Cerebrovascular Module Exam Flashcards
How do waveform morphologies differ in the ECA versus the ICA
a) more spectral broadening in the ECA
b) less flow in end- diastole in ECA
c) more flow in end-diastole in ECA
d) higher velocity in peak systolic in ECA
b) less flow in end- diastole in ECA
Which of the following is the most commonly identifiable branch of the external carotid artery
a) lingual artery
b) inferior thyroid artery
c) opthalmic artery
d) superior thyroid artery
d) superior thyroid artery
What would cause a left hemisphere infarction
a) Left ICA occlusion
b) Right ECA occlusion
c) Right ICA occlusion
d) Left ECA occlusion
a) Left ICA occlusion
WRONG (not A and,C and D)
Which vessel is most likely to have a low resistance flow in the presence of an ICA occlusion
a) ipsilateral CCA
b) ipsilateral ECA
c) contralateral ECA
d) ipsilateral ICA
? b) ipsilateral ECA
Doppler peak systolic velocities are approx 350 cm/s in the right ICA and end diastolic velocity of 95 cm/s. What is the percentage of diameter reduction?
a) 80-99%
b) 30-49%
c) 50-79%
d) 70-85%
c) 50-79%
Which symptom is most likely associated with vertebrobasilar insufficiency
a) diplopia
b) dysphasia
c) amaurosis fugax
d) syncope
a) diplopia
A patient shows symptoms of dizziness and an episode of blurred vision bilaterally. What would be most likely responsible
a) bilateral ICA stenosis
b) vertebrobasilar insufficiency
c) cerebral cortex insufficiency
d) an MCA infarction
b) vertebrobasilar insufficiency
Which of the following vessels connects the left and right anterior cerebral arteries
a) Anterior communicating artery
b) posterior communicating artery
c) carotid syphon
d) middle cerebral artery
a) Anterior communicating artery
A patient presenting with aphasia, left hemiplegia of the face and arm is suspected to have a blockage of which vessel
a) left posterior cerebral artery
b) right anterior cerebral artery
c) right middle cerebral artery
d) left middle cerebral artery
c) right middle cerebral artery
What is suggested by the findings of high resistance right ICA and low resistance left ICA waveforms
a) proximal right ICA disease
b) proximal disease of the left CCA
c) significant disease of the right syphon
d) distal left ICA obstruction
c) significant disease of the right syphon
What is the most important diagnostic criteria when interpreting that a stenosis has increased to greater than 80%
a) a peak systolic velocity greater than 125 cm/s
b) a peak systolic velocity greater than 250 cm/s
c) an end diastolic velocity greater than 140 cm/s
d) an ICA/CCA ratio greater than 3.5
c) an end diastolic velocity greater than 140 cm/s
Which of the following would most likely explain the findings of PSV’s of 145 cm/s in the CCA’s bilaterally in an otherwise healthy 35 year old
a) bilateral CCA stenosis
b) compensatory flow changes in response to collateralization
c) high cardiac output
d) hyperemia from exercise
c) high cardiac output
What is the significance of absent end diastole velocity in the CCA
a) proximal occlusion of the CCA
b) distal stenosis of the ECA
c) proximal stenosis of the CCA
d) distal occlusion of the ICA
d) distal occlusion of the ICA
What percentage of blood flows into the ICA from the CCA
a) 20-30%
b) 70-80%
c) 50%
d) 90-95%
b) 70-80%
Which of the following vessels is most likely to be evaluated through the transtemporal window
a) opthalamic artery
b) basilar
c) anterior communicating artery
d) posterior cerebral artery
d) posterior cerebral artery
What is the normal flow direction of the MCA
a) variable
b) bidirectional
c) retrograde
d) antegrade
d) antegrade
Transcranial doppler detects antegrade flow in the left ACA. What is the significance of that finding
a) compensatory posterior to anterior flow
b) contralateral ICA occlusion
c) normal finding
d) cross over collateralization
d) cross over collateralization
WRONG (Not and C)
What location is fibromuscular dysplasia usually found
a) proximal to mid CCA
b) mid to distal ECA
c) mid to distal ICA
d) proximal to mid ICA
c) mid to distal ICA
WRONG (Not b and D)
Which of the following scenarios could cause a low resistance pattern in the ECA
a) occlusion of the proximal subclavian artery
b) distal occlusion of the ECA
c) collateralization via the opthalmic artery
d) collateralization via the posterior communicating arteries
Bidirectional flow in the vertebral arteries indicates what
a) basilar artery stenosis
b) subclavian stenosis
c) subclavian steal
d) vertebral collateralization
b) subclavian stenosis
What best explains findings of a cervical bruit
a) less than 50% DR
b) presence of high grade stenosis
c) vessel occlusion
d) presence of high velocity turbulent flow
d) presence of high velocity turbulent flow
What location would an abnormally high resistance waveform be documented
a) proximal to an AVF
b) distal to an occlusion
c) distal to a high grade stenosis
d) proximal to an occlusion
d) proximal to an occlusion
What is the standardized criteria of NASCET
a) ICA/CCA ratio >4.0 >80% DR
b) ICA/CCA ratio > 3.5 > 60% DR
c) ICA/CCA ratio >2.0 >70 DR
d) ICA/CCA ratio > 4.0 > 70 DR
d) ICA/CCA ratio > 4.0 > 70 DR
What vessel would most likely have disease in a patient with left sided weakness and right amaurosis fugax
a) PCA
b) left ICA
c) right ICA
d) left MCA
c) right ICA
What vessel could be absent in a normal patient
a) basilar artery
b) posterior cerebral artery
c) posterior communicating artery
d) anterior cerebral artery
c) posterior communicating artery
Takayasu arteritis is most likely to affect which of the following vessels
a) mid to distal ICA
b) MCA
c) superficial temporal artery
d) subclavian artery
d) subclavian artery
What is the normal flow in the ACA
a) to and fro
b) retrograde
c) caudal
d) antegrade
b) retrograde
What is the normal flow pattern of the PCA
a) high resistance and retrograde
b) high resistance and antegrade
c) low resistance and retrograde
d) low resistance and antegrade
d) low resistance antegrade
