Sonography Certification Guide: Diagnostic Medical Sonography Essentials
                     Medical Technology
Sonography
ExamName: Sonography Certification Exam
Exam Version: 6.0
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Question 1. (Single Select)
Which statement best defines the ALARA principle?
A: The principle states that the lowest reasonable energy should be used to produce the clearest image.
B: The principle states that the highest reasonable energy should be used to produce the clearest image.
C: The principle states the level of energy is not included in when deciding what technique to use to get a
clear image.
D: The principle states that the lowest reasonable energy' should be used with minimal exposure for
obtaining the clearest image.
Answer: D
Explanation:
The as low as reasonably achievable (ALARA) principle stresses the use of the lowest
reasonable energy' when obtaining the clearest image and minimal exposure to the patient. The
principle also stresses that the FDA regulates the ultrasound instruments used because of the
bio effects of ultrasound and the effects on patient safety. Choices a, b, and c are not correct.
Question 2. (Single Select)
Pertinent information that must be obtained prior to performing a fine needle aspiration of the thyroid
includes all of the following except:
A: reviewing prior imaging and reports.
B: a signed and dated script for an FNA of the thyroid.
C: a signed consent form.
D: a prepared sterile tray.
Answer: D
Explanation:
Though a prepared sterile tray is necessary for a fine needle aspiration of the thyroid, it is
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not pertinent information. Reviewing prior images and reports, a script from the referring
physician, and a signed consent form are all pertinent information that must be obtained prior to an
invasive procedure such as an ultrasound-guided FNA of the thyroid.
Question 3. (Single Select)
The testicles are suspended within the scrotum by the:
A: vas deferens.
B: epididymis.
C: seminiferous tubules.
D: spermatic cord.
Answer: A
Explanation:
The spermatic cord suspends the testicles in the scrotum. The vas deferens transports sperm
to the urethra. The epididymis stores and excretes sperm. The seminiferous tubules produce sperm.
Question 4. (Single Select)
The least invasive type of thyroid biopsy that may be performed on a solitary thyroid nodule is a(n):
A: fine needle aspiration.
B: complete thyroidectomy.
C: core biopsy.
D: excisional biopsy.
Answer: A
Explanation:
A fine needle aspiration (FNA) of the thyroid gland is a minimally-invasive procedure that
involves the use of a very thin needle, usually an 18 to 25-gauge needle. The needle is guided
directly into the nodule under ultrasound and is moved around within the nodule to shear off as
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many cells as possible. An FNA is the least invasive of the procedures listed, but warrants the
poorest results. An excisional biopsy or a complete thyroidectomy are more invasive but allow the
pathologist to examine the tissue makeup, which increases the chance of a definite diagnosis. A core
biopsy also provides the pathologist with a larger sample of tissue. An FNA provides the pathologist
with cells examined under cytoloy, whereas the other choices provide the pathologist with tissue
samples examined under histology and increase the chance of diagnosis.
Question 5. (Single Select)
A 16-year-old male presents to the emergency department with left-sided scrotal pain,
nausea, and vomiting for the past several hours. He denies any recent trauma to his genitals.
During sonographic evaluation, an enlarged left testicle with decreased echogenicity was
documented. After further evaluation with color and spectral Doppler, intratesticular
vasculature was noted to be absent. The patient most likely presents with:
A: orchitis.
B: torsion.
C: an abscess.
D: a hematocele.
Answer: B
Explanation:
Torsion occurs when the spermatic cord becomes twisted, cutting off blood supply to the
testicle. It occurs more commonly in adolescents than in adults and more often in the left testicle.
The patient may present with scrotal pain, nausea, and vomiting. Sonographically, the testicle may
appear enlarged with decreased echogenicity, a hydrocele may be present, and interrogation of the
intratesticular vasculature may be absent with color and power Doppler evaluation. Torsion is
considered a medical emergency and must be treated immediately to prevent complete infarction
of the testicle. Orchitis is inflammation of the testes and presents as scrotal pain. Sonographically,
orchitis may have a variable appearance ranging from hypoechoic with hyperemic vasculature
under color and spectral Doppler evaluation to atrophic testes. Abscess may occur due to untreated
orchitis. The patient may present with scrotal pain and swelling. An avascular, sonolucent, or
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complex mass may be seen on the sonogram. A hematocele most often occurs after trauma and
causes blood to accumulate within the scrotum. It often mimics torsion and varies in sonographic
appearances from sonolucent to complex with septations.
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