Quiz 4: Vasculature review Flashcards
What is the most common cause of portal hypertension in North America?
Hepatitis C
Which of the following portal vein diameter measurements would first indicate possible portal hypertension?
- 11mm
- 12mm
- 13mm
- 14mm
13mm
A sonographer measures a portal vein diameter of 15mm indicating possible portal hypertension. What other extra-hepatic vessels should the sonographer evaluate to assess the sensitivity of the findings?
Splenic vein and SMV
What percentage of blood flow is supplied to liver via the hepatic artery?
25%
Which of the following characteristics suggest congestive heart failure as the cause of portal hypertension?
- Reversed portal vein flow
- Pulsative portal flow and dilated IVC
- Normal IVC and dilated hepatic veins
- Non-phasic MPV and reduced velocities
Pulsative portal flow and dilated IVC
What porto- systemic collateral is indicated by the arrow in this view of the liver?
Umbilical vein
Which of the following is a common finding of chronic portal vein thrombosis?
Cavernous transformation
Which of the following is not a possible precursor to Budd-Chiari syndrome?
- Thrombosis
- Tumor invasion
- Sinusoidal occlusion
- Hypercoagulable blood disorders
Sinusoidal occlusion
Which of the following main portal vein velocities indicates a shunt failure from a TIPS procedure?
- less than 30 cm/s
- Less than 90cm/s
- Greater than 30cm/s
- Greater than 90
Less than 30 cm/s
Which of the following is the most important information provided with a duplex study of the early post operative liver transplant?
- A-V fistula detection
- Hepatic artery patency
- Biliary duct assessment
- Pseudoaneurysm formation
Hepatic artery patency
How would a sonographer describe the spectral tracing in this image?
A normal multiphasic flow
What is the most common site for stenosis of a TIPS shunt?
Hepatic vein end
A patient presents to the department for a portal hypertension assessment. What would be the likely cause of this patient’s portal hypertension based on this spectral tracing?
Congestive heart failure
How would a sonographer describe this spectral tracing of the main portal vein?
Biphasic flow
Which of the following is a common sign of cirrhosis during a physical examination?
Jaundice
Which of the following collaterals is the reason why scanning the splenic vein at the splenic hilum may give a normal result?
Splenorenal
A patient presents to the department 1 year post TIPS placement for portal hypertension. During the exam the velocity of 210 cm/s is measured at a point of aliasing colour doppler in the stent. What is the most likely diagnosis?
Neo- intimal hyperplasia
A patient is surveyed post liver transplant and the hepatic artery waveform demonstrates a resistive index of 0.75. What is the likely diagnosis for this patient
Normal resistance because it is POST liver transplant
Which of the following components of the hepatic waveform indicates an increase in the right sided heart pressures?
- A absent A wave
- A decreased S wave
- An increased A wave
- An increased D wave
A decreased S wave
Which of the following diameters is considered dilated when measuring the IVC?
- 1.5
- 2.0
- 2.5
- 3.0
3.0
Based on the information provided in this image, what type of portal hypertension is suspected?
Post- hepatic
Hepatopetal flow is seen in the hepatic veins during phases of the cardiac cycle normally. T/F?
True
Which of the following pitfalls must be considered when scanning a suspected portal vein thrombosis?
- Inadequate doppler angle
- Undetected low velocities
- Undetected tumor
- All of the above
When scanning in a transverse plane over the portal confluence in an anterior window, which direction do you rotate the transducer to adequately measure the main portal vein?
Clockwise
