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Vascular Sonography > Non-atherosclerotic Arterial Pathology > Flashcards

Non-atherosclerotic Arterial Pathology Flashcards

1
Q

What is a type of vascular arteritis that is also known as thromboangitis obliterans?

A

Buerger’s disease

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2
Q

What size of arteries are affected by Buerger’s disease?

A

Small and medium sized

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3
Q

What is known as a type of Arteritis that affects the aorta and its large branches?

A

Takayasu’s arteritis

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4
Q

What type of arteritis is also known as temporal arteritis?

A

Giant Cell Arteritis (GCA)

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5
Q

What is the cause of peripheral arterial disease in 90% of patients?

A

Atherosclerosis

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6
Q

What layer of the vessel wall is affected by vascular arteritis?

A

Media

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7
Q

In vascular arteritis, what is the cell wall infiltrated with?

A

WBC’s - causes fibrosis of the wall

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8
Q

What are the symptoms of LOWER extremity arteritis?

A

Claudication and rest pain

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9
Q

What are the symptoms of UPPER extremity arteritis?

A
  1. Asymmetrical BP
  2. Dizziness
  3. Syncope
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10
Q

What patient population is usually seen with GCA?

A

Elderly patients

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11
Q

If a patient presents with headaches and temporal pain, what is the most likely diagnosis?

A

GCA

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12
Q

For GCA - The PSV that is twice the value of the PSV in adjacent more proximal vessel is indicative of what percent of stenosis?

A

Greater than 50%

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13
Q

Does GCA occur over a long or short distance of the artery?

A

Long section of the vessel

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14
Q

In what patient population is usually seen in Takayasu’s arteritis?

A

Younger patients

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15
Q

What is the most common site for Takayasu’s arteritis?

A

Subclavian artery

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16
Q

What layers of the wall are affected in GCA and in Takayasu’s arteritis?

A

GCA - only the tunica media

Takayasu’s - all 3 layers

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17
Q

What sonographic “sign” indicates Takayasu’s arteritis?

A

Macaroni sign - circumferential wall thickening in TRV

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18
Q

What is Buerger’s disease ALWAYS associated with?

A

Tobacco abuse

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19
Q

What is Buerger’s disease also known as?

A

Thromboangitis obliterans

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20
Q

What is the most common site of Buerger’s disease?

A

Small/medium arteries in the fingers and toes

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21
Q

T or F: Buerger’s disease is always unilateral?

A

FALSE: always bilateral

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22
Q

What are the SF of radiation-induced arteritis (RIA)?

A
  1. Wall thickening
  2. Stenosis caused by atherosclerosis at the radiation site and NOWHERE else
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23
Q

What is the most common site of embolization?

A

Cerebrovascular system

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24
Q

What are symptoms of embolic disease?

A
  1. Stroke
  2. Pallor
  3. Pulselessness
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25
Q

What is the most common source of embolic disease and what is it most commonly caused by?

A

Source: Heart/cardiac

Caused by: A-fib

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26
Q

Where does the thrombus typically form within the heart that can end up traveling through the arterial system?

A

LAA

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27
Q

What makes a pseudoaneurysm not a true aneurysm?

A

Usually cause by the leakage of blood after an injury, contained within the soft tissues

28
Q

What is the most common cause of a pseudoaneurysm and in what artery?

A

Cause: Iatrogenic - from catheterization

Artery: RT Common Femoral

29
Q

Patients present w/ pulsating mass over the site of a catheterization or traumatic injury, what would we expect to be the diagnosis?

A

Pseudoaneurysm

30
Q

What is a common sonographic appearance of a pseudoaneurysm?

A
  1. To-and-fro flow : yin-yang sign
  2. A vascular neck can be seen connecting the pseudoaneurysm from the artery
31
Q

In what abnormality will you see high-diastolic flow in an artery proximal to that abnormality?

A

AVF - abnormal connection between an artery and vein

32
Q

What is the popliteal artery compressed by in popliteal entrapment syndrome?

A

Medial head of the gastroc muscle or adjacent tendons

33
Q

What is the most frequent and fatal complication of Takayasu’s arteritis?

A

Aneurysm

34
Q

What are arterial aneurysms usually caused by?

A

Atherosclerosis

35
Q

Other than atherosclerosis, what can be a cause of arterial aneurysms? (3)

A
  1. Arteritis
  2. Marfan Syndrome
  3. Ehler’s Danlos syndrome
36
Q

What is known as a connective tissue disorder associated with AO arch aneurysms?

A

Marfan Syndrome

37
Q

What is a congenital defect in type III collagen that leads to arterial rupture with or without an aneurysm?

A

Ehler’s Danlos syndrome

38
Q

How much does the vessel diameter increase with non-atherosclerotic arterial aneurysms?

A

Greater than 50%

39
Q

When using spectral Doppler, peak systolic velocities are routinely recorded. Under which conditions is it particularly useful to record end- diastolic velocities?

A

When abnormally high or low resistance flow patterns are present

40
Q

Which layer of the vessel wall is most likely to undergo infiltration of white blood cells during the inflammatory process encountered with most arteritis diseases?

A

Media only

41
Q

In a patient presenting with signs and symptoms of giant cell arteritis and asymmetric blood pressures, what should also be assessed?

A

Upper extremity arteries

42
Q

Which vessels are most commonly affected by Takayasu’s arteritis?

A

Subclavian

43
Q

When present, where will lower extremity claudication symptoms with thromboangiitis obliterans most likely be localized?

a. the arch of the foot
b. the ankle
c. the calf
d. the thigh

A

A - because it affects smaller arteries - digits

44
Q

Which symptom would be typical in a patient with an arterial lesion due to radiation-induced arteritis?

A

Onset of claudication several months after completion of radiation treatment

45
Q

What are most iatrogenic arteriovenous fistula the result of?

a. femoral artery catheterization
b. central venous line placement
c. penetrating wounds
d. total knee replacement

A

A

46
Q

Which statement about popliteal artery entrapment syndrome is FALSE?

a. It affects males more frequently than females.
b. It often affects both limbs.
c. It is an acquired condition.
d. It is a congenital condition.

A

C - is congenital

47
Q

What is the preferred maneuver to diagnose popliteal artery entrapment syndrome?

a. ABI with treadmill exercise testing
b. duplex assessment with active plantar flexion
c. duplex assessment involving
d. rotating the limb physiologic testing with limb dependent then elevated

A

B

48
Q

Which condition is a congenital disorder of connective tissue often resulting in aneurysm formation?

a. Buerger’s disease
b. Takayasu’s disease
c. Ehlers–Danlos syndrome
d. Kawasaki syndrome

A

C

49
Q

What is the primary site for aneurysm development associated with Marfan’s syndrome?

a. the abdominal aorta
b. the common femoral artery
c. the popliteal artery
d. aortic arch

A

D

50
Q

What is a devastating complication of Ehlers–Danlos syndrome?

a. aneurysm
b. arterial rupture
c. thrombosis
d. atherosclerosis

A

B

51
Q

An 80-year-old female presents to the vascular lab with a palpable thrill in the right groin after catheterization procedure. Upon duplex assessment of the area, increased diastolic flow is noted in the very proximal right common femoral artery, and prominent pulsatility is noted in right common femoral vein. A significant color bruit is noted in the area as well. What do these findings suggest?

a. arteriovenous fistula of the common femoral vessels
b. acute arterial embolization
c. right common femoral artery dissection
d. pseudoaneurysm of the right common femoral artery

A

A

52
Q

A 42-year-old male smoker presents to the vascular lab with ischemic digit ulcers, on his fingers as well as his toes. The patient also notes some tingling in his feet. What should be suspected in this patient?

a. thromboangiitis obliterans
b. popliteal artery entrapment
c. Takayasu’s arteritis
d. aneurysmal disease of the subclavian artery

A

A - AKA buerger’s disease

53
Q

A 66-year-old female presents to the vascular lab with sudden onset of severe right lower extremity pain, pallor, and pulselessness. The patient describes a history of atrial fibrillation. What should be suspected in this patient?

a. right common femoral artery pseudoaneurysm
b. radiation-induced arteritis in the iliac system
c. cardiac source acute embolization to the right leg
d. acute thrombosis of a popliteal artery aneurysm

A

C

54
Q

A 73-year-old female presents to the vascular lab with temporal headaches, jaw claudication, visual disturbances, and a palpable cord over her forehead. What should be suspected in this patient?

a. thromboangitis obliterans
b. giant cell arteritis
c. Takayasu’s arteritis
d. pseudoaneurysm of the temporal artery

A

B

55
Q

A 53-year-old male presents to the vascular lab with a pulsatile mass in his right groin. The patient recently underwent a cardiac catheterization procedure. Upon duplex evaluation, an encapsulated mass is noted with to- and-fro flow noted in a channel connecting the right common femoral artery to the mass. What do these findings most likely represent?

a. arteriovenous fistula of the common femoral vessels
b. acute arterial occlusion
c. right common femoral artery dissection
d. pseudoaneurysm of the right common femoral artery

A

D

56
Q

A 32-year-old Asian female presents to the vascular lab with weak radial pulses and several transient ischemic attacks. What should be suspected in this patient?

a. thromboangiitis obliterans
b. giant cell arteritis
c. atherosclerotic disease of the carotid arteries
d. Takayasu’s arteritis

A

D

57
Q

A 75-year-old male presents to the vascular lab with cool, pulseless limb shortly after catheterization through the right common femoral artery. Upon duplex assessment, echogenic material was noted in the common femoral artery with a staccato type waveform obtained just proximal to this area. What do these findings suggest?

a. arteriovenous fistula of the common femoral vessels
b. right common femoral artery dissection
c. acute arterial occlusion of the right common femoral artery
d. pseudoaneurysm of the right common femoral artery

A

C

58
Q

When using spectral Doppler, peak systolic velocities are routinely recorded. Under which conditions is it particularly useful to record end- diastolic velocities?

a. Distal to a stenosis.
b. When an aneurysm is present.
c. When abnormally high- or low-resistance flow patterns are present.
d. End-diastolic velocities should always be recorded.

A

C

59
Q

Which layer of the vessel wall is most likely to undergo infiltration of white blood cells during the inflammatory process encountered with most arteritis diseases?

a. the media layer
b. the intima layer
c. the adventitia layer
d. both the intima and media equally

A

A

60
Q

In a patient presenting with signs and symptoms of giant cell arteritis and asymmetric blood pressures, what should also be assessed?

a. the aortic arch
b. the lower extremity arteries
c. the upper extremity arteries
d. the digits

A

C

61
Q

When assessing giant cell arteritis on grayscale imaging, an anechoic area is often present surrounding the affected vessel. How is this appearance often described on the image?

a. doughnut
b. halo
c. macaroni
d. burger

A

B

62
Q

Which vessels are most commonly affected by Takayasu’s arteritis?

a. the common carotid arteries
b. the innominate artery
c. the axillary arteries
d. the subclavian arteries

A

D

63
Q

Which symptom would be typical in a patient with an arterial lesion due to radiation-induced arteritis?

a. onset of claudication several months after completion of radiation treatment
b. visual disturbances and jaw claudication
c. ischemic ulcers of the digits during radiation treatment
d. pulsatile mass in the area of radiation treatment

A

A

64
Q

Pseudoaneurysms can be seen with all of the following EXCEPT:

a. postcardiac catheterization.
b. as an inflammatory response.
cat site of infection of synthetic grafts
d. with dialysis access grafts.

A

B

65
Q

What does the “Yin-Yang” symbol describe?

a. the flow pattern in an arteriovenous fistula
b. the flow pattern in an aneurysm sac
c. the flow pattern at an area of dissection
d. the flow pattern in a pseudoaneurysm sac

A

D

66
Q

What are most iatrogenic arteriovenous fistula the result of?

a. femoral artery catheterization
b. central venous line placement
c. penetrating wounds
d. total knee replacement

A

A

Vascular Sonography (17 decks)

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