AHPC Licensure Examination — Sonography

Sample Sonography practice questions

Try these 12 questions from different topics. Open "Show answer" to check yourself and read the explanation.

1. Question 1 · Doppler Physics & Hemodynamics

   What causes a Doppler frequency shift?

   1. A.Absolute motion of the sound source only
   2. B.Relative motion between the sound source and the reflector
   3. C.Changes in tissue attenuation
   4. D.Changes in beam intensity
   Show answer

   Answer: B. Relative motion between the sound source and the reflector

   Doppler shift requires relative motion between source and receiver; if both are stationary (or moving identically), there is no shift.

2. Question 2 · Renal Doppler

   What peak systolic velocity (PSV) threshold at the site of stenosis suggests hemodynamically significant (≥60%) renal artery stenosis?

   1. A.> 100 cm/s
   2. B.> 150 cm/s
   3. C.> 180–200 cm/s
   4. D.> 250 cm/s
   Show answer

   Answer: C. > 180–200 cm/s

   A PSV exceeding 180–200 cm/s at the site of focal narrowing is the primary direct criterion for hemodynamically significant renal artery stenosis.

3. Question 3 · Biliary System Ultrasound

   The correct technique for measuring common bile duct (CBD) diameter is:

   1. A.Outer wall to outer wall
   2. B.Inner wall to inner wall
   3. C.Outer wall to inner wall
   4. D.Any consistent reference point
   Show answer

   Answer: B. Inner wall to inner wall

   Always measure inner-wall to inner-wall — outer-wall measurement overestimates the true luminal size.

4. Question 4 · Obstetric & Gynaecological Ultrasound

   The most common site of ectopic implantation is the:

   1. A.Ovary
   2. B.Cervix
   3. C.Ampullary portion of the fallopian tube
   4. D.Interstitial (cornual) portion of the fallopian tube
   Show answer

   Answer: C. Ampullary portion of the fallopian tube

   Approximately 95% of ectopic pregnancies implant in the fallopian tube, with the ampullary portion being the most common single site.

5. Question 5 · Gastrointestinal Ultrasound

   Ulcerative colitis characteristically involves which part of the gastrointestinal tract?

   1. A.Any part of the GI tract from mouth to anus
   2. B.The colon and rectum only, in a continuous pattern from the rectum
   3. C.Only the small intestine
   4. D.Skip lesions throughout the colon
   Show answer

   Answer: B. The colon and rectum only, in a continuous pattern from the rectum

   UC is limited to the colon and rectum, extending proximally in a continuous pattern, always starting in the rectum — unlike Crohn's disease, which can affect any part of the GI tract with skip lesions.

6. Question 6 · Ultrasound Physics

   Which statement about diagnostic ultrasound is correct?

   1. A.It always uses X-rays
   2. B.It produces images only after radioactive injection
   3. C.It forms images using high-frequency sound rather than ionizing radiation
   4. D.It cannot show blood flow
   Show answer

   Answer: C. It forms images using high-frequency sound rather than ionizing radiation

   Ultrasound transmits and receives high-frequency sound and can display anatomy and motion in real time.

7. Question 7 · Image Optimization & Safety

   How should a sonographer apply ALARA during an examination?

   1. A.Maximize output for every scan
   2. B.Continue scanning after the question is answered
   3. C.Ignore displayed safety indices
   4. D.Use the lowest output and shortest exposure that still answer the clinical question
   Show answer

   Answer: D. Use the lowest output and shortest exposure that still answer the clinical question

   Although ultrasound does not use ionizing radiation, acoustic exposure should still be minimized while preserving diagnostic quality.

8. Question 8 · Patient Identification & Quality

   The name on the ultrasound request does not match the patient’s stated identity. What should happen?

   1. A.Pause the examination and resolve the identity discrepancy through the approved process
   2. B.Change the request from memory
   3. C.Scan first and verify after reporting
   4. D.Use another patient’s previous images
   Show answer

   Answer: A. Pause the examination and resolve the identity discrepancy through the approved process

   Correct patient and request verification is fundamental to preventing wrong-patient diagnostic harm.

9. Question 9 · Liver & Spleen

   In a normal adult, compared with the right renal cortex, the liver is usually:

   1. A.Much less echogenic, appearing almost anechoic like fluid
   2. B.Always markedly brighter than bone
   3. C.Equal or slightly more echogenic
   4. D.Impossible to compare
   Show answer

   Answer: C. Equal or slightly more echogenic

   A liver much brighter than the kidney with poor beam penetration suggests fatty infiltration.

10. Question 10 · Pancreas & Retroperitoneum

    A key vascular landmark lying posterior to the body of the pancreas is the:

    1. A.Inferior mesenteric artery running along its anterior border
    2. B.Left renal artery
    3. C.Portal vein bifurcation
    4. D.Splenic vein
    Show answer

    Answer: D. Splenic vein

    The splenic vein runs along the posterior pancreas to join the SMV behind the neck.

11. Question 11 · Kidneys & Urinary Tract

    A normal adult kidney measures about:

    1. A.5–6 cm in length, the size of an adult thumb
    2. B.18–20 cm in length
    3. C.10–12 cm in length
    4. D.25 cm in length
    Show answer

    Answer: C. 10–12 cm in length

    Small echogenic kidneys suggest chronic kidney disease.

12. Question 12 · Thyroid & Neck

    Ultrasound features that raise suspicion of thyroid malignancy include:

    1. A.A purely cystic nodule with comet-tail artefacts inside it
    2. B.A solid, hypoechoic, taller-than-wide nodule
    3. C.A spongiform appearance
    4. D.Smooth margins and a halo
    Show answer

    Answer: B. A solid, hypoechoic, taller-than-wide nodule

    TI-RADS scores composition, echogenicity, shape, margins and echogenic foci.