduced appearance of lobe artifact
improved axial but degraded lateral resolution

A

reduced appearance of lobe artifact

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23
Q

On a scrotal ultrasound exam, how do you differentiate acute epididymitis from post-vasectomy enlargement of the epididymis?

use dual screen imaging
use color Doppler
use power Doppler
use a stand off pad

A

use color Doppler

** hypervascularity is demonstrated with infection, but not with post-surgical changes

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24
Q

The artifact that is produced when the incident beam hits a curved surface and produces an acoustic shadow is referred to as:

lobe artifact
posterior shadowing
refractive shadowing
comet tail artifact

A

refractive shadowing

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25
Q

If the entire image is too dark, what console adjustment should you make first?

adjust the near field TGC
increase the output power
adjust the far field TGC
increase overall gain

A

increase overall gain

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26
Q

When performing a Doppler evaluation of the renal arteries the cursor angle should be set at ___ degrees or less for the main renal arteries and ___ degrees or less for the intraparenchymal arteries.

45, 60
20, 0
60, 20
60, 45

A

60, 20

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27
Q

If the entire image is too bright, what console adjustment should you make first?

decrease the overall gain
adjust the far field TGC
adjust the near field TGC
decrease the output power

A

decrease the output power

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28
Q

How are the gain settings adjusted to the proper level for evaluation of abdominal structures?

A normal GB or IVC should look anechoic throughout the exam

the spleen echogenicity should be set to a medium grey level at the start of the exam

the liver echogenicity should be set to medium grey at the start of the exam

the anterior abdominal fat should appear as a medium grey level throughout the exam

A

A normal GB or IVC should look anechoic throughout the exam

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29
Q

Which of the following is a resonance artifact only seen with a gas/tissue interface?

mirror imaging
misregistration
ringdown
posterior shadowing

A

ringdown

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30
Q

A patient presents for a liver ultrasound with contrast to evaluate a tumor. Which of the following lists the correct machine settings needed for the exam?

MI over 1.5, harmonics off, and focal zone at the abdominal wall

low MI, harmonics off, and focal zone at the abdominal wall

highest output power setting available, harmonics on, and at least three focal zones surrounding the area of interest

low MI, harmonics on, and focal zone placed at the area of interest

A

low MI, harmonics on, and focal zone placed at the area of interest

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31
Q

While performing a Doppler evaluation of the main RAs, multiple patient positions may be required in order to maintain a Doppler angle of ___ degrees or less.

0
30
60
90

A

60

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32
Q

Color Doppler demonstrates the ___.

direction of flow only
peak velocity of blood flow only
average velocity and direction of flow
peak velocity and direction of flow

A

average velocity and direction of flow

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33
Q

Which of the following techniques will lead to degraded lateral resolution?

trapezoidal field of view on linear array
increase in number of focal zones
increased probe frequency
none of the above

A

trapezoidal field of view on linear array

**increasing size of FOV will lead to increased beam divergence which leads to reduced lateral resolution

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34
Q

What is the cause of the vertical acoustic shadow seen on the images?

electrical interference
element damage
patient motion
air in the trachea

A

element damage

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35
Q

Increasing the imaging depth will:

improve temporal resolution
reduce beam intensity
increase the PRF
reduce the frame rate

A

reduce the frame rate

**pulses are longer/slower which reduces frame rate

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36
Q

Increasing the ___ will most improve the ability to properly trace the contour of this Doppler waveform.

sweep speed
velocity scale
wall filter
baseline

A

sweep speed

**decreases the amount of Doppler information displayed over a shorter time

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37
Q

While performing color Doppler on a routine renal ultrasound, extreme turbulence is noted at the RRA origin. How should your exam change to evaluate the finding?

use PW Doppler to record a flow pattern in the area of turbulence

advise the patient that they may have to return for an additional exam because of the suspected renal stenosis

have the patient perform the Valsalva maneuver and reassess the vessel for changes

all of the above

A

use PW Doppler to record a flow pattern in the area of turbulence

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38
Q

Which Doppler artifact is demonstrated on the image?

side lobes
reverberation
cross talk
aliasing

A

cross talk

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39
Q

What change in system controls can reduce the appearance of color displayed over vessel walls?

decreasing color priority
decreasing color PRF
increasing color threshold
increasing persistence

A

decreasing color priority

**lower threshold settings reduce the display of color

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40
Q

Which of the following exams does not require angle corrected Doppler evaluation?

RA duplex
TIPS evaluation
IVC duplex
AO duplex

A

IVC duplex

41
Q

Which imaging plane can demonstrate the IVC and the AO on the same image in a normal patient?

coronal and TRV
coronal only
mid SAG only
TV only

A

coronal and TRV

42
Q

When performing contrast enhanced ultrasound evaluation of the liver, when are the images obtained?

after the saline flush, record an image the area of interest every 60 seconds

when the contrast is first visualized in the areas of interest and again when it dissipates completely

at the start of the contrast injection, record an image the area of interest every 30 seconds

at the start of the saline flush, record the area of interest for 1 minute and image every 30-60 seconds until the 6 minute mark

A

at the start of the saline flush, record the area of interest for 1 minute and image every 30-60 seconds until the 6 minute mark

43
Q

Put the following in order in decreasing echogenicity:

renal sinus, renal parenchyma, liver, spleen, pancreas

renal parenchyma, spleen, liver, pancreas renal sinus

pancreas, spleen, liver, renal sinus, renal parenchyma

renal sinus, pancreas, spleen , liver, real parenchyma

A

renal sinus, pancreas, spleen , liver, real parenchyma

44
Q

Which type of transducer would be used to evaluate a palpable lump in the neck?

3MH curvilinear sequential array
12MHz linear phased array
12MHz curvilinear phased array
12MHz sector phased array

A

12MHz linear phased array

45
Q

What acoustic artifact is commonly seen with a liver abscess, adenomyomatosis of the GB, and emphysematous cholecystitis?

mirrior image artifact
posterior enhancement
propagation speed artifact
posterior reverberation artifact

A

posterior reverberation artifact

46
Q

You are currently using a curved probe with a 3.5MHz frequency to evaluate a patient’s liver. What can be done to better visualize the area indicated by the arrow?

switch to a 12MHz linear probe
switch from a curved array to a vector array of the same frequency
switch to a 2.5MHz curved probe
switch to a 5MHz linear probe

A

switch to a 5MHz linear probe

** would provide the largest near field

47
Q

All of the following techniques will aid in the visualization of a small renal calculi with questionable shadowing, EXCEPT:

using multiple scanning planes to evaluate the kidney

reducing the dynamic range

decreasing transducer frequency

rescanning the patient in the decubitus position

A

decreasing transducer frequency

48
Q

What acoustic artifact is demonstrated by the mass within the liver?

comet tail artifact
reverberation
posterior enhancement
dirty shadowing

A

posterior enhancement

49
Q

What can be used to alter the displayed brightness of the image after it has been stored in the memory?

compression
post-processing
pre-processing
rejection

A

post-processing

50
Q

What acoustic artifact is demonstrated on the image by the red X?

posterior enhancement
speed error
edge shadowing
mirror imaging

A

mirror imaging

51
Q

All of the following can cause artifactual debris within a simple cyst, EXCEPT:

improper gain settings
increased rejection settings
superficial location of the cyst
small size of the cyst

A

increased rejection settings

52
Q

Which of the following adjustments would reduce the aliasing displayed on the image while maintaining the diagnostic quality?

reducing the color Doppler gain is the preferred method to remove the appearance of color aliasing on the image

repositioning the patient and scanning through the anterior abdominal wall will reduce or eliminate the color aliasing

increasing the color scale velocity setting is the preferred method to reduce the aliasing in the RA

increasing the color priority setting is the preferred method to reduce the aliasing in the RA

A

increasing the color scale velocity setting is the preferred method to reduce the aliasing in the RA

53
Q

Which of the following operator controls adjusts the beam intensity?

output
overall gain
dynamic range
TGC

A

output

54
Q

When you change the angle on the Doppler cursor, the ___ also changes.

amplitude of the reflected signal
the volume of flow interrogated
the wall filter settings also change
flow velocity displayed

A

flow velocity displayed

55
Q

B-color can be helpful in the evaluation of:

subtle differences in tissues
low velocity blood flow
high velocity blood flow
anechoic fluid/cysts

A

subtle differences in tissues

56
Q

What is the name of the universally accepted image file type that is used by a PACS system to store and view images?

MPEG
DICOM
AVI
JPEG

A

DICOM (digital imaging and communications in medicine)

57
Q

Increasing the size of the field of view will ___ the frame rate.

cause a 50% decrease
decrease
have no effect on
increase

A

decrease

58
Q

Which of the following machine adjustments will produce black and white 2D images?

reducing the compression
reducing overall gain
increasing dynamic range
reducing monitor contrast

A

reducing compression

** compression adjusts the dynamic range or number of shades of gray on the image

59
Q

Which supplemental technique, used to better visualize the size of a large hydrocele, is demonstrated on the image?

extended field of view
vector array imaging
harmonic imaging
curved array imaging

A

curved array imaging

60
Q

Harmonic imaging:

improves the spatial resolution but causes degradation of temporal resolution

is not recommended for use on fetal exams due to increased beam intensity

uses information from reflections creates by the non-linear behavior of sound waves to form the image

improves spatial resolution but causes degradation of contrast resolution

A

uses information from reflections creates by the non-linear behavior of sound waves to form the image

61
Q

Posterior shadowing can be helpful in the diagnosis of all of the following, EXCEPT:

GB calculi
choledocholithiasis
nephrocalcinosis
steatosis

A

steatosis

62
Q

___ may be a cause for liver echoes distal to the GB to appear brighter than the surrounding parenchyma.

posterior enhancement
decreased gain settings
portal venous reflections
posterior shadowing

A

posterior enhancement

63
Q

Why did the sonographer steer the US image during the thyroid biopsy?

to make the US beam more perpendicular to the nodule

to reduce the side lobe artifact

to make the US beam more perpendicular to the long axis of the needle

to better visualize the borders of the nodule

A

to make the US beam more perpendicular to the long axis of the needle

64
Q

Which statement is true about the image?

the red arrows are pointing to the anterior wall of the Baker cyst and the associated enhancement

the red arrows are pointing to the posterior wall of the Baker cyst and the associated shadowing

the red arrows are pointing to the anterior wall of the Baker cyst and the associated shadowing

the red arrows are pointing to the posterior wall of the Baker cyst and the associated enhancement

A

the red arrows are pointing to the anterior wall of the Baker cyst and the associated enhancement

65
Q

In order to assess low velocity flow, which of the following operator adjustments should be made?

decrease wall filter setting and compression
increase scale setting
decrease compression
decrease the rejection and wall filter setting

A

decrease the rejection and wall filter setting

66
Q

When the sonographer decreases the imaging depth the ___.

PRF will decrease
frame rate will decrease
PRF will increase
elevational resolution will improve

A

PRF will increase

67
Q

Time gain compensation is necessary due to:

the inability of high frequency transducers to penetrate the body effectively

sound impedance difference between transducer and skin

the non-linear behavior of sound waves

reflection, refraction, and scatter

A

reflection, refraction, and scatter

68
Q

Which imaging plane is most commonly used to obtain the length of the spleen during an abdominal ultrasound?

TRV
SAG
axial
coronal

A

coronal

69
Q

A patient presents with a palpable lump adjacent to the umbilicus. Which of the following transducers would be best to use for this exam?

10MHz linear array
3.5 MHZ linear array
3.5MHz curvilinear array
8MHz sector array

A

10MHz linear array

70
Q

Which of the following would be associated with posterior enhancement artifact in the liver tissues?

fatty infiltration
lymphoma
dilated intrahepatic ducts
large lipoma

A

dilated intrahepatic ducts

71
Q

Power Doppler:

is preferred for evaluation of blood flow in a TIPS shunt

is preferred for evaluation of blood flow in a patient with suspected PHTN

is less sensitive than color Doppler when evaluating renal transplant perfusion

display is not dependent on incident beam angle

A

display is not dependent on incident beam angle

72
Q

An average sized patient presents with a fever, acute RLQ pain and vomiting. The ER physician wants to rule out appendicitis in this patient. Which transducer would best be suited for the exam?

5MHz curvilinear
3MHz curvilinear
12MHz linear
5MHz linear

A

5MHz linear

73
Q

The use of multiple focal zones will improve ___ but degrade ___.

axial resolution, lateral resolution
temporal resolution, lateral resolution
lateral resolution, axial resolution
lateral resolution, temporal resolution

A

lateral resolution, temporal resolution

74
Q

___ resolution is defined as the ability of an ultrasound system to differentiate structures on an image based on variations in the brightness of the echo/pixel.

contrast
axial
elevational
lateral

A

contrast

75
Q

Which acoustic artifact is demonstrated on the image?

posterior shadowing
comet tail
mirror imaging
range resolution

A

mirror imaging

76
Q

All of the following controls affect the amount of color fill in a vessel evaluated with color Doppler, EXCEPT:

sample size
color Doppler baseline
sample angle
color Doppler scale settings

A

color Doppler baseline

** affects what color is displayed but not how much color is displayed

77
Q

Which imaging plane can produce a longitudinal image of the IVC and the AO on the same image?

coronal and TRV
mid SAG only
coronal only
TRV only

A

coronal only

78
Q

A contrast agent consists of a cellulose suspension is administered to a patient to better visualize:

an aortic aneurysm
the pancreatic tail
functioning thyroid nodules
non-functioning adrenal adenomas

A

the pancreatic tail

79
Q

What is the twinkle artifact?

mosaic color pattern displayed in a linear pattern posterior to a dense object, such as a renal stone

thin line of reverberation artifact that is caused by calcium deposits in the renal parenchyma

varied brightness of vascular calcifications causes a twinkling effect on 2D

describes the color display seen as urine is entering the bladder during real time imaging

A

mosaic color pattern displayed in a linear pattern posterior to a dense object, such as a renal stone

80
Q

Which of the following renal abnormalities is commonly associated with propagation speed artifact?

staghorn calculus
mycetoma
hypernephroma
4cm renal angiomyolipoma

A

4cm renal angiomyolipoma

81
Q

Increasing the wall filter setting could reduce the display of all of the following, EXCEPT:

aliasing artifact
clutter artifact
beam width artifact
cross talk artifact

A

aliasing artifact

82
Q

Which of the following probe frequencies should be used when trying to evaluate the pancreas in an obese patient?

3MHz curvilinear
3MHz linear
5MHz vector
5MHz curvilinear

A

3MHz curvilinear

83
Q

Harmonic imaging will:

improve temporal resolution

allow for deeper penetration with improved spatial resolution

degrade lateral resolution and improve axial resolution

reduce the appearance of microbubble contrast on a contrast echo

A

allow for deeper penetration with improved spatial resolution

84
Q

Which acoustic artifact is a common sonographic sign of emphysematous pylonephritis?

side lobe
misregistration
resonance artifact
propagation speed error

A

resonance artifact

85
Q

Acoustic Radiation Forced Impulse (AFRI) is typically used to assess the ___ for signs of ___.

kidneys, obstructive calculi
AO, stenosis
abdominal wall, hernia formation
liver, chronic disease

A

liver, chronic disease

86
Q

No flow is detected while performing a color Doppler evaluation of a normal splenic vein. What will improve the color display?

increase the color packet size
increase the sample size
increase the color velocity scale
increasing angle of insonation

A

increase the color packet size

87
Q

Which acoustic artifact will commonly be identified with hydrocele formation?

edge shadowing
posterior shadowing
posterior enhancement
comet tail artifact

A

posterior enhancement

88
Q

Propagation speed artifact, reverberation artifact and the bayonet artifact are acoustic artifacts seen with:

needles
pneumothorax
abdominal aortic aneurysms
abscess formation

A

needles

89
Q

Which of the following correctly describes why the arcuate arteries are not easily or accurately evaluated by PW Doppler?

because the flow is very low resistance

the renal capsule attenuates the Doppler signal so only limited information is reflected to the probe

because the blood flows perpendicular to the Doppler sound beam

because the blood flows parallel to the Doppler sound beam

A

because the blood flows perpendicular to the Doppler sound beam

90
Q

Which acoustic property causes the echogenic appearance of the diaphragm related to surrounding structures?

refraction
attenuation
specular reflection
non-specular reflection

A

specular reflection

**occurs with large smooth structure

91
Q

When performing contrast enhanced ultrasound evaluation of the liver, when is the timer started for the procedure?

when the contrast is first visualized in the areas of interest

at the start of the contrast injection

at the start of the saline flush

after the saline flush

A

at the start of the saline flush

92
Q

Which probe can best evaluate the surface nodularity of the liver in a patient with cirrhosis?

vector 10MHz
curved 8MHz
curved 5MHz
linear 7.5MHz

A

linear 7.5MHz

93
Q

A mass that demonstrates propagation speed artifact may lead to a positive diagnosis of:

lipoma
staghorn calculus
renal cyst
RCC

A

lipoma

94
Q

Which of the following will improve the color Doppler visualization of flow in the arcuate arteries?

increased transducer frequency
increased wall filter settings
reduced color gain
smaller packet size

A

increased transducer frequency

** for small vessels
increase frequency, packet size, and color gain settings

95
Q

Which of the acoustic artifacts is demonstrated on the image?

range resolution
volume averaging
mirror image
side lobes

A

mirror image

96
Q

What system settings should be adjusted to better visualize the abnormality displayed?

increase the dynamic range
turn off compound imaging
reduce the rejection settings
turn up the overall gain

A

turn off compound imaging

97
Q

Which of the following best describes the probe position used to evaluate the long axis of the pancreas?

TRV oblique probe position at the midline with notch side of the probe rotated slightly superior to the side of the probe without the notch

SAG probe position just to the left of midline with notch rotated slightly to the left side of the patient

TRV oblique probe position at the midline with notch side of the probe rotated slightly inferior to the side of the probe without the notch

SAG probe position just to the left of midline with notch rotated slightly to the right side of the patient

A

TRV oblique probe position at the midline with notch side of the probe rotated slightly inferior to the side of the probe without the notch

98
Q

Potential bioeffects of ultrasound can be minimized by which of the following?

increase PRF
decrease overall gain
reduce exam time
using a lower frequency transducer

A

reduce exam time

ARDMS ABD REVIEW (27 decks)

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