UTC Clinical Procedures & Protocols 2 — Questions and Answers
Question 1: When performing a transabdominal pelvic ultrasound, why is a full urinary bladder required?
- It prevents bowel gas from obscuring the uterus and ovaries (Correct answer)
- It increases blood flow to the pelvic organs
- It reduces patient discomfort during the exam
- It improves Doppler signal detection
Correct answer: It prevents bowel gas from obscuring the uterus and ovaries
A full bladder acts as an acoustic window, displacing bowel gas and providing a fluid path for sound waves to reach pelvic structures.
Question 2: A patient presents with right upper quadrant pain and jaundice. Which ultrasound protocol should be prioritized first?
- Renal ultrasound
- Hepatobiliary ultrasound (Correct answer)
- Pancreatic protocol
- Aortic protocol
Correct answer: Hepatobiliary ultrasound
Jaundice with RUQ pain indicates possible biliary obstruction, making hepatobiliary ultrasound the priority to evaluate the liver, bile ducts, and gallbladder.
Question 3: During a carotid duplex exam, the sonographer identifies a heterogeneous plaque at the bifurcation. What is the next appropriate step?
- Stop the exam and call the radiologist immediately
- Document with grayscale imaging and add color/spectral Doppler through the area (Correct answer)
- Skip the area to avoid dislodging the plaque
- Switch to a lower-frequency transducer only
Correct answer: Document with grayscale imaging and add color/spectral Doppler through the area
Standard protocol requires documenting plaque morphology with grayscale then assessing hemodynamic significance with color and spectral Doppler.
Question 4: Which patient preparation is standard before an abdominal aorta ultrasound?
- NPO for 4–6 hours to reduce bowel gas (Correct answer)
- A full urinary bladder
- IV contrast administration
- Prone positioning only
Correct answer: NPO for 4–6 hours to reduce bowel gas
Fasting for 4–6 hours minimizes bowel gas that can obscure the aorta and its branches, improving image quality.
Question 5: When scanning a patient for a suspected DVT in the lower extremity, which technique is applied to verify vein compressibility?
- Applying gentle transducer pressure perpendicular to the vessel (Correct answer)
- Increasing color Doppler gain until aliasing appears
- Having the patient perform a Valsalva maneuver only
- Elevating the leg 45 degrees before scanning
Correct answer: Applying gentle transducer pressure perpendicular to the vessel
Normal veins fully collapse with gentle transducer compression; non-compressibility is the primary criterion for DVT diagnosis.
Question 6: A sonographer is performing a fetal biophysical profile (BPP). Which parameter is assessed with non-stress test (NST) data rather than real-time ultrasound?
- Fetal breathing movements
- Fetal tone
- Fetal heart rate reactivity (Correct answer)
- Amniotic fluid volume
Correct answer: Fetal heart rate reactivity
Fetal heart rate reactivity is assessed via external cardiotocography (NST), while the four remaining BPP components are evaluated by real-time ultrasound.
Question 7: What is the correct transducer orientation for obtaining a transverse view of the liver in standard protocol?
- Transducer marker pointing toward patient's right side (Correct answer)
- Transducer marker pointing toward patient's left side
- Transducer marker pointing cephalad
- Transducer marker pointing caudad
Correct answer: Transducer marker pointing toward patient's right side
In transverse abdominal imaging, the transducer marker points to the patient's right, placing the right side of the image on the left side of the screen per standard convention.
UTC Clinical Procedures & Protocols 2
When performing a transabdominal pelvic ultrasound, why is a full urinary bladder required?