Other Topics 2% Flashcards
____________ refers to a collection of mucinous material within the adventitial wall layer of the affected vessel.
Adventitial cyst.
- Adventitial cysts are a collection of mucinous material within the adventitial wall layer of the affected vessel. The cysts predominantly form in the walls of the peripheral arteries, with the popliteal artery most commonly affected. It is most common in young to middle-aged men with no other vascular disorders. Usually presents as multiple anechoic or hypoechoic areas within the wall. No blood flow is detected in the areas. The cysts can cause narrowing of the vessel lumen and stenosis.
All of the following correctly describe thoracic outlet syndrome, except:
A. The Adson’s maneuver is used during assessment for TOS.
B. PPG or PVR tracings can be used to evaluate a patient with suspected TOS
C. Patients commonly experiencing dull, aching pain and paresthesia in the affected arm/shoulder
D. The Homan’s sign indicates a positive test result for TOS.
D
Homan’s sign refers to pain in the calf with quick dorsiflexion of the foot, seen with DVT.
Which of the following changes in flow can be seen with a Baker’s cyst?
A. pulsatile flow in the superficial femoral vein
B. pulsatile flow in the popliteal vein
C. continuous flow in the popliteal artery
D. continuous flow in the popliteal vein
D
A Baker’s cyst can cause extrinsic compression of the popliteal vein which leads to a loss of phasicity and a continuous waveform.
All of the following correctly describe compartment syndrome, except:
A. most commonly occurs due to trauma
B. can occur in the leg or arm
C. prevents blood flow in and out of surrounding tissues
D. all forms of compartment syndrome are considered an emergency
D
FeedBack:Acute compartment syndrome is an emergency, but chronic compartment syndrome is not an emergency. The acute onset of compartment syndrome is usually associated with trauma and a broken leg or arm. Increased pressure in the osteofascial compartment will prevent blood flow in and out of surrounding tissues. This can cause permanent muscle and nerve damage.
Which of the following is least likely to be a complication caused by a Baker’s cyst?
A. Pain
B. Thrombosis due to valvular insufficiency
C. Thrombosis due to extrinsic compression
D. Swelling
B
FeedBack:A Baker’s cyst does not directly affect the valvular competence and will not usually lead to insufficiency. Never say never in medicine :)
A patient presents for a lower extremity venous Doppler due to leg pain in the groin and upper thigh after a recent car accident. After viewing these findings in the common femoral vein, what should you do next on this patient’s exam?
Picture is of aliasing neck coming out of CFV
A. evaluate the common femoral artery for signs of an AV fistula
B. evaluate the common femoral artery for a pseudoaneurysm
C. perform a blood pressure on the thigh
D. perform the color and Doppler evaluation of the superficial femoral vein to rule out thrombus
A
FeedBack:Note the pulsatility in the venous waveform which is consistent with the presence of arterial inflow proximally in the vessel. The mosaic color pattern indicates turbulence at the connection with the artery.
Lymphedema is commonly related to all of the following, except:
A. peripheral arterial disease
B. obstruction of the lymphatic system
C. history of radiation therapy
D. history of cancer
A
FeedBack:Lymphedema can be caused by many things but is commonly seen with infection, injury, trauma, or cancer that affects the lymphatic system. Radiation therapy or removal of lymph nodes related to cancer can also cause lymphedema.
The most common location of a Baker’s cyst is:
A. Anterior patellar space
B. Medial popliteal fossa
C. Inguinal canal
D. Medial antecubital fossa
B
FeedBack:The most common location of a Baker’s cyst is in the medial popliteal fossa. Most are an incidental finding on a lower extremity exam.
How do the microbubbles in an ultrasound contrast agent change the image?
A. increase the resistance to flowing blood to make it more visible
B. microbubbles cannot be used to evaluate arterial flow due to embolism risk
C. increase vasodilation to move the bubbles more quickly so they are visible to ultrasound
D. increase the reflectivity of flowing blood
D
FeedBack:Microbubbles in an ultrasound contrast agent increase the reflectivity of flowing blood.
All of the following describe an AV fistula caused by an interventional procedure, except:
A. pulsatile venous outflow
B. dilated venous collaterals adjacent to the fistula
C. direct connection between a single artery and vein
D. low resistance arterial inflow
B
FeedBack:An AVM is a congenital malformation with multiple connections between the arterioles and venules without a capillary bed in between. Venous collaterals will develop and dilate over time. An AVF is a direct connection of an artery or vein caused by trauma or interventional procedure. Due to the acute formation of the connection, there are no collaterals present. The arterial inflow and venous outflow will demonstrate the same hemodynamic characteristics in an AVM and AVF, increased arterial flow volume, low resistance arterial inflow and pulsatile, turbulent venous outflow.
While scanning a patient following a recent car accident you identify an arteriovenous connection in the left groin. How can you determine if this finding is related to the recent trauma or it is a congenital abnormality?
A. Determine the location of the AVM
B. Perform a Doppler evaluation of flow within the connected vessels
C. Locate the number of connections between the artery and the vein
D. Evaluate the deep veins for associated thrombus
C
FeedBack:A congenital malformation (AVM) will usually have multiple connections between the artery and the vein. An AV fistula(AVF) caused by trauma is usually a single connection between the artery and vein. The other items listed would be possible exam techniques used to evaluate the patient, but they will not differentiate a congenital AVM from a traumatic AVF
The images displayed are from an aortic Doppler evaluation on a ER trauma patient. What should you evaluate next?
image is of Abdominal AO dissection
A. renal arteries for stenosis
B. iliac arteries for dissection
C. iliac veins for thrombus
D. IVC for thrombus
B
FeedBack:There is a dissection present in the aorta. You should evaluate the proximal and distal end of the dissection to assess the extent.
An AV malformation is most commonly caused by:
A. hemodialysis access
B. trauma
C. a congenital defect
D. recent angiography procedure
C
FeedBack:An AVM is a congenital defect. An AVF is caused by trauma or an interventional procedure.
