MOCK Midterm Flashcards

1
Q

What must be known for the US to convert the Doppler frequency shift to a velocity?

A

Doppler angle

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2
Q

Using 60 degrees for your Doppler angle improves (2)

A

Reliability of velocity

Consistency throughout exam and from one exam to the next

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3
Q
Describe the levels of pulsatility with the vessel:
Subclavian A
ICA
ECA
CCA
Vertebral
A
Subclavian A: High pulsatility
ICA: Low pulsatility
ECA: Mod pulsatility
CCA: Mod pulsatility
Vertebral: Low pulsatility
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4
Q

SCA waveform

A

High pulsatility, high resistance

Little/no EDV

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5
Q

T/F poor cardiac activity profoundly affects flow in cerebrovascular system

A

True

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6
Q

What parameter is used to assess stenosis in patients with heart condition?

A

Ratio NOT velocities

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7
Q

T/F pressure will decrease following a hemodynamically significant stenosis

A

True

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8
Q

In the event of SSS, what happens? (3)

A

Ipsilateral vertebral flow is reversed
Damped flow distal to stenosis, tardus parvus waveform
Ipsilateral brachial pressure decreased (>20 mmHg)
Contralateral brachial pressure not affected

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9
Q

T/F the RT and LT brachial pressures must differ by 20 mmHg to be considered significant in SSS

What does the waveform look like at 20 mmHg vs. 40 mmHg

A

True

At 20 mmHg vertebral artery waveform is bidirectional

At 40 mmHg VA waveform retrograde flow

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10
Q

The opthalmic artery may be a source of collateral flow in which circumstance?
What direction of flow will be visualized in the OA?
What feeds the opthalmic artery?

A

ICA high grade stenosis/occlusion
Retrograde OA flow
ECA feeds the OA

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11
Q

What parameters are useful in grading a stenosis? (3)

A

PSV
EDV
ICA/CCA Ratio

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12
Q

T/F colour Doppler is not affected by the colour box angle

A

False

Steer box in the same direction as the angle

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13
Q

T/F Internalization of the ECA occurs in the event of ICA occlusion

A

True

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14
Q

A high grade stenosis occurs when the lumen diameter is significantly reduced

A

True

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15
Q

T/F Tardus parvus waveform indicates a hemodynamically significant prox stenosis

A

True

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16
Q

What describes a stroke?

A

Motor/sensory deficit lasting > 24hr

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17
Q

Major cause of vascular disease

A

Atherosclerosis

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18
Q

ICA symptoms include (3)

A

Paralysis on contralateral side
Decreased level of consciousness
Amaurosis fugax

(NOT ataxia)

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19
Q

What neurological symptom is related to atherosclerosis disease in the posterior circulation

A

Vertigo

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20
Q

Continuous wave Doppler can be used in all the following (3)

A

Peri-orbital
Extracranial arteries
Trans cranial arteries

(NOT ocular pneumoplethysmography)

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21
Q

What is the most utilized of the Doppler criteria for estimation of percentage diameter stenosis?

A

PSV

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22
Q

What artifact is encountered with pulsed Doppler in a hemodynamically significant stenosis/

A

Aliasing

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23
Q

Aliasing occurs when _________

How may it be corrected? (5)

A

Frequencies exceed the Nyquist limit (1/2 PRF)

Corrected:
Change probe position
Decrease depth
Increase PRF
Increase Dop angle
Lower frequency
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24
Q

3 advantages of power Doppler

A

Defining occlusive vessels (detection slow flow)
Independent of angle
No aliasing

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25
Q

Tunica media can be described as

A

Layer of muscle and elastic tissue

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26
Q

Variable plaque morphology can be described as

A

Heterogenous with anechoic areas

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27
Q

The cerebrovascular vessels arise from the

A

Aortic arch

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28
Q

Branches of the subclavian artery include (4)

A

Vertebral
Internal thoracic
Thyrocervical & costocervical trunk
Dorsal scapular

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29
Q

ICA spectral analysis description (3)

A

Rapid increase velocity during systole
Clear window
Continuous antegrade flow during diastole

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30
Q

Term that describes flow in normal carotid artery

A

Laminar/parabolic

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31
Q

First major branch of ICA with clinical significance

A

Opthalmic artery

32
Q

Maneuver that identifies the Doppler signal is coming from the ECA

A

Temporal tapping

33
Q

Nonatheromatous causes of turbulent flow in the carotid arteries may include (3)

A

Increase vessel diameter
Kinking of ICA
Tortuosity of ICA

34
Q

Which branch of the ICA is in the cervical section of the neck

A

None (dumb question)

35
Q

The gradual decrease in blood flow due to narrowing does not produce symptoms until it reaches the point of “critical stenosis”. Which diameter reduction constitute a critical stenosis?

A

70% diameter reduction

36
Q

Distal to a critical stenosis, the spectral analysis depicts what characteristics (3)

A

PSV decrease
EDV decrease
Turbulent flow

37
Q

What 2 things describe carotid body tumours?

A

Rare neoplasm

Paraganglionic tissue

38
Q

The extracranial posterior circulation is composed of

A

The paired vertebral arteries

39
Q

Doppler waveform characteristics of SSS (2)

A

Declaration/reversed/alternating flow in ipsilateral VA

Diminished waveform distal to the stenosis or occlusion

40
Q

Vertebrobasilir system provides ___% of blood to the intracranial system

A

20-30%

41
Q

In trans cranial Doppler, which of the following foes the suboccipital window examine? (2)

A

Veterbral arteries

Basilir arteries

42
Q

The middle cerebral artery is divided into which of the following segments

A

M1 & M2

43
Q

Brain stem is supplied by which of the following arteries?

A

Basilar artery

44
Q

SSS can be detected in which of the intracranial vessels? (2)

A

Intracranial vertebral

Basilir artery

45
Q

NASCET criteria - a narrowing of 16-49% can be described as (2)

A

Pansystolic spectral broadening and

PSV <125 cm/s

46
Q

Defining criteria for >80% stenosis is

A

EDV >140 cm/s

47
Q

Grade the following
PSV 140 cm/s
EDV 105 cm/s
ICA/CCA ratio 3

A

50-69%

48
Q

Surgical procedure to remove the atheromatous plaque material or blockage in the lining of the artery to reduce risk of stroke is termed carotid endarterectomy

A

True

49
Q

What condition is characterized by a component of reverse flow called pulsus bisferans (double peak per cardiac cycle)

A

Aortic regurgitation

50
Q

Externalization of the CCA occurs in

A

Complete occlusion of the ipsilateral ICA

51
Q

Doppler FU of a stent post-endartectomy (3)

A

Smooth velocity increase into stent
Velocity parameters used to grade carotid stenosis is not valid for post-stent evaluation
Velocities tend to be higher due to loss of wall elasticity and increased stiffness

52
Q

Paget-Schrotters syndrome can be classified as a thoracic outlet syndrome

A

True

53
Q

The mechanical compression of an artery by the skeletomuscular system, tumour or inflammatory mass can cause the patient to have symptoms of

A

Entrapment syndrome

54
Q

S/s claudication of the buttock area, impotence and decreased pulses in the lower limbs suggests

A

Leriche syndrome

55
Q

Pseudoaneurysms have a classic Doppler appearance termed “Yin-Yang”

A

True

56
Q

A sonographic sign of intimacy flap leads to diagnosis of

A

Dissection

57
Q

Hemodialysis access grafts (3)

A

Central venous catheter
Synthetic AV bridge graft
Primary AV fistula

58
Q

What % of hemodialysis patients are not candidates for AV graft?

A

50%

59
Q

The middle cerebral artery is divided into which of the following segments

A

M1 & M2

60
Q

Brain stem is supplied by which of the following arteries?

A

Basilar artery

61
Q

SSS can be detected in which of the intracranial vessels? (2)

A

Intracranial vertebral

Basilir artery

62
Q

NASCET criteria - a narrowing of 16-49% can be described as (2)

A

Pansystolic spectral broadening and

PSV <125 cm/s

63
Q

Defining criteria for >80% stenosis is

A

EDV >140 cm/s

64
Q

Grade the following
PSV 140 cm/s
EDV 105 cm/s
ICA/CCA ratio 3

A

50-69%

65
Q

Surgical procedure to remove the atheromatous plaque material or blockage in the lining of the artery to reduce risk of stroke is termed carotid endarterectomy

A

True

66
Q

What condition is characterized by a component of reverse flow called pulsus bisferans (double peak per cardiac cycle)

A

Aortic regurgitation

67
Q

Externalization of the CCA occurs in

A

Complete occlusion of the ipsilateral ICA

68
Q

Doppler FU of a stent post-endartectomy (3)

A

Smooth velocity increase into stent
Velocity parameters used to grade carotid stenosis is not valid for post-stent evaluation
Velocities tend to be higher due to loss of wall elasticity and increased stiffness

69
Q

Paget-Schrotters syndrome can be classified as a thoracic outlet syndrome

A

True

70
Q

The mechanical compression of an artery by the skeletomuscular system, tumour or inflammatory mass can cause the patient to have symptoms of

A

Entrapment syndrome

71
Q

S/s claudication of the buttock area, impotence and decreased pulses in the lower limbs suggests

A

Leriche syndrome

72
Q

Pseudoaneurysms have a classic Doppler appearance termed “Yin-Yang”

A

True

73
Q

A sonographic sign of intimacy flap leads to diagnosis of

A

Dissection

74
Q

Hemodialysis access grafts (3)

A

Central venous catheter
Synthetic AV bridge graft
Primary AV fistula

75
Q

What % of hemodialysis patients are not candidates for AV graft?

A

50%