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Vascular II & Physics II > Vascular 25 & 32 > Flashcards

Vascular 25 & 32 Flashcards

1
Q

What percent of patients of HYPERtension have underlying renal disease

A

6%, test will say hypo and that is wrong

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2
Q

Renal artery stenosis should be suspected with (4)

A

sudden onset or worsening chronic HYPERtension, azotemia, unexplained renal insufficiency/pulmonary edema, hypertensive children

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3
Q

What is azotemia

A

high nitrogen compounds in the blood

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4
Q

What is the average kidney length

A

8-13cm (BE ABLE TO IDENTIFY A # WITHIN THIS RANGE)

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5
Q

Renal arteries are _____ to the _____ renal vein

A

inferior, left (KNOW THAT IT IS INFERIOR TO THE LEFT RENAL VEIN)

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6
Q

Renal arteries have ______ segmental branches ____ to the hilum

A

2-5, proximal

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7
Q

Duplicate renal arteries often arise from

A

aortic wall below main renal artery

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8
Q

Duplicate renal arteries usually occur on the

A

left side

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9
Q

Medial FMD and non-atherosclerotic disease affects

A

mid-to -distal segment of artery (MAY SAY SOMETHING ELSE ON TEST, KNOW THIS SEGMENT)

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10
Q

What produces “string of beads” appearance on ultrasound or angiogram

A

medial FMD (FMD ALWAYS MEANS STRING OF BEADS)

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11
Q

What is the sonographic appearance of FMD

A

string of beads, MULTIPLE segmental concentric narrowing and dilations

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12
Q

Renal arteries lie

A

INFERIOR TO LEFT RENAL VEIN

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13
Q

Normal renal length

A

9-13cm

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14
Q

Renal length >cm compared to contralateral kidney indeicates

A

compromised flow in smaller kidney

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15
Q

PSV of normal renal artery

A

90-120 cm/s

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16
Q

In normal renal artery, normal range for distal renal artery is

A

70-90cm/s

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17
Q

Flow0Reducing Renal Artery stensosis, PSV increases significantly above

A

180 cm/s (MORE THAN 180, VELOCITY INCREASES)

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18
Q

Characteristics of flow reducing renal artery stenosis are (3):

A

elevated velocity, post stenotic turbulence, dampened distal waveforms

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19
Q

Dampening parvus tardus signal distally showing greater than

A

60% renal artery stenosis

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20
Q

In renal artery occlusion, low velocity doppler signals are usually noted in the

A

renal medullary signals (ABSENCE OF FLOW)

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21
Q

PSV ______ and length _____ consistent with CHRONIC renal artery occlusion

A

<10cm/s, <9cm

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22
Q

Normal renal parenchymal signals demonstrate

A

continuous high diastolic flow

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23
Q

Normal renal parenchymal is ______ of systolic velocity

A

40-50%

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24
Q

Elevated renovascular resistance is

A

not a consideration (WITH 40-50% HIGH DIASTOLIC FLOW)

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25
Q

Parenchymal disease results in impedance to arterial inflow, diastolic-to-systolic velocity ration ____ or resistive index ______ indicates increased ____

A

<0.3, >0.8, renovascular resistance/medical renal disease

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26
Q

Acceleration index (AI) of ____ indicates proximal flow limiting lesion

A

<3.78

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27
Q

Acceleration time (AT) of ____ indicates proximal renal artery disease

A

> 100ms (ACCEL TIME IS WHEN FLOW STARTS TO WHEN FLOW PEAKS–HOW LONG)

28
Q

Renal-Aortic ration (RAR) of ____ is consistent with ____

A

> 3,5, >60% stenosis

29
Q

In renal vein thrombosis, what is the “nutcracker syndrome”

A

left renal vein compressed by mesentary or SMA (COMPRESSION OF LEFT RENAL VEIN)

30
Q

With renal stents, slight velocity increase is expected due to

A

reduction in ARTERIAL COMPLIANCE

31
Q

What resistive index is predictive of unsuccessful renal revascularization

32
Q

What is an RI of 0.9 predictive of? Is it useful?

A

unsuccessful renal revascularization, no

33
Q

What should you do first to saline for it to be used

34
Q

Microbubbles are (3)

A

nonuniform in size, relatively small, unstable (HOW WOULD YOU DESCRIBE MICROBUBBLES CAUSED BY AGITATION)

35
Q

What is a patent foramen ovale (PFO) also called

A

intracardiac shunt (RULLIGN OUT CARDIAC SHUNT)

36
Q

What size should the microbubbles be

A

less than 8 microns

37
Q

What are microbubble shells made of

A

human serum albumin, lipid, phosolipid

38
Q

Why is IV infusion also used

A

prolongedenhancement times

39
Q

What is a method that can prolong enhancement times

A

IV infusion

40
Q

To be clinically effective, tissue-specific agents must

A

affinity for target tissues, ability to alter tissue appearance

41
Q

What changes the signal impedance of normal or abnormal tissues

A

tissue specific agents

42
Q

Thrombus-specific agents (2):

A

attach to fibrin, enhance thrombus detection

43
Q

What type of agent helps with thrombus detection

A

tissue specific

44
Q

Ability to enhance the lysis of thrombus using targeting ultrasound contrast agents and ultrasound energy

A

sonothrombolysis (KNOW THIS DEFINITION)

45
Q

Harmonic imaging is ____ and also called ____

A

twice the transmit frequency (second harmonic)

46
Q

Harmonics is sending out ___ and receiving ____

47
Q

Harmonic imaging have a ____ signal-to-noise ration

48
Q

What will improve with harmonics

A

better signal/resolution

49
Q

What is a contrast-specific equipment modification

A

low mechanical index (MI)

50
Q

What minimizes destruction of microbubbles

51
Q

Top two uses for contrast are

A

echocardiography, liver evaluation

52
Q

Contrast agents can be used to differentiate ____ from _____

A

stenosis, occlusion

53
Q

Contrast agents increase visualization of

A

iliac arteries with bowel gas

54
Q

How does contrast aid in peripheral arteries

A

poor visualization of deeply located or small vessels, low veloctiy flow, low volume blood flow

55
Q

Contrast agents can be used to increase the diagnostic accuracy in identifying thrombus at what percent

56
Q

Evaluation of carotid artery vasa vasorum and plaque neovascularity may prove to be useful to identify _____ and determine _____

A

vulnerable plaques, risk of cardiovascular events

57
Q

Hepatic applications can be used to

A

enhance detection and characterization of hepatic masses, assess flow through transjugular intrahepatic portosystemic shunt (TIPS)

58
Q

Hepatic applications improve detection of ____ both in ____ and those with ____

A

intra and extrahepatic blood flow, normal subjects, portal hypertension

59
Q

In renal artery stenosis, evaluation of main renal and intrarenal vesses limited by what anatomical variants

A

duplicate or accessory renal arteries

60
Q

Contrast agents are useful in exams and have

A

reduced exam times

61
Q

For organ transplants, contrast agents improve assessment of blood flow leading to the transplant as well as within

A

the parenchyma of the transplanted organ

62
Q

Contrast agents improves ability to detect what in native and transplant organs

A

ischemic regions

63
Q

Contrast has the ability to _____ in real time using CES improves _____ and ______

A

assess blood flow, detection, characteristics of endoleaks

64
Q

Contrast has the ability to _____ in real time using CES improves _____ and ______

A

assess blood flow, detection, characteristics of endoleaks

65
Q

Peripheral arterial applications (3):

A

differentiate stenosis from occlusion, increase visualization of iliac arteries with bowel gas, degree of arterial collateralization

Vascular II & Physics II (21 decks)

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