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RVT Review > Chapter 13 > Flashcards

Chapter 13 Flashcards

1
Q

what is a capability for duplex with aorto-iliac vessels?

A

evaluate vessels for stenosis, status of bypass grafts, aneurysmal disease

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2
Q

what is a capability for duplex with renal arteries?

A

to document >60% stenosis

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3
Q

what is a capability for duplex with mesenteric arteries?

A

to document significant stenosis, or evaluation of mesenteric bowel ischemia

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4
Q

what is a capability for duplex with kidneys?

A

to help in evaluation of nephrosclerotic disease and transplants

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5
Q

what is a capability for duplex with liver?

A

suspected portal HTN pre/post liver transplants, and other

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6
Q

what is some limitations for duplex of the abdomen?

A 
side of patient
bowel gas
previous abd surgery/ scar tissue
shortness of breath and rapid respirations 
patients in non-fasting state
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7
Q

what is patient positioning?

A

supine
RLD
LLD

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8
Q

what size transducer do you use?

A

5, 3, 2,25 MHz

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9
Q

what vessels do you observe for aortio-iliac arteries?

A 
celiac
SMA
Aorta (p, m, d)
CIA
ELA (prox-distal)
IIA
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10
Q

what is an aorto-iliac artery aneurysm?

A

a dilation >3cm or an increase in diameter of 50% greater than original artery

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11
Q

what are major AAA located?

A

infrarenal

they are atherosclerotic

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12
Q

what are the types of true aneurysms?

A

fusiform and saccular

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13
Q

what is the most frequent complication of a AAA?

A

rupture, embolization of the peripheral aneurysms

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14
Q

what will be patient history with a RAS?

A

patient will have HTN.

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15
Q

with HTN what kind of HTN is common with renals?

A

renovascular HTN

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16
Q

what is renovascular HTN?

A

RAS secondary to atherosclerosis, fibromuscular dysplasia) or occlusion

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17
Q

what vessels do you evalaute with RAS?

A 
celiac artery and SMa
aorta near SMA 
locate renal arteries 
renal artereies 
segmentals
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18
Q

what is a landmark to find the LRA?

A

LRV

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19
Q

are resistance are renal arteries?

A

low resistant

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20
Q

what resistance is the AO?

A

high resistant

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21
Q

what resistance is the SMA and IMA?

A

fasting high

non-fasting low

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22
Q

what should you obtain PSV and EDV for in a RAS?

A

renal artery- prox-distal

upper/ lower pole of kidney in segmental arteries

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23
Q

how do you calculate renal to aortic ratio (RAR)?

A

highest renal artery PSV/ Aorta PSV

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24
Q

what is normal RAS level?

A

<3.5

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25
what is abnormal RAS Level?
>3.5
26
what does a >3.5 suggest in a RAS?
>60% diameter reduction
27
with which situations can you not use the RAR?
if AAA is present | if aorta PSV >90cm/s or <40cm/s
28
what is the normal measurement for kidneys?
10-12cm
29
when the RAS is looking abnormal what else should you look for?
look for a renal artery PSV of 180-200cm/s followed by post-stenotic turbulance
30
what is end diastolic ratio?
parencynmal resistance ratio (PR) end diastolic V ___________ PSV
31
what is a normal EDR ratio?
>0.2 or >20%
32
what is an abnormal EDR ratio?
<0.2 or <20%
33
what is the formula for resistivity index (RI)?
PSV-EDV _______ PSV
34
what is a normal RI?
<0.75 or .8
35
what is an abnormal RI?
>0.75 or .8
36
what do abnormal renal measurements indicate?
abnormal calculations indicate an increase in distal resistance or nephrosclerotic disease
37
what would happen to the waveform distally with a proximal high grade stenosis?
dampened, weak doppler signal distally, but still of low resistant quality. or tardus-parvus
38
what are patient symptoms for mesenteric ischemia?
history of dull, achy, crampy, abdominal pain 15-30min after meals
39
what is the pain called with mesenteric ischemia?
mesenteric angina
40
why does the pain messenteric angina occur?
due to stenosis or occlusion of the SMA, celiac, or IMA
41
what exam do you use for a chronic/ acute mesenteric ishchemia?
arteriogram
42
T/F you use a non fasting patient to do the mesenteric ischemia test on
false | fasting patient
43
which vessels do you look at with mesenteric ischemia?
CA SMA (p-d) IMA Aorta (check for abnormality)
44
what is the food challenge?
patient ingest high caloric liquid (e.g Ensure) and you repeat the exam 20-30min later or sooner if symtpms arise
45
when will hyperemic response being after the food challenge?
about 10min with max response in apprx 30 min
46
post- prandially what do you obtain?
PSV and EDV of the SMA
47
what should you document with the food challenge?
amount of high caloric liquid ingested (usually 1-2cans) onset, type, and duration of symptoms time began the post-prandial study
48
what is the preprandial PSV, EDV, and Flow reversal for SMA?
PSV: high EDV: low flow reversal: yes
49
what is the preprandial PSV, EDV, and Flow reversal for CA?
PSV: high EDV: high flow reversal : no
50
what is the post-prandial PSV, EDV, and Flow reversal for SMA?
PSV: marked increase EDV: marked increase loss of flow reversal yes
51
what is the post prandial PSV, EDV, and Flow reversal for CA?
PSV: no change EDV: no change loss of flow reversal NA
52
what is the normal velocity for the SMA?
110-177cm/s
53
what is the stenosis for SMA?
PSV >275cm/s = >70% diameter reduction
54
what is the normal velocity for CA?
50-160cm/s
55
what is the stenosis for CA?
PSV >200cm/s = >70% diameter reduction
56
T/F the liver and spleen have fixed metabolic requirements so they are not influenced by post-prandial state
true
57
what does the CA branch into?
hepatic, splenic and left gastric
58
T/F the IMA is usually found on US
false
59
why is it difficult to locate the IMA?
small
60
if the IMA is easily observed what does that suggest?
SMA occlusion
61
T/F IMA serves as a collateral
true
62
what must happen to be consistent with a chronic mesenteric ischemia?
2 of 3 mesenteric vessels have to be abnormal
63
what is the celiac band syndrome?
extrinsic compression of celiac artery origin by the median arcuate ligament of the diaphragm
64
what happens with the celiac band syndrome?
reversible celiac artery stenosis occurs during expiration (ligament presses down over artery). high velocity signals, indicative of stenosis, are improved with deep inspiration.
65
what vessels do you look at with a liver transplant?
portal vein, hepatic veins, IVC, hepatic artery
66
where can thrombus occur post op of the liver?
portal vein, IVC and/or hepatic artery which can lead to hepatic infarction
67
what is the most common complication with liver transplant?
acute rejection which is a cellular process
68
transplanted RA is anastomosed to what?
EIA or IIA
69
transplanted RV is anastomosed to what?
EIV
70
what does B-mode signs of kidney rejection include?
increased renal transplant size, increased cortical echogenicity
71
what can acute kidney rejection do?
increases arterial resistance
72
what do they confirm rejection?
biopsy | or indicator of increased arterial resistance

RVT Review (30 decks)

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