US Guided Procedures Flashcards
Which of the following is a contraindication for harvesting of the greater saphenous vein?
A: Baker’s cyst in the ipsilateral popliteal fossa
B: Chronic obstruction of the peroneal veins
C: Valvular incompetence in the greater saphenous vein
D: Chronic obstruction of the femoral vein
D: Chronic obstruction of the femoral vein
Which of the following is true regarding compression techniques used to treat a pseudoaneurysm of the femoral artery in the groin?
A: Compression should be performed in 30 second intervals with color Doppler evaluation in between compressions
B: Blood pressure evaluation cannot be performed anywhere on the legs until the stalk to the pseudoaneurysm is closed
C: Pressure equivalent to 100mmHg should be performed in three ten minute intercals and if this does not close the stalk, alternative treatment must be considered.
D: Thrombin injection is more effective than compression techniques in pseudoaneurysms with large diameter stalks
D: Thrombin injection is more effective than compression techniques in pseudoaneurysms with large diameter stalks.
A patient is undergoing balloon angioplasty of the left CFA. The physician just completed the first expansion of the balloon and asks you to check the flow with Doppler. Where is the preferred location to evaluate flow?
A: Dorsalis pedis or posterior tibial artery
B: distal superficial femoral artery
C: proximal superficial femoral artery
D: popliteal artery
A: Dorsalis pedis or posterior tibial artery.
The physician is trying to increase flow distal to the obstruction. It is most important to evaluate flow in the most distal areas to evaluate improvement in overall perfusion of the leg.
Which of the following statements is false regarding intraoperative duplex evaluation during a carotid endarterectomy?
A: the highest probe frequency available is preferred for intraoperative duplex evaluation.
B: the probe is placed in direct contact on the vessel that is being evaluated so the sterile technique is required.
C: due to the increased attenuation of sound caused by air in the extracranial vessels, the lowest probe frequency available is preferred for the exam.
D: The technique is used to assess the immediate flow changes within the vessel undergoing the endarterectomy.
C: Due to the increased attenuation of sound caused by air in the extracranial vessels, the lowest probe frequency available is preferred for the exam.
The vessel should not contain air because it would become a cerebral embolism.
A patient presents for a follow up exam after a recent endarterectomy that was performed 3 days ago. The intraoperative report indicates a possible shelf lesion in the ICA. How will this be demonstrated on today’s exam?
A: <3mm intimal flap demonstrates a false lumen with turbulent flow
B: >3mm intimal flap that causes turbulence and increased velocity
C: <3mm intimal flap that causes turbulence and increased velocity
D: Hyperechoic plaque in the vessel lumen with an abrupt edge
D: Hyperechoic plaque in the vessel lumen with an abrupt edge.
The carotid artery is lacerated and the atheroma formation is scraped for removal in an endarterectomy.
What are some complications with an endarterectomy?
Intimal flap, dissection, shelf lesion (residual hyperechoic plaque in the lumen that has an abrupt edge), and platelet aggregate (hypoechoic/anechoic material adjacent to vessel wall that causes increased flow velocity)
You are evaluating a patient that had a balloon angioplasty on the proximal SFA 3 years ago. The acceleration time in the CFA is 230ms. This finding is most suggestive of:
A: recurrence of stenosis in the proximal superficial artery
B: normal arterial inflow
C: iliac artery stenosis
D: obstruction in the distal SFA
C: iliac artery stenosis
Accelerated flow is usually due to proximal stenosis. Iliac is the next proximal vessel from the CFA.
Which of the following techniques cannot be used to monitor distal flow in the leg while compression therapy for a pseudoaneurysm is performed?
A: PPG sensor on the ankle
B: Pressure monitor on the great toe
C: Doppler evaluation of the PTA or DPA
D: PPG sensor on the great toe
A: PPG sensor on the ankle
When PPG is used to evaluate ARTERIAL flow, the sensors are put on the great toes.
When PPG is used to evaluate VENOUS reflux, the sensor is placed on the calf near the ankle.
A patient presents for a pre-procedure scan for placement of a central venous catheter in the internal jugular vein. In order to avoid potential hematoma or AV fistula formation, the relationship of the vein to the ___ must be documented on today’s exam.
A: ICA
B: CCA
C: External jugular vein
D: Sternocleidomastoid muscle
B: CCA
If the CCA is punctured, serious complications can occur.
Where is the most common site of stenosis in a TIPS (transjugular intrahepatic portosystemic shunt)?
A: biliary anastomosis
B: portal vein anastomosis
C: hepatic artery anastomosis
D: hepatic vein anastomosis
D: Hepatic vein anastomosis
What is the preferred patient position during catheter RETRACTION in an endovenous laser ablation treatment?
A: standing
B: seated with legs dangling
C: Trendelenburg
D: reverse Trendelenburg
C: Trendelenburg
When catheter is INSERTED, reverse Trendelenburg is helpful.
When catheter is RETRACTED, Trendelenburg is best to reduce blood volume in the leg and help facilitate closure of the vein.
(The less blood in the vein, the easier to successfully treat the vein)
In most cases, a PICC line is inserted in the basilic vein exam and advanced until the tip reaches:
A: axillary vein
B: proximal subclavian vein
C: atriocaval junction
D: brachiocephalic vein
C: atriocaval junction
Which of the following is true regarding the initial post-op examination of a TIPS placement?
A: It helps establish baseline velocities for upcoming follow up exams
B: It should be performed within 30 days following the procedure.
C: Marked ascites is a common finding for the initial post op exam on a TIPS patient.
D: CTA is most commonly performed for the initial evaluation of a TIPS procedure.
A: It helps to establish baseline velocities for upcoming follow up exams
(Initial evaluation should be performed with Doppler US within 24 hours of shunt placement)
When Thrombin is injected in a pseudoaneurysm, the clotting should begin:
A: within 5-10 seconds post-injection
B: after one minute of manual compression following the injection
C: within 24 hours
D: within 5-10 minutes post injection
A: within 5-10 seconds post-injection
A physician orders a vein mapping of the left upper extremity for potential arterial bypass harvesting, but does not indicate which vessel he plans to use. Which vein is most commonly used for bypass?
A: radial vein
B: brachial vein
C: antecubital vein
D: cephalic vein
D: cephalic vein
