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ARDMS RVT REVIEW > Duplex Scanning & Color Flow of the Abdominal Vessels > Flashcards

Duplex Scanning & Color Flow of the Abdominal Vessels Flashcards

1
Q

aneurysm diameter

A

> 3 cm

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2
Q

most aneurysms are true aneurysms which means

A

they involve all three layers of the blood vessel

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3
Q

most common shape of aneurysm

A

fusiform

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4
Q

most common location of aneurysms

A

infrarenal

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5
Q

most common cause of aneurysms

A

atherosclerosis

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6
Q

what is a mycotic aneurysm?

A

aneurysm caused by infection

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7
Q

AAAs have been associated with (4)

A
  1. Marfan syndrome
  2. syphilis
  3. familiar inheritance
  4. infection
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8
Q

what is renovascular hypertension?

A

secondary form of high BP often caused by renal artery stenosis or occlusion

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9
Q

2 things that occur in response to renovascular hypertension

A
  1. kidneys produce renin
  2. sodium and fluid retention
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10
Q

when evaluating the kidneys, PSV of the AO is obtained ____

A

just distal to the SMA

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11
Q

when evaluating the kidneys, PSV and EDV are obtained from (3)

A
  1. renal arteries ( prox, mid, dist )
  2. segmental arteries
  3. interlobar arteries ( upper & lower poles)
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12
Q

renal-to-aortic ratio (RAR) =

A

renal artery PSV / aortic PSV

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13
Q

normal RAR result

A

< 3.5

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14
Q

abnormal RAR result

A

≥ 3.5 which indicates a 60% greater diameter reduction

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15
Q

RAR may not be accurate in the presence of (3)

A
  1. AAA
  2. PSV of the AO are < 40 cm/sec
  3. PSV of the AO are > 90-100 cm/sec
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16
Q

PSV of AO ≥ 180-200 cm/sec with poststenotic turbulence is suggestive of ___

A

≥ 60% diameter reduction

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17
Q

significant stenosis will exhibit ____ turbulence and there will be ____ in the abnormal waveform

A

poststenotic turbulence
spectral broadening

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18
Q

normal kidney length

A

10 - 12 cm

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19
Q

end diastolic ratio (EDR) =

A

EDV / PSV

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20
Q

EDR is also known as (2)

A

parenchymal resistance ratio (PRR)
diastolic/systolic ratio (DSR)

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21
Q

normal ERD result

A

≥ 0.2

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22
Q

abnormal EDR result

A

< 0.2 which indicates an increase in resistance within the kidney

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23
Q

Pourcelot’s ratio is also known as

A

resistivity index (RI)

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24
Q

Pourcelot’s ratio/RI =

A

RI = ( PSV - EDV ) / PSV

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25
Q

Pourcelot’s ratio/RI is used to determine whether resistance is increasing in

A

transplanted kidneys

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26
Q

normal RI result

A

< 0.7

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27
Q

abnormal RI result

A

≥ 0.7

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28
Q

renal resistive-index value (RRIV) =

A

RRIV = ( 1 - EDV ) / PSV

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29
Q

in the RRIV equation, PSV and EDV are from the ___ arteries

A

segmental arteries

30
Q

RRIV helps prospectively identify patients whose renal function of BP will improve after correction of ___

A

RA stenosis

31
Q

RRIV < 0.75 suggests

A

improvement

32
Q

RRIV ≥ 0.75 suggest

A

worsening

33
Q

acceleration time (AT) is

A

time interval from the onset of systole to the initial peak

34
Q

prox stenosis of ≥ 60% diameter will have a AT of ___

A

≥ 100 msec

35
Q

acceleration index (AI) is ___

A

slope of the Doppler velocity waveform

36
Q

AI =

A

( onset of systole velocity - PSV ) / AT

37
Q

positive result is AI ≤ _____

A

291 cm/sec

38
Q

mesenteric ischemia is also known as

A

mesenteric angina

39
Q

mesenteric ischemia is

A

abdominal pain 15-30 mins after meals

40
Q

chronic mesenteric ischemia is suggested when

A

there are abnormal findings for at least ⅔ of mesenteric vessels ( celiac, SMA, IMA )

41
Q

mesenteric ischemia is difficult to diagnose, ____ is essential for diagnosis

A

arteriogram

42
Q

in the presence of a ___, the patient is given a high calorie liquid meal after the fasting study

A

mesenteric bypass graft

43
Q

after a high calorie liquid meal is given, what are the 3 things that should be documented?

A
  1. amount ingested and time it took to complete drinking liquid
  2. time the postprandial testing begins
  3. number of minutes between ingestion and onset of any symptoms
44
Q

postprandial testing of the mesenteric arteries should be repeated ___ after the meal

A

20-30 mins

45
Q

the fasting state determines ___

A

the presence of significant prox stenosis

46
Q

the postprandial state evaluates ___

A

the function of a mesenteric bypass graft

47
Q

fasting SMA is ___ resistance

A

high

48
Q

postprandial SMA is ____ resistance

A

low

49
Q

the ___ is not affected posprandially

A

celiac artery

50
Q

fasting SMA

PSV -
EDV -
flow reversal -

A

PSV - high
EDV - low
flow reversal - yes

51
Q

fasting celiac artery

PSV -
EDV -
flow reversal -

A

PSV - high
EDV - high
flow reversal - no

52
Q

postprandial SMA

PSV -
EDV -
flow reversal -

A

PSV - marked increase
EDV - marked increase
flow reversal - yes

53
Q

postprandial celiac artery

PSV -
EDV -
flow reversal -

A

PSV - no change
EDV - no change
flow reversal - n/a

54
Q

normal PSV of SMA

A

110-177 cm/sec

55
Q

normal PSV of celiac artery

A

50-160 cm/sec

56
Q

PSV of SMA that predicts ≥ 70% diameter reduction

A

PSV ≥ 275 cm/sec

57
Q

PSV of celiac artery that predicts ≥ 70% diameter reduction

A

PSV ≥ 200 cm/sec

58
Q

what is celiac band syndrome?

A

extrinsic compression of the celiac artery by the median arcuate ligament of the diaphragm

59
Q

celiac band syndrome

high-velocity signals of stenosis improve with ___ and return with ___

A

improve with deep inspiration
return with expiration

60
Q

celiac band syndrome

an audible ___ can be auscultated

A

bruit

61
Q

2 possible collateral connections between the SMA and IMA

A
  1. arc of Riolan
  2. marginal artery of the colon (aka marginal artery of Drummond)
62
Q

preoperative duplex evaluation of candidates for liver transplant include (3)

A
  1. document patency of PV, splenic vein, SMV, HVs, IVC, and HA
  2. observe for abnormalities and/or other vasculature
  3. determine status of biliary tree
63
Q

postoperative duplex evaluation of liver transplants include (2)

A
  1. document patency of PV, splenic vein, SMV, HVs, IVC, and HA
  2. document PV flow direction and vessel size
64
Q

PV size should be

A

≤ 1 cm up to 1.5 cm

65
Q

postoperative liver transplant complications (4)

A
  1. allograft rejection
  2. pseudoaneurysm
  3. hepatic infarction
  4. thrombosis of PV, IVC, and/or HA
66
Q

most renal transplants are found in the ___

A

right iliac fossa

67
Q

3 renal transplant anastomosis used

A
  1. RA end to side with EIA
  2. RA end to end with IIA
  3. RA end to side with EIV
68
Q

in a renal transplant, the donor ureter is usually implanted into ___

A

the bladder directly

69
Q

postoperative follow up of renal transplant include Doppler spectral analysis of (7)

A
  1. AO
  2. EIA or IIA
  3. EIV
  4. donor RA and RV
  5. allograft vessels
  6. PSVs and EDVs of all vessels
  7. flow resistance
70
Q

B-mode signs of renal transplant rejection (3)

A
  1. increased allograft size
  2. increased cortical echogenicity
  3. hypoechoic regions in the parenchyma
71
Q

___ is the most reliable method for rejection diagnosis

A

biopsy

72
Q

duplex scanning can help diagnose (4)

A
  1. RA stenosis
  2. RV thrombosis
  3. arteriovenous fistula
  4. pseudoansurysms

ARDMS RVT REVIEW (12 decks)

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