Pathology (32%) Flashcards
Vertigo is a common symptom related to disease of which of the following vessels?
A: MCA
B: ACA
C: ICA
D: basilar
D: Basilar
What is Lemierre Syndrome?
Lemierre Syndrome refers to thrombophlebitis of the jugular veins with oropharyngeal infection, such as pharyngitis/tonsillitis.
A patient presents for an exam due to a history of Lemierre Syndrome. What vessels should be evaluated for associated findings?
A: Bilateral internal jugular veins
B: Superficial veins of the lower extremity
C: Bilateral radial and ulnar veins
D: Deep veins of the lower extremity
A: Bilateral internal jugular veins
What is the most common cause of cerebrovascular disease?
A: atherosclerosis
B: vasospasm
C: stroke
D: embolism
A: Atherosclerosis
___ uses a catheter with a rotating head to break up the plaque and suction capabilities to remove it from the artery.
A: An endarterectomy procedure
B: A valvulotome procedure
C: An angioplasty procedure
D: An atherectomy procedure
D: An atherectomy procedure
What arteries are most commonly affected by Takayasu arteritis?
A: forearm
B: calf
C: subclavian and common carotid
D: subclavian and brachial
C: subclavian and common carotid
What is Takayasu arteritis?
Causes hypertrophic area(s) of inflamed tissue usually found in the aorta and its branches. It is associated with supravalvular stenosis and aortic coarctation.
Which of the following factors listed below is NOT a part of Virchow’s triad of symptoms?
A: Blood stasis
B: Recent fall
C: Polycythemia vera
D: Hyperpigmentation
D: Hyperpigmentation
Polycythemia vera refers to hypercoagulability
In the circle of Willis, if a difference ___ is present between the velocities taken in the same vessel on both sides, this can indicate intracerebral disease.
A: >20%
B: >30%
C: >40%
D: >50%
B: >30%
Which of the following characteristics is most suggestive of renal vein thrombosis?
A: reduced diastolic flow in the renal arteries
B: prominent flow in the segmental and intralobar arteries
C: turbulent venous flow within the kidney
D: low resistance flow in the intrarenal arteries
A: reduced diastolic flow in the renal arteries
How is Heparin administered to a patient with DVT?
A: intravenous
B: orally
C: subcutaneous injection
D: intra-arterial
A: intravenous
A patient presents for a carotid Doppler exam due to left arm and leg paresthesia. Which vessel should be closely evaluated for a potential vascular cause of the symptom?
A: left ICA
B: right ICA
C: right vertebral
D: left vertebral
B: right ICA.
Symptoms of a stroke that occur in the body are associated with ICA disease on the contralateral side.
Which renal arteries are evaluated with Doppler in an ultrasound exam that is used to perform an indirect evaluation for renal artery stenosis?
A: main renal artery
B: segmental and parenchymal arteries
C: aorta
D: main renal artery, segmental and parenchymal arteries
B: segmental and parenchymal arteries
Elevated erythrocyte sedimentation rate and C-reactive protein (CRP) levels are associated with which of the following?
A: Fibromuscular dysplasia
B: Marfan syndrome
C: Klippel Trenaunay syndrome
D: Giant cell arteritis
D: Giant cell arteritis
A patient presents for a lower extremity venous Doppler exam due to a history of May-Thurner Syndrome. What vessel should you closely evaluate for related findings?
A: Bilateral distal femoral veins
B: Right iliac vein
C: Bilateral popliteal veins
D: Left iliac vein
D: Left iliac vein
May-Thurner Syndrome refers to increased incidence of left DVT due to extrinsic compression by RIGHT iliac artery.
Which of the following is a symptom usually related to vertebrobasilar disease?
A: Unilateral visual disturbances
B: Expressive aphasia
C: Dysphagia
D: Receptive aphasia
C: Dysphagia
A patient presents for a carotid ultrasound. The chart states there is a history of dilaated cardiomyopathy and an intra-aortic balloon pump is present. Which of the following correctly describes how to evaluate the patient for carotid stenosis?
A: The PSV is invalid, but the EDV should be measured.
B: Waveforms from the common carotid artery will have two SPV and the SECOND one should be measured.
C: The patient should be r/s until after the pump is removed because there is no way to ecaluate carotid stenosis while a pump is active.
D: Waveforms from the CCA will have two SPV and the FIRST one should be measured
D: Waveforms from the CCA will have two systolic peaks and the first one should be measured.
The first peak is contraction. The second peak is the pump.
A pulsatility index of > 1.2 in the cerebral vessels indicates:
A: normal flow resistance
B: vasospasm
C: mildly decreased resistance
D: severely decreased resistance
B: Vasospasm
What is median arcuate ligament syndrome?
When the arc-shaped band of tissue in the chest area (median arcuate ligament) presses on, or traps, the celiac artery (artery that supplies blood to organs in upper abdomen)
What are three other names for median arcuate ligament syndrome? (MALS)
Celiac artery compression
Celiac axis syndrome
Dunbar syndrome
Which of the following correctly describes the symptoms associated with MALS?
A: groin pain that is relieved by placing the legs in the dependent position
B: calf pain relieved by stretching the muscles
C: abdominal pain that is relieved by deep inspiration
D: abdominal pain that is relieved by eating a fatty meal
C: Abdominal pain that is relieved by deep inspiration
When evaluating the Doppler waveform at a focal stenosis in the proximal ICA, which of the following doppler characteristics will be demonstrated?
A: increased PSV, decreased EDV
B: increased PSV, increased diastolic flow reversal
C: increased PSV, increased EDV
D: decreased PSV, increased EDV
C: Increased PSV and EDV
If a left ICA occlusion is present, which of the following is true?
A: the RIGHT ophthalmic artery will demonstrate decreased or absent flow
B: the right MCA flow will be decreased or absent with normal flow in the right internal carotid siphon
C: the left MCA will demonstrate decreased or absent flow
D: the right MCA flow will be decreased or absent with flow reversal in the right internal carotid siphon
C: The left MCA flow will demonstrate decreased or absent flow
A patient with aortic coarctation distal to the left subclavian artery origin will demonstrate:
A: no change in ankle pressures with exercise
B: increased bilateral ABIs
C: bounding pedal pulses
D: systemic HTN with increased brachial pressures
D: Systemic HTN with increased brachial pressures
Which is NOT a pathway for ECA to ICA collateralization?
A: superficial temporal artery to supraorbital artery
B: angular artery to frontal artery
C: superficial temporal artery to frontal artery
D: angular artery to facial artery
D: angular to facial artery
The facial artery is a branch of the ECA. The angular artery is a terminal branch of the facial artery.
Where is the Doppler cursor placed in the aorta to obtain the velocity used in the renal aortic ratio?
A: just below the diaphragm
B: 2cm above the aortic bifurcation
C: at the location of the highest recorded velocity
D: at the level of the renal artery origins
D: at the level of the renal artery origins
Which of the following indicates a significant SMA stenosis?
A: dilated inferior mesenteric artery that is easily visualized sonographically
B: mesenteric - aortic ration > 2.5
C: pain in the abdomen when hungry that is relieved by eating/digestion
D: PSV >200cm/s
A: dilated inferior mesenteric artery that is easily visualized sonographically
The IMA is usually very tough to find in most patients. If the artery is visible and easily evaluated, it usually means it is dilated d/t compensatory flow related to an SMA stenosis.
The most accurate Doppler predictor of ICA stenosis is:
A: the peak systolic velocity
B: the end diastolic velocity
C: the diastolic ratio (ICAd/CCAd)
D: the systolic ratio (ICAs/CCAs/)
B: the end diastolic velocity
If a patient complains of recent onset of uncontrollable systemic HTN with average BP readings exceeding 170/90mmHG, what vascular cause should be suspected?
A: subclavian stenosis
B: portal HTN
C: renal artery stenosis
D: hepatic congestion
C: renal artery stenosis
Broca aphasia can be defined as:
A: inability to swallow food
B: inability to understand speech, speak, or follow directions
C: inability to swallow liquids
D: inability to speak but can understand and follow directions
D: inability to speak but can understand and follow directions
(Broca aphasia is expressive aphasia)
If there is a 90% stenosis in the left carotid siphon, which is true?
A: left ICA will be high resistance
B: left MCA flow will be high resistance
C: right MCA will be high resistance
D: left vertebral flow will be high resistance
A: left ICA flow will be high resistance
Distal stenosis will lead to high resistance flow proximally
A peak systolic velocity of 100 cm/s is an indication of ___ in the ICA
A: normal flow
B: mild stenosis
C: moderate stenosis
D: severe stenosis
A: normal flow
The PSV in the ICA is normal when it is less than 125cm/s
What is the most common lower extremity venous disorder?
A: superficial thrombophlebitis
B: venous insufficiency
C: May Thurner syndrome
D: DVT
B: venous insufficiency
Which is not an expected clinical finding in a patient with a venous stasis ulcer?
A: severe pain
B: discoloration of the affected area
C: oozing
D: located at the medial malleolus
A: severe pain
Venous ulcers are usually mildly painful. Arterial ulcers usually cause significant pain.
Which can lead to a false negative diagnosis of ICA stenosis?
A: congestive heart failure
B: anemia
C: tortuosity
D: increased cardiac output
A: congestive heart failure
this is due to abnormally decreased velocities in the carotid system.
When evaluating a focal stenosis of the femoral artery, where should you place the cursor to obtain the highest velocity related to the stenosis?
At the narrowest point in the vessel or immediately distal to the focal point of the stenosis
Why is the carotid compression technique performed?
A: to evaluate the presence of intracranial collateral formation
B: to evaluate the venous outflow of the intracranial vessels
C: to evaluate the effects of vasospasm
D: to evaluate the carotid as a potential arterial graft
A: to evaluate the presence of intracranial collateral formation
ONLY THE PHYSICIAN CAN PERFORM THIS
The renal-aortic ratio is invalid in patients with:
A: renal vein thrombosis
B: abdominal aortic aneurysm
C: medullary sponge kidney
D: diabetes
B: AAA
Which of the following will have no effect on venous flow in the lower extremeties?
A: severe tricuspid stenosis
B: premature ventricular contractions
C: significant tricuspid regurgitation
D: congestive heart failure
B: Premature ventricular contractions.
Which would be used to describe a Doppler waveform taken in the mid ICA with a critical stenosis of the prox segment?
A: increased resistive index
B: damped
C: peaked
D: increased pulsatility index
B: damped
Tardus pardus waveform is the result of:
A: significant proximal arterial stenosis
B: distal arterial obstruction
C: <50% proximal arterial stenosis
D: partial venous obstruction
A: significant proximal arterial stenosis
According to the Bernoulli Principle, where will you find the lowest pressure in a vessel with stenosis?
A: distal to
B: at the site of
C: proximal to
D: in the collateral vessels
B: at the site of the stenosis
Pressure is lowest at the stenotic site, which causes an increased pressure gradient from proximal to the stenosis to stenosis site.
Median arcuate ligament syndrome (MALS) involves compression of which vessel during respiration?
A: main portal vein
B: superior mesenteric artery
C: inferior mesenteric artery
D: celiac axis
D: Celiac axis
