TheoryFree Sonography ARDMS Practice Test
Take a free Sonography ARDMS practice test for 2026 with questions, answers, explanations, PDF download and timed mock exam links.
Sonography ARDMS Questions
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Q1The liver is divided into right and left lobes by which structure on its visceral surface?
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✓ Correct answer: Falciform ligament / ligamentum teres
The falciform ligament (containing the ligamentum teres, the obliterated umbilical vein) divides the liver into right and left lobes on the anterior surface. The IVC marks the right posterior boundary but does not divide the lobes.
Q2Which hepatic vein drains directly into the inferior vena cava and runs between the right and left lobes?
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✓ Correct answer: Middle hepatic vein
The middle hepatic vein lies in the main lobar fissure and drains directly into the IVC, separating the right and left lobes. The right and left hepatic veins drain their respective lobes.
Q3On a transverse sonogram, the main lobar fissure connecting the gallbladder fossa to the right portal vein creates which appearance?
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✓ Correct answer: Exclamation mark sign
The main lobar fissure seen in continuity with the gallbladder neck and the right portal vein produces an 'exclamation mark' or 'golf-club' appearance on transverse imaging, a reliable landmark for the interlobar division.
Q4According to the Couinaud segmental system, segment I refers to which portion of the liver?
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✓ Correct answer: Caudate lobe
In the Couinaud classification, segment I is the caudate lobe, which has independent blood supply from both portal veins and hepatic veins draining directly into the IVC.
Q5Which Couinaud segments comprise the left lateral section of the liver?
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✓ Correct answer: II and III
Segments II and III form the left lateral section, lying to the left of the left hepatic vein. Segment IV (quadrate lobe) is the left medial section, and segments V–VIII comprise the right lobe.
Q6What percentage of hepatic blood flow is supplied by the portal vein?
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✓ Correct answer: 75%
Approximately 75% of total hepatic blood flow comes from the portal vein, while the remaining 25% is delivered by the hepatic artery. Despite lower volume, the hepatic artery supplies about 50% of hepatic oxygen.
Q7On color Doppler, normal portal venous flow in the main portal vein is best described as:
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✓ Correct answer: Continuous low-velocity flow toward the liver (hepatopetal)
Normal portal flow is hepatopetal (toward the liver), continuous, and low velocity (typically 15–40 cm/s). Hepatofugal (reversed) flow is a sign of portal hypertension.
Q8The classic sonographic appearance of hepatic steatosis (fatty liver) is:
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✓ Correct answer: Increased echogenicity (hyperechoic liver) with decreased beam penetration
Fatty infiltration increases hepatic echogenicity (brighter than the renal cortex), and the excess fat attenuates the sound beam, causing poor deep penetration and reduced visualization of intrahepatic vessels.
Q9Which sonographic finding is MOST specific for advanced hepatic cirrhosis?
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✓ Correct answer: Nodular liver surface contour with ascites
A nodular liver surface (due to regenerative nodules and fibrosis) combined with ascites is the most specific sonographic combination for cirrhosis. Hyperechogenicity alone suggests steatosis.
Q10A simple hepatic cyst on ultrasound characteristically demonstrates:
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✓ Correct answer: Anechoic interior, thin imperceptible wall, and posterior acoustic enhancement
A simple cyst has no internal echoes, paper-thin walls, and shows posterior acoustic enhancement because sound passes through fluid with minimal attenuation. Any internal complexity warrants further evaluation.
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