Final Exam Questions - Semester 1

Question 1

Which of these statements is a benefit of the Magnetic Resonance Angiography (MRA)?
1) It provides the best overall evaluation
2) It does not require ionizing radiation
3) It is a quick procedure
4) It is very sensitive

Answer 1

2) It does not require ionizing radiation

Question 2

What process is included in the inflammatory response of a plaque formation?
A. Cell necrosis
B. Fibromuscular cap formation
C. Macrophage lysis
D. Fatty streak forms

Answer 2

D. Fatty streak forms

Question 3

Thinking of the atherosclerotic process during which stage would one see fatty streak forming on an ultrasound?

A. Early Athero
B. Inflammatory Response
C. Atheromatous Thickening
D. Advanced Athero

Answer 3

B. Inflammatory Response

Question 4

You are scanning a patient that has a high-grade stenosis of the ICA but is not fully occluded. You notice you are not getting any color fill. What should your first knob adjustment be to try to get a “trickle flow” in the ICA? (Considering the box is steered correctly.)
A) Increase color gain
B) Decrease color scale
C) Increase color scale
D) Decrease color gain

Answer 4

B) Decrease color scale

Question 5

In what degree of stenosis are we likely to see a “string sign” after decreasing the color scale?
A. < 50 %
B. 70 - 95 %
C. Total occlusion
D. > 95 %

Answer 5

D. > 95 %

Question 6

During a complete innominate artery occlusion, which of the following artery also supplies the right common carotid artery?
A. Left common carotid artery
B. Right external carotid artery
C. Right vertebral artery
D. Basilar artery

Answer 6

C. Right vertebral artery

Question 7

Evaluate the attached image and choose correct answer: A= 90 angle, B=45 angle
A) Letter A indicates area with the highest angle of incidences, highest detected shift and the strongest signal.
B) Letter B indicates area with the lowest angle of incidences, and letter A indicates area with the lowest detected shift and the strongest signal.
C) Letter A indicates area with the highest angle of incidences, lowest detected shift and the weakest signal.
D) Letter B indicates area with the lowest angle of incidences, lowest detected shift and the weakest signal.

Answer 7

C) Letter A indicates area with the highest angle of incidences, lowest detected shift and the weakest signal.

Question 8

Which of the following hemispheric symptoms could a patient have that would indicate that the dominant hemisphere of the brain has been affected?
A. Ataxia
B. Hemiplegia
C. Aphasia
D. Lateralized Paresthesia

Answer 8

C. Aphasia

Question 9

Which of the following best describes the ICA?
A. Is a common area of plaque build-up
B. Has a waveform opposite of the vertebral artery
C. Demonstrates continuous spectral tracing in Spectral Doppler
D. Demonstrates a flashy color in Color Doppler

Answer 9

C. Demonstrates continuous spectral tracing in Spectral Doppler

Question 10

High resistance flow pattern in the distal portion of the ICA would suggest which condition?
A. Prox CCA
B. Prox ICA
C. Severe Distal ICA Stenosis
D. Vertebral Artery

Answer 10

C. Severe Distal ICA Stenosis

Question 11

You are scanning in color doppler mode. You see an artifact where color doppler signals are assigned to areas outside of the vessel. Which knob and what adjustment should be made to confine the color doppler signals to the vessel?
A. Color scale should be increased
B. Color gain should be increased
C. Color gain should be decreased
D. Color scale should be decreased

Answer 11

C. Color gain should be decreased

Question 12

If you’re told that the waveform of the image above belongs to a mid vertebral artery image, where can we expect the obstruction to be present?
A. distal arterial obstruction
B. proximal arterial obstruction
C. not enough information to tell where the stenosis occurs
D. obstruction in mid segment of the vessel

Answer 12

B. proximal arterial obstruction

Question 13

In a patient without stenosis, the vertebral artery and the common carotid artery should:
A. flow in different directions, appear as the same color
B. flow in the same direction, appear as the same color
C. flow in the same direction, appear as different colors
D. flow in different directions, appear as different colors

Answer 13

B. flow in the same direction, appear as the same color

Question 14

What is the most common technique used to identify the vertebral artery?
a. view the CCA and angle the transducer slightly posteriorly
b. view the subclavian artery and angle the transducer superiorly
c. view the basilar artery and angle the transducer inferiorly
d. view the vertebral processes and angle the transducer medially

Answer 14

a. view the CCA and angle the transducer slightly posteriorly

Question 15

In Advanced Atherosclerosis, 2 things you should see are _____________ and ______________.
A: intraplaque hemorrhaging, recruitment of lymphocytes
B: scar tissue formation, rupturing of the fibrous cap
C: fatty streak formation on the intimal wall, macrophage lysis
D: cell necrosis, deposition of LDL in the intima

Answer 15

B: scar tissue formation, rupturing of the fibrous cap

Question 16

If there is this condition and a severe carotid disease, there will be the following present?
a) subclavian steal syndrome
b) abdominal aortic aneurysm
c) varicose veins
d)pulmonary embolism

Answer 16

a) subclavian steal syndrome

Question 17

Which of the following are considered Vertebral Basler symptoms?
A. Aphasia and Dysarthria
B. Diplopia and Syncope
C. Hemiparesis and Amaurosis Fugax
D. Lateralized Paresthesia and Ataxia

Answer 17

B. Diplopia and Syncope

Question 18

You are doing a sagittal scan on a patient who is lying prone. What would you expect to see on the right side of the screen?
a. patients anterior
b. patients superior
c. patients posterior
d. patients inferior

Answer 18

d. patients inferior

Question 19

Which layer of the arteries help maintain blood pressure?
a) tunica media
b) tunica intima
c) tunica adventitia
d) tunica elastica

Answer 19

a) tunica media

Question 20

During the 3rd stage of plaque formation, what would you expect to see?
A) fibromuscular cap formation
B) excess blood lipids accumulate in intima
C) migration of smooth muscle cells from media
D)monocytes in intima becoming macrophages

Answer 20

A) fibromuscular cap formation

Question 21

When evaluating measurement of stenosis, assuming a bulb diameter of 9mm, distal ICA diameter of 5mm and a residual lumen of 5mm- which method would give a higher percent stenosis?
A. NASCET Method
B. Bulb Method
C: Both methods would be equal
D: It will vary

Answer 21

B. Bulb Method

Question 22

What is the relationship of risk and cost of the modalities (duplex, angiogram, cta, mra)?
A) Direct. As risk increases, cost also increases.
B) Inverse. As risk increases, cost decreases.
C) Random. No association between risk and cost may be inferred.
D) Changing. Although a relationship has previously existed, current technological developments are dramatically decreasing mr costs. With mr now becoming most affordable, the previous relationship has been upset.

Answer 22

A) Direct. As risk increases, cost also increases.

Question 23

What about the CCA waveform will suggest proximal stenosis or occlusion?
A) Rounding, less amplitude, delay in rise time
B) Rounding, less amplitude, faster in ride time
C) Sharper, higher amplitude, delay in rise time

Answer 23

A) Rounding, less amplitude, delay in rise time

Question 24

A patient was admitted to the hospital due to a car accident but when admitted the doctor noticed the patient’s left side of the face was drooping. When asked how long this has been going on, the patient responded slurringly, “Since yesterday.” The doctor also noticed lack of movement in the left eye.
The patient most likely experienced which cerebrovascular symptom?
A) CVA
B) TIA
C) RIND

Answer 24

C) RIND

Question 25

A patient was admitted to the hospital due to a car accident but when admitted the doctor noticed the patient’s left side of the face was drooping. When asked how long this has been going on, the patient responded slurringly, “Since yesterday.” The doctor also noticed lack of movement in the left eye. And had exhibited _______ and ________ symptoms. (Choose two answers below)
A) Aphasia
B) Dysarthria
C) Ataxia
D) Dysphasia
E) Amaurosis Fugax

Answer 25

B) Dysarthria
E) Amaurosis Fugax

Question 26

In the presence of an ICA occlusion, confusion between the ICA and ECA may occur due to the ____ waveform changing and demonstrating a ______ waveform.
A. ICA, high resistance
B. ICA, low resistance
C. ECA, high resistance
D. ECA, low resistance

Answer 26

D. ECA, low resistance

Question 27

When using the NASCET method on an angiogram to evaluate the diameter reduction in a stenosis; where would the stenosis be found?
A. ICA
B. CCA
C. Bulb
D. ECA

Answer 27

A. ICA

Question 28

When estimating stenosis in B-mode, which plane do you always want to evaluate in
A. Longitudinal
B. Sagittal
C. Transverse
D. Coronal

Answer 28

C. Transverse