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Scan Lab > Scan Lab Final 2024 > Flashcards

Scan Lab Final 2024 Flashcards

1
Q

What does “TIPS” stand for?

A

Transjugular intrahepatic portosystemic shunts

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2
Q

What two vessels does the tips usually connect?

A

Right hepatic vein and right portal vein

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3
Q

True/False
You only measure the velocity at the mid portion of the TIPS to determine if it is completely patent

A

False

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4
Q

What is the most common reason a patient gets a TIPS?

A

Portal hypertension

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5
Q

What is the most common complication in a TIPS?

A

Stenosis within the TIPS

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6
Q

Which characteristics best describe flow in the main portal vein?

A

Low velocity and hepatopedal flow

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7
Q

The flow in the left portal vein should be ______________ in a patient with a TIPS:

A

Hepatofugal

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8
Q

A _______ velocity change from previous exams denotes possible malfunction within a TIPS. (in cm/s)

A

> 50cm/s

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9
Q

In the setting of chronic cirrhosis, flow in the hepatic artery will be ______ resistance

A

Low resistance

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10
Q

What does RAR stand for?

A

Renal Aortic velocity ratio

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11
Q

When performing a renal artery stenosis exam, which two vessels do you use a sample gate with the angle correct on?

A

Renal artery and Aorta

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12
Q

another name for a dominant follicle is a _________ follicle

A

Graafian follicle

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13
Q

For ovarian Doppler, you should expect to decrease your ________ when evaluating for torsion

A

PRF

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14
Q

With an LMP, you need to know the ______ day of the last menstrual cycle.

A

First

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15
Q

Ovarian torsion causes the ovary to become edematous giving the ovarian a _________ echogenecity

A

HypOechoic

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16
Q

What two vessels supply oxygenated blood to the ovaries?

A

Uterine artery and ovarian artery

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17
Q

The left ovarian vein travels superiorly into what vessel?

A

Left renal vein

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18
Q

Term for the surgical removal of the ovary:

A

Oophorectomy

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19
Q

Color flow is a _____________ type of measurement.

A

Qualitative

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20
Q

With a properly placed ________, you will get a more accurate evaluation

A

Sample gate

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21
Q

To ensure accuracy, your angle correct should be set at _____ degrees or less.

A

60 degrees

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22
Q

_________ ultrasound is a vital component in evaluating the female pelvis

A

Doppler

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23
Q

Ovarian veins are known to _________ during pregnancy

A

Dilate

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24
Q

Once ruptured, the follicle turns into a ___________________

A

Corpus luteum

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25
Q

The ___________ sign represents the twisting of the ovaries, vascular pedicle

A

Whirlpool sign

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26
Q

Where does the ovarian artery originate?

A

Aorta

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27
Q

Normal parenchymal ovarian artery flow has ______ velocities

A

Low

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28
Q

List the vessels imaged for the mesenteric Doppler protocol:

A

Ao (prox, mid, distal)
Celiac axis
Hepatic artery
Splenic artery
SMA (prox, mid, distal)
IMA

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29
Q

Celiac and hepatic artery will have _______ resistance

A

Low

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30
Q

SMA while fasting needs to be ______ (____ resistance) with a brief period of flow reversal, and little to no flow in diastole

A

Triphasic, high resistance

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31
Q

IMA is going to have ______ flow characteristic as the SMA

A

The same

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32
Q

After the patient consumes approximately 16 to 20 fluid ounces of ________, Then you wait ______ minutes to go back and reevaluate the same vessels with color and pulse wave.

A

-a high calorie drink (such as boost or ensure)
-Wait 20 minutes

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33
Q

What we are looking for in the post prandial exam is a(n) _____ in the PSV and EDV in the _______

A

an
INCREASE
in PSV and EDV in the
SMA

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34
Q

There are only guidelines per the PSV/EDV for the ______ and the ______

A

SMA and Celiac axis

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35
Q

Renal artery is slightly __________ to the renal vein

A

Anterior

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36
Q

Sample gates on the Renal artery Doppler protocol must have the correct…

A

Size, placement, and angle correct (AO & renal artery only) in the direction of blood flow

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37
Q

Color Doppler can be fine tuned with _______

A

Scale

(Sensitivity = good)

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38
Q

Purpose of Renal artery stenosis evaluation:

A

-To evaluate the kidneys when the patient presents with sudden onset hypertension and/or fluctuating blood pressures

-To identify renal stenosis before renal failure occurs

39
Q

What is the primary imaging modality for Renal artery stenosis in possible surgical and non-surgical situations?

A

-u/s if the first choice for typical evaluation of the kidney

-CT is the first choice in cases of possible surgical situations

40
Q

Most common reason for a renal artery stenosis examination?

A

Any uncontrolled or sudden blood pressure issues and/or hypertension

41
Q

What type of flow occurs right before a stenosis in the renal artery

A

Laminar flow

42
Q

Flow directly after stenosis in the renal artery is __________

A

Turbulent

43
Q

Where in location of a stenosis in the renal artery do you check for blood flow?

A

Before, during, and after the stenosis.

44
Q

Renal Doppler protocol:

A

• Full Kidney protocol
• Doppler the arcuate arteries at upper, mid, & lower poles
• Doppler the renal vein
• Renal artery Doppler @ prox, mid, & dist ANGLE CORRECT
• Gray scale, color, and pulse wave of the mid aorta ANGLE CORRECT

45
Q

Why do you also evaluate the vein during a RAS exam?

A

To rule out thrombus (looks like slow flow in the vein)

46
Q

*
Formula for End Diastolic Ratio (EDR):

A

EDV / PSV = EDR

47
Q

What is a normal EDR?

A

> 0.2

48
Q
  • Formula for acceleration time (AT):
A
49
Q

What is a normal acceleration time (AT)?

A

<100 milliseconds

50
Q

How is renal artery stenosis most often treated?

A

With angioplasty and/or stunting

51
Q

Where are the calipers placed for acceleration time?

A

End diastolic pattern to early systolic peak

52
Q

Renal Aortic Ratio (RAR) formula:

A

Highest Renal Artery PSV / Aorta PSV

53
Q

Normal value for RAR:

A

<3.5

54
Q

Formula for resistive index (RI):

A

(PSV - EDV) / PSV

55
Q

Normal value for RI:

A

<0.8

56
Q

When there is torsion in the ovaries, you will image it in….

A

B-mode (grayscale), color Doppler, and power Doppler.

57
Q

Ovaries have what type of waveform?

A

Low resistance (10-35 cm/s)

58
Q

Arterial spectral waveform for an ovarian Doppler has an alternating _____ uptake and systolic peak and has _____ diastolic flow.

A

Quick uptake
Lower diastolic flow

59
Q

Left ovarian vein drains into the…

A

Left renal vein

60
Q

Right ovarian vein drains…

A

Directly into the IVC

61
Q

Venous spectral waveform on an ovarian Doppler has what type of flow in diastole?

A

continuous, low resistance recurring flow

62
Q

Venous spectral waveform on an ovarian doppler has what type of flow in systole?

A

Reduced flow signal

63
Q

What is used to detect the presence of blood flow in a select area at a known depth with a given sample gate?

A

Pulsed wave Doppler

64
Q

What is used along with PW doppler that allow for a more concise evaluation of a given vessel?

A

Sample gate

65
Q

When the waveform is above the baseline, flow is traveling…

A

Toward the transducer

66
Q

When the waveform is below the baseline, the flow is moving…

A

Away from the transducer

67
Q

What information does color Doppler provide?

A

Directional information and relative velocity of flow

68
Q

What is color Doppler dependent on?

A

Optimization of angles, the flow that is being interrogated, and the transducer

69
Q

Higher/faster velocities appear ______ in color

A

Brighter

70
Q

Slower velocities appear _______ in color

A

Darker

71
Q

What type of Doppler is used when more sensitivity is needed for subtle flow and is not dependent on specific Doppler angles?

A

Power Doppler

72
Q

What displays blood flow movement with no directional information

A

Power Doppler

73
Q

Ovarian flow patterns vary depending on…

A

The degree of torsion and duration

74
Q

While doing an ovarian Doppler examination, non-existent vascular flow is indicative of…

A

An oophorectomy

75
Q

List the classic sonographic signs of ovarian torsion:

A
  • Unilateral enlarged edematous with small peripheral follicles

-Little to no vascular flow

-Free fluid in the cul-de-sac

76
Q

Clinical/Physical symptoms of ovarian torsion:

A

lower abdominal pain
Fever
Nausea/vomiting
Peritoneal irritation

77
Q

Important patient history to get prior to ovarian Doppler exam:

A

-LMP
-G/P
-Surgical history
-Age

78
Q

What is the purpose of ultrasound for a TIPS procedure?

A

To examine the abdomen and determine the presence and amount of ascites.

79
Q

What is being assessed during a TIPs ultrasound examination?

A

-ascites
-any hepatic hematoma,
-biliary obstruction,
-debris in the GB or CBD.
-the shunt

80
Q

What is the usual placement of the shunt for a TIPS procedure?

A

between the right portal and right hepatic veins.

81
Q

(TIPS)
What is the normal appearance of the stent via ultrasound?

A

The stent is echogenic and looks like two parallel curvilinear lines.

82
Q

(TIPS)
During a Doppler interrogation, what is being sampled?

A

Velocity, flow direction and waveforms patterns are sampled

83
Q

(TIPS)
Velocity, flow direction and waveform patterns are sampled at the:

A

MPV
Portal vein end of shunt
Mid shunt
Hepatic vein end of shunt
Left portal vein
Hepatic artery

84
Q

Flow in a normal TIPS progresses (blank) the transducer, then will appear to be (blank) for a short segment (d/t the flow being perpendicular to the beam).

A

Progresses towards the transducer then appears absent for a short segment

85
Q

(TIPS)
As the shunt curves away from the probe, the color is…

A

displayed in a different hue.

86
Q

(TIPS)
In the MPV, flow will be (blank) before the shunt

A

hepatopedal

87
Q

(TIPS)
Flow will be (blank) at the Hepatic vein

A

Hepatofugal

88
Q

(TIPS)
Once at the mid of the shunt, flow is…

A

Hepatofugal

89
Q

After a TIPS placement, flow in the left portal vein is…

A

Hepatofugal

90
Q

(TIPS)
Velocities will vary widely throughout the shunt, usually increasing from the (blank) to the (blank)

A

portal venous end to the hepatic venous end

91
Q

(TIPS)
Velocities in the shunt range from…

A

50-190cm/sec.

92
Q

(TIPS)

What is the best means of documenting any changes within the shunt and will act as an early indicator of shunt compromise?

A

Serial evaluations

93
Q

When / how often is a patient scanned for a TIPS procedure?

A

The patient is usually scanned pre procedure, post procedure, 3 months post procedure, and then every 6 months to a year. This should be done at the same clinic or records

Scan Lab (2 decks)

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