Chapter 17

Question 1

What is a newly formed clotted blood within a vein, generally less than 14 days old called?

Answer 1

Acute thrombus

Question 2

What is a vein that is the companion vessel to an artery and travels within the deep muscular compartments of the leg called?

Answer 2

Deep vein

Question 3

What is the inward projection of the intimal layer of a vein wall producing two semilunar leaflets, which present the retrograde movement of blood flow called?

Answer 3

Valves

Question 4

What is a small vein that connects the deep and superficial venous systems; a vein that passes between the deep and superficial compartments of the leg called?

Answer 4

Perforating vein

Question 5

What is clotted blood within a vein that has generally been present for a period of several weeks or months called?

Answer 5

Chronic thrombus

Question 6

What is a vein that is superior to the muscular compartments of the leg; travels within superficial fascial compartments; has no corresponding companion artery called?

Answer 6

Superficial vein

Question 7

Which category of veins are the main conduit for blood, are surrounded by muscle, and have an accompanying artery?

Answer 7

Deep veins

Question 8

What is the main function of the superficial venous system under normal conditions?

Answer 8

To help regulate the body temperature

Question 9

In which way do valves in perforating veins ensure that blood moves, under normal conditions?

Answer 9

From the superficial to the deep system

Question 10

From epidemiologic studies, what percentage of patients develop postthrombotic symptoms?

Answer 10

30%

Question 11

Which limb of Virchow’s triad is demonstrated by a venous thrombus that starts at a valve cusp?

Answer 11

Stasis

Question 12

A patient presents to the vascular lab for lower extremity venous evaluation. The patient has known Factor V Leiden genetic factor. Under what risk factor of Virchow’s triad does this patient fall?

Answer 12

Hypercoagulability

Question 13

Many patients with venous thrombosis are asymptomatic; however, when symptoms occur, what are some of the most common?

Answer 13

Extremity pain, tenderness and swelling

Question 14

What would a high probability for DVT correspond to on Well’s score?

Answer 14

> 3 points

Question 15

When can a false-negative D-dimer be seen in the presence of DVT?

Answer 15

Assay cannot detect low levels of fibrin

Question 16

For routine operation of a vascular lab, the use of a high-frequency linear transducer (10 to 18 MHz) is recommended for the evaluation of which of the following?

Answer 16

Superficial vein reflux

Question 17

Why will using a reverse Trendelenburg position to examine the lower extremity venous system make the exam more difficult?

Answer 17

Veins without thrombus will be harder to compress

Question 18

What is the primary method used to determine the presence of thrombus in the extremity veins?

Answer 18

Transducer compression of the veins

Question 19

Which of the following is NOT a normal qualitative Doppler feature evaluated in the lower extremity venous system?

Answer 19

Continuity of signal

Question 20

Which of the following large deep veins are commonly bifid?

Answer 20

The femoral and popliteal veins

Question 21

Which vessels are NOT routinely evaluated in a lower extremity venous duplex examination?

Answer 21

Anterior tibial veins

Question 22

Which veins are one of the major blood reservoirs located in the calf?

Answer 22

Soleal veins

Question 23

What do bright intraluminal echoes and well-attached thrombus suggest?

Answer 23

Chronic thrombus

Question 24

In what case will indirect assessment of the iliac veins and IVC using Doppler at the common femoral veins suggest evidence of obstruction?

Answer 24

The Doppler spectrum exhibits continuity

Question 25

During a lower extremity venous duplex examination, a thin, white structure is noticed moving freely in the lumen of the vein. What does this most likely represent?

Answer 25

Valve leaflet

Question 26

Which of the following is a normal response to venous flow with a Valsalva maneuver?

Answer 26

Cessation of flow

Question 27

A patient presents to the vascular lab with sudden onset of left lower extremity pain and swelling. Upon duplex examination, lightly echogenic material is noted within a dilated femoral vein, and the femoral vein does not compress with applied transducer pressure. What do these findings suggest?

Answer 27

Acute deep venous thrombosis

Question 28

When a patient presents with right heart failure, what impact is often observed in the spectral Doppler waveform in the lower extremities?

Answer 28

Increased pulsatility

Question 29

A patient presents to the emergency department with a massively swollen right lower extremity which is extremely painful and bluish in color. What do these findings suggest?

Answer 29

Phlegmasia cerulen dolens

Question 30

Which treatment option is typically reserved for emergent situations in larger veins of the iliofemoral region?

Answer 30

Thrombolysis

Question 31

What is the primary treatment of acute lower extremity deep venous thrombosis?

Answer 31

Anticoagulation

Question 32

Duplex ultrasound for the evaluation of the deep and superficial venous system has largely replaced ________________ for the detection of DVT.

Answer 32

Venography

Question 33

Duplex ultrasound has the capability to diagnose, localize, and determine the age of ________________.

Answer 33

Thrombus