Quiz 1 - Carotid Protocol, Pt Care, Sono Care, Cerebriovascular Symptoms

Question 1

With a suspected carotid artery stenosis, what should you do if the lumen is very narrow?

Answer 1

Open up sample gate

Question 2

ICA waveform (5)

Answer 2

Low resistant, low pulsitility
Rounded peak on systole
Systolic window
High diastolic flow
Away from the baseline

Question 3

CCA wall thickening of ____ is normal

Answer 3

<0.9 mm

Question 4

Document in your report (5)

Answer 4

Wall thickening in CCA with measurement <0.9 mm is normal
Location of plaque
Thickness of plaque
Degree of luminal reduction
Plaque morphology (grey scale is better)

Question 5

ECA recognition vs ICA (5)

Answer 5

Smaller than ICA
Always branches
Anterior towards face
High resistance waveform
Responds to temporal tap

Question 6

ECA waveform (4)

Answer 6

High resistance, mod pulsatility
Sharp upstroke
Closer to baseline
Low diastolic flow

Question 7

Transducer position that best visualizes carotid bifurcation and ICA

Answer 7

Posterolateral approach

Question 8

The temporal tap identifies which vessel?

Answer 8

ECA

Question 9

What is a normal waveform for the SCA? What is a pathological sign?

Answer 9

Normal - triphasic, high resistant

Path - low resistant/damped monophonic

Question 10

ICA recognition vs ECA (5)

Answer 10

Larger
No branches
Deep and posterior 
Low resistance waveform
Does not respond to temporal tap

Question 11

Vertebral artery evaluation

3

Answer 11

Longitudinal image between transverse processes of vertebral bodies
PSV measurement
Direction of flow to R/O SSS

Question 12

Important history questions (9)

Answer 12

Previous stroke/TIA
Smoker
High BP
Cholesterolemia
Sudden headaches
Diabetes
Dizziness
Amaurosis faugax
Weakness

Question 13

Carotid artery scan indications (6)

Answer 13

Stroke
Bruit
Headaches
Weakness
F/U carotid exam
Surveillance post endarterectomy/stent

Question 14

T/F a carotid protocol is always bilateral

Answer 14

True

Question 15

If the patient has subclavian steal (4)

Answer 15

Bilateral brachial systolic measurements
The side with the inn/subclavian stenosis will have lower pressure
Damped/monophonic flow
40 mmHg difference between arms (reverse flow) - 20 mmHg it’s bidirectional

Question 16

T/F

TIA affects opposite of the brain except amaurosis fugax

Answer 16

True

Question 17

RIND stands for

What does it mean

Answer 17

Reversible Ischemic Neurological deficit - Sx lasting >24 hr, resolves thereafter

Question 18

SYMPTOMS of potential stroke (6)

Answer 18

Dizziness
Syncope
Numbness affecting tongue, face, with hemiparesis
Slurred speech/aphasia
Headaches

Question 19

The most cause of stroke is infarction of ______

Answer 19

MCA - middle cerebral artery

Question 20

Endarterectomy

Answer 20

Surgically removes art hero atoms plaque, reduces risk of stroke
Artery narrowed >70% + pt symptomatic CEA recommended

Question 21

Compare vertebrovascular (posterior circulation) TIA symptoms VS carotid (anterior circulation) TIA symptoms

Answer 21

Posterior: BILATERAL motor/sensory deficits
Anterior: UNILATERAL motor/sensory deficits

Question 22

Non-surgical methods for treating carotid atherosclerosis includes (2)
What are the risks

Answer 22

Balloon angioplasty and atherectomy

Acute embolization secondary to these procedures