Arterial Final exam Flashcards
A low resistance waveform pattern is expected in which of the following vessels
a) subclavian artery
b) post-prandial SMA
c) CFA
d) pre-prandial SMA
b) post-prandial SMA
- post prandial SMA has low resistance and increased EDV
Upon renal duplex to rule out renal vascular hypertension, what would be the significance of the following findings: Aorta PSV 80 cm/s and 240 cm/s in the proximal left renal artery
a) there is no flow reducing stenosis of the aorta
b) this is consistent with a 50% diameter reduction of the left renal artery
c) within normal limits
d) this confirms a >60% diameter reduction of the left renal artery
c) within normal limits
Upon penile doppler, what is indicated by an increase to the dorsal venous flow velocity
a) rules out vasculogenic impotence
b) arteriovenous fistula
c) venous leak
d) venous refulx
c) venous leak
Which finding would confirm the diagnosis of a >75% diameter reduction of the distal SFA which has a PSV of 320 cm/s
a) an ABI of 0.4
b) a PSV of 78 cm/s proximal to the site of elevated velocities
c) a proximal PSV 4 times greater than the stenotic PSV
d) a proximal PSV of approximately 160 cm/s
b) a PSV of 78 cm/s proximal to the site of elevated velocities
What hemodynamic changes occur in the distal limb due to arterial obstructive disease
a) vasodilation and decreased resistance
b) vasodilation and increased resistance
c) vasoconstriction and increased resistance
d) vasoconstriction and lower resistance
a) vasodilation and decreased resistance
Ankle/brachial indices found in the patients with claudication are
a) 1.0-1.3
b) > 1.3
c) 0.5-0.8
d) unreliable due to incompressibility
c) 0.5-0.8
Which of the following most accurately describes ischemic ulcers?
a) very painful and most commonly located on dorsum of foot or bony regions
b) very painful and most likely seen superior to medial malleolus
c) painless but oozing on site
d) mildly painful and relieved by elevation
a) very painful and most commonly located on dorsum of foot or bony regions
Takayasu’s arteritis is most commonly found in
a) elderly women
b) young women
c) elderly men
d) young men
b) young women
Which of the following can be used as a landmark for the left renal artery
a) IVC
b) Aorta
c) Right renal vein
d) SMA
d) SMA
WRONG (not D and C)
A patient presenting with ischemic rest pain would complain of
a) foot pain when elevated and relieved when dependent
b) pain when foot is still and relieved upon movement
c) pain upon dependency and relief when elevated
d)pain upon exercise and relieved upon rest
a) foot pain when elevated and relieved when dependent
What is celiac band syndrome
a) chronic mesenteric ischemia involving the celiac artery and its branches
b) Arteritis of the trunk of the celiac artery causing compression
c) Compression of the celiac trunk by the superior mesenteric ligament
d) compression of the celiac artery by the median arcuate ligament of the diaphragm
d) compression of the celiac artery by the median arcuate ligament of the diaphragm
Angiography reveals an occluded right iliac artery. Which treatment would most likely be performed?
a) femoral-femoral bypass
b) balloon angioplasty with stent
c) femoral-popliteal bypass
d) axilo-femoral bypass
a) femoral-femoral bypass
What is the difference between analog and spectral analysis display of CW doppler analysis?
a) Analog uses spectral analysis to display true frequency shifts
b) Analog estimates frequency shift information
c) Spectral doppler uses a zero-crossing frequency meter
d) Spectral analysis displays frequency shift information on the X-axis
b) Analog estimates frequency shift information
In the presence of an AV fistula, the proximal artery would demonstrate what type of flow patterns
a) low resistance with increased diastolic flow
b) increased resistance with contrast forward flow
c) low resistance with decreased diastolic flow
d) high resistance with diastolic flow reversal
a) low resistance with increased diastolic flow
Atherosclerosis affects which layers of the artery
a) intimal and medial layers
b) tunica externa
c) tunica media only
d) intimal and adventitial layers
a) intimal and medial layers
What best describes the technique for accurately obtaining a systolic pressure?
a) inflate cuff to 100mmHg and listen for pulsations. Record pressure upon return
b) None of the above
c) inflate cuff to point at which the audible signal disappears and record pressure
d) Inflate cuff to suprasystolic pressures, slowly deflate until pulsation returns, record pressure
d) Inflate cuff to suprasystolic pressures, slowly deflate until pulsation returns, record pressure
Patient has a fistula graft in the upper extremity and is now experiencing symptoms of tingling in the arm. What would this most likely be caused by?
a) steal syndrome
b) graft embolism
c) graft aneurysm
d) fistula occlusion
a) steal syndrome
Which of the following bypasses require the use of a valvutome?
a) In situ GSV graft
b) PTFE graft
c) Reversed GSV graft
d) Gore-tex graft
a) in situ GSV graft
A patient presents with back and abdominal pain. What is the most likely vascular disease process?
a) renal artery stenosis
b) aortic stenosis
c) abdominal aortic aneurysm
d) iliac disease
c) abdominal aortic anuerysm
What would be an indication of liver transplant rejection ?
a) absent end diastolic flow in the hepatic artery
b) hepatopedal flow in the portal vein
c) hepatofugal flow in the hepatic veins
d) elevated end diastolic velocity in the hepatic artery
a) absent end diastolic flow in the hepatic artery
What type of waveform would indicate the presence of a proximal arterial obstruction
a) pulses bisferiens
b) absent diastolic component
c) tardus parvus
d) bidirectional
c) tardus parvus
The renal to aorta velocity ratio cannot be used when there is which of the following
a) nephrosclerosis
b) FMD
c) renal artery PSV >400 cm/s
d) AAA
d) AAA
During the angiography a focal stenotic lesion is found, what would most likely be the course of treatment
a) fem-pop bypass
b) In situ GSV graft
c) balloon angioplasty
d) Gore-tex graft
c) balloon angioplasty
What findings would confirm the presence of extrinsic compression of the artery with thoracic outlet syndrome?
a) normal resting PPG waveforms that flatten as the patients arm is in different positions
b) normal resting PPG waveforms with increased amplitude peaks in various arm positions
c) flattening of the PPG waveform at rest which normalizes when patient raises arm at 180 degree angle to torso
d) moderate to severely abnormal PPG waveforms at rest with flattened peaks
a) normal resting PPG waveforms that flatten as the patients arm is in different positions
What clinical finding is most pertinent in a patient with suspected Buergers disease
a) diabetic
b) hypertension
c) smoker
d) absent pulses
c) smoker
A 32 year old male patient with a history of alcohol abuse and heavy smoking presents to the ultrasound department with pain at night bilaterally and gangrenous ulcers on the feet. What disease process is suspected
a) thromboangitis obliterans
b) atherosclerosis
c) arteritis
d) phelgmasia cerulea dolens
a) thromboangitis obliterans
Which of the following principles, effects or laws apply to decreased pressure with increased flow speed
a) Bernoulli effect
b) Poiseuille law
c) Reynolds law
d) Murphys law
a) Bernoulli effect
Laminar flow is disrupted and turbulence occurs when the Reynolds number meets or exceeds what value
a) 100
b) 200
c) 1000
d) 2000
d) 2000
The highest pressure in the arterial system is found in what region or organ?
a) posterior tibial arteries
b) left ventricle of the heart
c) abdominal aorta
d) internal carotid artery
b) left ventricle of heart
Which of the following arterial wall structures is in direct contact with blood flow?
a) intima
b) media
c) adventitia
d) endothelium
d) endothelium
Perfusion in tissue is controlled by vasoconstriction and vasodilatation in which of the following structures
a) capillaries
b) arterioles
c) large feeding arteries
d) small veins
b) arterioles
Which of the following is not a risk factor for peripheral arterial disease?
a) venous reflux/insufficiency
b) diabetes mellitus
c) hypercholesterolemia
d) tobacco abuse
a) venous reflux/insufficiency
What is the most significant factor affecting diastolic blood flow in the lower extremities?
a) cardiac output
b) systemic blood pressure
c) vasodilation in the capillary bed
d) vasoconstriction/dilation in the arterioles
d) vasoconstriction/dilation in the arterioles
The vaso vasorum supplies blood flow to what structure
a) arterial wall
b) vas deferens
c) capillaries
d) toes
a) arterial wall
Of the symptoms listed below, which is generally not associated with arterial insufficiency
a) blue toe syndrome
b) dependent rubor
c) limb swelling
d) rest pain in feet and toes
c) limb swelling
Which of the following is another name for the internal iliac artery
a) profunda iliac
b) profunda femoris
c) inferior epigastric
d) hypogastric
d) hypogastric
What is the first major tibial artery branching off the distal popliteal artery
a) dorsalis pedis artery
b) peroneal artery
c) gastrocnemius artery
d) anterior tibial artery
d) anterior tibial artery
What is the most common symptom of peripheral arterial disease
a) rest pain
b) claudication
c) trophic nails
d) reduced pedal pulses
b) claudication
Thromboangitis obliterans is a fixed occlusive disease of the digits. What is another name for this condition
a) marfan syndrome
b) raynauds syndrome
c) takayasu arteritis
d) buergers disease
d) buergers disease
The “blue toe” syndrome is a symptom of what condition
a) vasospasm
b) arteritis
c) atheroemboli
d) popliteal entrapment
c) atheroemboli
Which artery supplies the most blood to the gluteus maximus muscle
a) hypogastric artery
b) inferior buttock artery
c) inferior epigastric artery
d) internal pudendal artery
a) hypogastric artery
