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Vascular > Quiz 7 > Flashcards

Quiz 7 Flashcards

1
Q

Look at indications for abdominal doppler

A

on first slide show

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2
Q

what may a physician find in AAA?

A

patients may present with a pulsatile mass around the umbilical level

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3
Q

what is necessary to fully evaluate the AAA?

A

duplex and colour doppler

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4
Q

how can you rule out dissection

A

using 2D as well as duplex colour doppler

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5
Q

what measurment considered AAA?

A

over 3 cm

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6
Q

what is the caliper placement when measuring AAA?

A

outer wall to outer wall

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7
Q

what does hepatic artery aneurysm cause?

A

abdominal pain

bleeding into the GI tract

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8
Q

what is useful to determine turbuent arterial waveforms with aneurysms?

A

doppler US

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9
Q

what do people with hepatic artery aneurysm have done?

A

selective angiography of the CA and SMA

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10
Q

what are grafts?

A

Repair of aneurysmal vessels such as the abdominal aorta and iliac arteries involves grafts to restore flow to the pelvis and lower limbs

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11
Q

what is a good surveillance protocol for grafts?

A

doppler US

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12
Q

what is a complication for grafts?

A
  • restenosis
  • occlusion
  • graft leaking
  • pseudoaneurysm
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13
Q

percentage of SMA embolism in acute mesenteric ishemia

A

50%

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14
Q

percentage of SMA thrombosis in acute mesenteric ishemia

A

25%

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15
Q

percentage of non-occlusive mesenteric ishemia

A

20%

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16
Q

what is the percentage of mesenteric venous thrombosis

A

5%

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17
Q

when looking for mesenteric ischemia where do you look?

A

doppler of

  • proximal SMA
  • pre and post prandial
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18
Q

what is the SMA preprandial waveform?

A

high resistant with low diastolic flow

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19
Q

what is the post prandial waveform in the SMA?

A

lower resisitant with continuous and higher diastolic flow

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20
Q

what does the SMA show in the event of ischemia?

A

atherosclerosis-waveforms do not change if the stenosis is significant

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21
Q

who is chronic mesenteric ishemia usually seen in?

A
  • younger women
  • smokers
  • 2/3 with other vascular disease
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22
Q

what is shown clinically with chronic mesenteric ischemia?

A

bruit

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23
Q

what are the classic symtoms of chronic mesenteric ischemia?

A
  • post prandial pain
  • weight loss
  • food fear
  • GI ulceration
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24
Q

slide 17 PWP 1

A

look at this slide

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25
Q

where is hypervasculatity seen?

A
  • thyroid-graves disease
  • epididymitis
  • hyperemia of bowel wall-chrons
  • inflammed lymph nodes
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26
Q

what is ultrasound useful in ruling out for trauma?

A
  • artriovenous fistula (AVF)

- pseudoaneurysm

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27
Q

what are the most common organs to be infarcted?

A

spleen

kidney

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28
Q

what is infarct caused by?

A
  • arterial embolus
  • thrombus
  • atherosclerotic plaque
  • trauma
  • extrinsic tumour compression
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29
Q

what is most helpful in ruling out infarct?

A

colour/power doppler

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30
Q

how does pseudocyst form?

A

results from a bout of pancreatitis

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31
Q

erosion of tissue outside the pancreas may involve what?

A

splenic artery wall

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32
Q

what are renal doppler indications?

A
  • pre and post transplant
  • renal artery stenosis
  • fibromuscular dysplasia
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33
Q

what must your settings at to evaluate suspected renal artery stenosis?

A
  • angle correct
  • 60 degrees
  • doppler measurments of the PSV prox, central, dist the the extrarenal main reanl arteries
34
Q

what should be used for calculating the renal artery to aortic ratio (RAR)

A

PSV of suprarenal aorta

35
Q

what should be used when measuring the resistive indices (RI)?

A

spectral doppler of intrarenal arteries

36
Q

if tadus parvus waveform is shown, what does this suggest?

A

proximal stenosis

37
Q

what are a good predictor of RA disease?

A

resistive indices

38
Q

what is the gold standard for evaluating RAS?

A

CTA or MRI, however renal artery doppler is usually the first test performed

39
Q

why is renal artery doppler the first test performed?

A
  • non-invasive
  • no radiation
  • no contrast
40
Q

what is done after transplanted kidneys?

A

doppler evaluations to document vascular patency and blood flow characteristics

41
Q

what structures may be examined after a renal transplant?

A
  • main renal artery and vein
  • ateria and venous anastomoses
  • illiac artery and vein
  • intrarenal arteries
42
Q

what occurs with fibromuscular dysplasia in young females?

A

sudden uncontrollable hypertension

43
Q

what is fibromuscular dysplasia? (FMD)

A

abnormal cell growth in the walls of renal arteries (non-atherosclerotic)

44
Q

what is usualy affected with FMD?

A

usually mis to distal RA’s affected

45
Q

what does FMD cause?

A

narrowing within the artery and impairs the blood flow to the kidney

46
Q

what could happen if FMD is left untreated?

A

dissection could occur

47
Q

how is FMD shown on ultrasound?

A

doppler areas of aliasing and stenosis

48
Q

how is FMD shown on angiogram?

A

areas of narrowng and widening

49
Q

who is at risk for renal artery stenosis?

A
  • atherosclerosis
  • FMD
  • HBP
  • diabetics
  • smokers
50
Q

how many measuements are taken of the kidneys?

A

3 (sag should be 9-12cm)

51
Q

what do we compare with echogenicity of the kidneys

A
  • cortex to sinus
  • adjacent liver/spleen
  • right and left kidneys
  • thickness of the kidneys
52
Q

what must be obtained in renal artery doppler?

A

RAR

53
Q

where do you meausre the PSV when obtaining RAR?

A

aorta

  • prox
  • mid
  • distal at renal hilum
54
Q

what must we demonstate in colour when doing RAR?

A

renal artery length in colour to observe any changes

55
Q

what is the normal range for RAR?

A

under 3.5

56
Q

what is the normal PSV range in the aorta?

A

50-100 cm/s

sample just prox to renal arteries

57
Q

when do we not use angle correct?

A

sonographic index used to assess for renal artery disease but we do not use angle correct (intrarenal)

58
Q

how is RI calculated?

A

measuring the PSV and EDV within the segmental branch or arcuate artery in the cortex

59
Q

what is the formula for RI?

A

PSV-EDV/PSV

60
Q

what is the normal RI measument?

A

0.4-0.7 (over this indicates renal artery disease)

61
Q

what are sone signs of RA stenosis?

A
  • tardus parvus waveform distal to stenosis
  • increased main reanl artery (PSV over 180 cm/s)
  • post stenotic turbulence distal to site of stenosis
62
Q

what makes up the portal venous system?

A
  • SV
  • SMV
  • IMV
  • MPV
  • PV
  • HV
  • IVC
63
Q

what are the causes of portal hypertension?

A
  • cirrhosis
  • alcohol
  • hepatitis
64
Q

what causes portal vein blood clots?

A
  • pancreatitis
  • cancer
  • portal hypertension
65
Q

what do you access with if portal hypertension is present?

A
  • determine if flow is hepatofugal or hepatopetal in direction of both intra and extrahepatic branches
  • evaluate for varices, patent umbilical vein, caput medusae, cavernous transformation
  • Evaluate TIPS and DSRS
66
Q

what does TIPS stand for?

A

transjugular intrahepatic portosystemic shunt

67
Q

what does DSRS stand for?

A

distal splenorenal shunt

68
Q

what may happen with abnormal portal venous flow (hepatofugal)?

A

splenorenal shunt may be spontaneous or created

69
Q

what is cavernous transformation?

A

multiple large tortous vessels occupying the portal vein bed

70
Q

what are some signs of portal hypertension?

A
  • cirrhotic liver
  • splenomegaly
  • increased MPV size (under 13mm is normal)
  • GI varices
  • ascities
  • clot-SV or PV
71
Q

why do we look at the IVC?

A
  • evaluate vena cava filters (greenfilter)
  • Rule out tumor or thrombus invasion from renal cell or adrenal carcinoma
  • over dilation of HV and IVC due to right heart failure
72
Q

what is useful to evaluate phasicity?

A

duplex

73
Q

what is a sign of IVC occlusion?

A

bilateral leg swelling

74
Q

what are causes if IVC occlusion?

A
  • extrinsic compression-nodes
  • RCC
  • hepatocellular carcinoma
75
Q

what usually results from penetrating abdominal injury?

A

vena cava pseudoaneurysm

76
Q

what is Vena cava pseudoaneurysm assocated with?

A

arterial-venous fistula

77
Q

what cn right heart failure lead to?

A

overdistension of IVC and Hepatic veins

78
Q

what will happen with overdistension of IVC and Hepatic veins?

A
  • These vessels will appear larger than normal due to backup of blood flow
  • The normally phasic flow due to respiratory movements are absent
  • The IVC will measure almost the same in AP during expiration and inspiration
79
Q

Renal vein thrombosis

A
  • Underlying disease
  • Dehydration
  • Hypercoagulability
  • Tumors of the kidneys and adrenals may grow into veins
  • Extrinsic compression-tumor, fibrosis, trauma
80
Q

is hepatic artery aneurysm rare or common?

A

rare

81
Q

what do hepatic artery aneurysms have a high rate of?

A

rupture and can be fatal

Vascular (10 decks)

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