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Vascular Sonography > Vascular Finals multiple choice questions from Workbook > Flashcards

Vascular Finals multiple choice questions from Workbook Flashcards

1
Q

What determines the propagation speed of sound?

a. the source of the sound
b. the thickness of the piezoelectric crystal
c. the medium through which the sound is moving
d. both the sound source and the medium

A

C

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2
Q
  1. What is the number of pulses per second emitted by an ultrasound system called?

a. spatial pulse length
b. pulse repetition frequency
c. pulse repetition period
d. pulse duration

A

B

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3
Q

What information is needed in order to determine spatial pulse length?

a. frequency and wavelength
b. propagation speed and the number of cycles per pulse
c. wavelength and the number of cycles per pulse
d. period and pulse repetition frequency

A

C

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4
Q

What is the percentage of time the machine is transmitting sound in to the patient called?

a. pulse repetition period
b. duty factor
c. acoustic impedance
d. frame rate

A

B

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5
Q

What is the minimum number of piezoelectric elements necessary to perform continuous-wave Doppler?

a. one
b. two
c. three
d. ten

A

B

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6
Q

Which of the following has the highest attenuation?

a. water
b. muscle
c. bone
d. air

A

C

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7
Q

What type of reflection results when sound encounters structures that are smaller than the transmitted beam’s wavelength?

a. specular
b. non-specular
c. refractory
d. Rayleigh scattering

A

B

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8
Q

Which of the following must be present for reflection to occur?

a. acoustic impedance mismatch
b. difference in propagation speeds between two media
c. structures much smaller than the ultrasound beam’s wavelength
d. a change in the direction of
the sound beam

A

A

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9
Q

What is a change in direction of the transmitted beam at an interface called?

a. reflection
b. backscatter
c. refraction
d. attenuation

A

C

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10
Q

On a spectral display, what is represented on the vertical axis?

a. time
b. velocity
c. signal amplitude
d. depth

A

B

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11
Q

What is a complex processing technique that converts complex frequency shifts into a spectral waveform?

a. fast Fourier transform
b. spectral broadening
c. autocorrelation
d. Nyquist criterion

A

A - FFT

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12
Q

Which of the following describes sending multiple pulses down one scan line to create a color Doppler image?

a. Nyquist criterion
b. ensemble length
c. autocorrelation
d. fast Fourier transform

A

B

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13
Q

Which processing technique results in better lateral resolution and reduces reverberation artifact?

a. spatial compounding
b. tissue harmonic imaging
c. time gain compensation
d. fast Fourier transform

A

B

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14
Q

During an ultrasound evaluation of the aorta, a surgical clip is encountered. What artifact would likely be present owing to this clip?

a. shadowing
b. comet tail
c. enhancement
d. mirror image

A

B - for metallic objects whereas ring-down is for gas/air bubbles

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15
Q

What is an artifact caused by wall motion that can be reduced by using a wall filter?

a. clutter
b. mirror image
c. reverberation
d. grating lobes

A

A

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16
Q

Why can arterioles control the resistance of the vascular bed?

a. They have concentric layers of smooth muscle cells.
b. They are the smallest arteries in the circulatory system.
c. They are the vessels leading to the capillaries.
d. They have all three main layers of tissue: intima, media, and adventitia.

A

A

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17
Q

Which of the following is NOT an example of a large elastic artery?

a. the common carotid arteries
b. the superficial femoral arteries
c. the common iliac arteries
d. the aorta

A

B

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18
Q

Which of the following is NOT an example of a large vein?

a. the portal vein
b. the inferior vena cava
c. the superior vena cava
d. the brachial vein

A

D

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19
Q

Which statement regarding the first branch of the internal carotid artery is TRUE?

a. The ophthalmic artery is usually the first branch at the petrous level.
b. The ophthalmic artery is usually the first branch at the cavernous level.
c. The ophthalmic artery is usually the first branch at the cerebral level.
d. The internal carotid artery does not have branches.

A

C

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20
Q

Which statement regarding the venous drainage of the head and neck is FALSE?

a. Drainage occurs in the posterior portion via vertebral veins.
b. Vertebral veins are formed by a dense venous plexus.
c. The external jugular veins drain into the brachiocephalic veins.
d. The internal jugular veins drain into the brachiocephalic veins.

A

C

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21
Q

Which tissues do branches of the right or left subclavian arteries supply?

a. the brain and neck
b. the thoracic wall and shoulder
c. the aortic arch
d. both A and B

A

D

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22
Q

Which of the following are the terminal branches of the popliteal artery?

a. the tibial and peroneal arteries
b. the genicular and sural arteries
c. the anterior and posterior tibial arteries
d. the anterior tibial artery and tibioperoneal trunk

A

D

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23
Q

Typically, what happens as the popliteal vein and artery pass through the adductor canal?

a. The vein moves from medial to lateral of the artery.
b. The vein moves from lateral to medial of the artery.
c. The vein moves from anterior to posterior of the artery.
d. The vein moves from posterior to anterior of the artery.

A

B

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24
Q

Which of the following statements regarding the gravitational energy and hydrostatic pressure is FALSE?

a. They are components of the total energy in the vascular system
b. They tend to cancel each other
c. They are components of the kinetic energy in the vascular system
d. They are expressed in relation to a reference point.

A

C

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25
Q

What causes blood in the vascular system to move from one point to the next?

a. hydraulic filtering
b. pressure or energy gradient
c. hydrostatic pressure
d. inertia

A

B

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26
Q

Which of the following statements regarding the velocity of the blood flow is FALSE?

a. Velocity refers to the rate of displacement of blood in time.
b. The velocity of the blood increases from the capillaries to the venous system.
c. The velocity of the blood increases from the aorta to the capillaries.
d. The velocity of the blood changes with cross-sectional area of the vessels.

A

C

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27
Q

In the vascular system, what represents the potential difference or voltage in Ohm’s law?

a. volume flow
b. resistance
c. pressure gradient
d. vessel radius

A

C

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28
Q

When vessels are arranged in parallel, how does this affect the entire system?

a. lower total resistance than when vessels are in series
b. higher total resistance than when vessels are in series
c. does not affect the total resistance of a system
d. disrupts flow in collaterals

A

A

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29
Q

Which of the following characterizes low-resistance flow?

a. retrograde flow
b. alternating antegrade/retrograde flow
c. antegrade flow
d. constriction of arteriolar bed

A

C

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30
Q

Which of the following characteristics regarding high-resistance flow is FALSE?

a. The flow profile may be two to three phases.
b. The flow displays alternating antegrade/retrograde flow.
c. The flow profile is due to vasoconstriction of arterioles.
d. The flow profile is due to vasodilation of arterioles.

A

D

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31
Q

Which of the following statements regarding laminar flow is FALSE?

a. The layers of cells at the center of the vessels move the fastest.
b. The layers of cells at the wall of the vessels do not move.
c. The velocity at the center of the vessels is half the mean velocity.
d. The difference in velocities between layers is due to friction.

A

C

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32
Q

What is required to move blood flow in a turbulent system?

a. higher velocities
b. greater pressure
c. larger radius
d. smaller radius

A

B

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33
Q

What is the function of the hydraulic filter of the arterial system (composed of the elastic arteries and high-resistance arterioles)?

a. Ensure adequate gas/nutrient exchange in the arteries.
b. Convert the cardiac output flow to steady flow.
c. Ensure adequate conduction of the pressure wave.
d. Distribute flow to the capillaries.

A

B

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34
Q

How is the resistance in the arterial system controlled?

a. By the contraction and relaxation of smooth muscle cells in the media of arterioles.
b. By the contraction and relaxation of the heart.
c. By the contraction and relaxation of muscle cells in the surrounding tissue.
d. By the capacitance of the arterial system.

A

A

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35
Q

Which of the following statements about collateral vessels is FALSE?

a. Collaterals are preexisting pathways.
b. The resistance in collaterals is mostly fixed.
c. Vasodilator drugs have a large effect on collaterals.
d. Midzone collaterals are small intramuscular branches.

A

C

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36
Q

Approximately how much blood does the venous portion of the vascular system hold?

a. 66% to 67% of the total volume of blood
b. One-third of the total volume of blood
c. 3% to 4% of the total volume of blood
d. Half of the total volume of blood

A

A - 2/3rds

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37
Q

Which statement about the resistance of the venous system is NOT correct?

a. Veins offer resistance to flow through increase in pressure.
b. Veins offer natural resistance to flow in some areas of the body.
c. An elliptical shape in the vein increases the resistance.
d. A circular shape in the vein decreases the resistance.

A

A

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38
Q

In a 6-foot-tall individual in a standing position, hydrostatic pressure will add approximately how much to the measured pressure at the ankle?

a. 170 mm Hg
b. 100 mm Hg
c. 15 mm Hg
d. 20 mm Hg

A

B

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39
Q

What is the pressure gradient across the capillary bed in an uplifted arm owing to the change in hydrostatic pressure?

a. 100 mm Hg
b. 80 mm Hg
c. 40 mm Hg
d. 20 mm Hg

A

C

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40
Q

Once a vein has acquired a circular shape, how can the volume of blood in the vessel only change with?

a. large increase of pressure
b. little increase of pressure
c. no increase of pressure
d. negative pressure

A

A

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41
Q

When an individual moves from a supine to a standing position, which of the following pressures specific to the venous system increases?

a. osmotic pressure
b. hydrostatic pressure
c. transmural pressure
d. gravitational force

A

C - pressure within the vein

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42
Q

How does the action of the calf muscle pump, under normal circumstances, offset fluid loss in interstitial tissue?

a. It helps increase the venous pressure.
b. It helps decrease the venous pressure.
c. It helps decrease the osmotic pressure.
d. It helps decrease the interstitial pressure.

A

B

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43
Q

Under normal circumstances, the inspiration phase of respiration results in all of the following EXCEPT:

a. an ascent of the diaphragm.
b. a descent of the diaphragm.
c. an increase in intra-abdominal pressure
d. A decrease in intra-thoracic pressure.

A

A

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44
Q

With total or partial thrombosis of proximal major veins of the lower extremities, what action is not unusual for the flow profile from distal nonoccluded veins to do?

a. To change from continuous to phasic
b. To change from phasic to pulsatile
c. To change from pulsatile to phasic
d. To change from phasic to continuous

A

D

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45
Q

How are primary varicose veins distinguished from secondary varicose veins?

a. Do not affect the small saphenous vein.
b. Develop in the absence of deep venous thrombosis.
c. Do not rely on the calf muscle pump.
d. Do not rely on proper valve closure in the deep veins.

A

B

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46
Q

Increased pressure in the distal venous system seen in secondary varicose veins is because of all of the following EXCEPT:

a. distal obstruction of the venous system
b. bidirectional flow in the perforators.
c. increased pressure in the deep venous system. d. increased pressure in the superficial venous system

A

A

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47
Q

What caused venous distension during pregnancy?

a. an increased venous flow velocity
b. incompetent valves
c. an increased compliance of the veins
d. compression of the superior vena cava

A

C

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48
Q

What does a continuous venous flow profile from veins of the lower extremities mean?

a. The flow is no longer responsive to pressure changes from respiration.
b. The flow is increased in pregnancy.
c. It is the result of incompetent valves in the deep system.
d. It is the result of incompetent valves in the superficial system

A

A

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49
Q

What are the major physiology components governing blood flow in the venous system?

a. venous capacitance
b. transmural pressure
c. hydrostatic pressure
d. all of the above

A

D

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50
Q

What is the SECONDARY goal of examination of the extra-cranial carotid artery system by duplex ultrasound?
a.To identify patients at risk for stroke
b. To diagnose fibromuscular dysplasia
c. To document progression of disease
d. To screen for iatrogenic problems

A

C

51
Q

A patient presents to the vascular lab for a carotid-vertebral duplex examination. Upon questioning, the patient reveals a 2-week history of intermittent blindness in the right eye. The symptoms resolve within a few seconds. What would these symptoms indicate?

a. CVA
b. RIND
c. TIA
d. DVT

A

C

52
Q

What is the most common technique used to identify the vertebral artery?

a. View the common carotid artery and angle the transducer slightly posteriorly.
b. View the subclavian artery and angle the transducer superiorly.
c. View the basilar artery and angle the transducer inferiorly.
d. View the vertebral processes and angle the transducer medially.

A

A

53
Q

When qualifying the appearance of plaque by ultrasound, the use of which of the following terms is discouraged owing to poor reliability?

a. homogeneous/heterogeneous
b. smooth/irregular
c. ulcerated
d. calcified

A

C

54
Q

In a normally hemodynamically low-resistance system or vessel, such as the internal carotid and vertebral arteries, what will a change to high- resistance pattern suggest?

a. proximal stenosis or occlusion
b. distal stenosis or occlusion
c. steal syndrome
d. normal change because of exercise

A

B

55
Q

Which of the following is NOT a characteristic of normal Doppler waveform contour?

a. brisk systolic acceleration
b. sharp systolic peak
c. increased spectral broadening
d. clear spectral window

A

C

56
Q

What type of flow is characterized by a blunted, resistive waveform that often occurs before total occlusion?

a. steal flow
b. tardus parvus flow
c. bidirectional flow
d. string sign flow

A

D

57
Q

A patient presents to the vascular lab with a severe distal CCA obstruction; however, the internal carotid and external carotid artery remain patent. What is this lesion typically called?

a. subclavian steal syndrome
b. string sign lesion
c. choke lesion
d. tardus parvus lesion

A

C

58
Q

During duplex evaluation of the carotid artery system, velocities in the external carotid artery reached 250 cm/s, and turbulence was noted just after the area of increased velocity. What do these findings suggest?

a. >50% stenosis
b. Normal findings for the ECA
c. 50% to 79% stenosis
d. >80% stenosis

A

A

59
Q

What is a likely source of the symptoms in patients under 50 years of age presenting to the vascular lab with symptoms of stroke (without typical risk factors)?

a. dissection of one of the carotid vessels
b. stenosis due to atherosclerosis
c. carotid body tumor
d. tortuous distal ICA with kinking of the vessel

A

A

60
Q

When performing Doppler on a tortuous internal carotid artery, how should the cursor be aligned if a velocity measurement must be made on a curved segment of the artery?

a. Set the angle cursor so that it is at the inside of the curve.
b. Set the angle cursor so the middle of the cursor is parallel to the walls and center stream.
c. Set the angle cursor so the end of the cursor is parallel to the walls and at the highest point of the curve
d. Set the angle cursor where the highest
velocities are indicated by color Doppler.

A

B - in the middle

61
Q

Which of the following is a major feature that should be present for a diagnosis of dissection?

a. a color pattern clearly showing two flow directions in the true lumen
b. identifiable thrombus within false lumen
c. atherosclerosis along the posterior wall
d. a hyperechoic (white/bright) line in the lumen of the artery

A

D

62
Q

Which condition consists of a repetitive pattern of narrowing and small dilatation in an internal carotid artery, giving the appearance of a “string of beads”?

a. dissection
b. aneurysms
c. fibromuscular dysplasia
d. presence of enlarged lymph nodes

A

C

63
Q

In a patient with hypertension, incidental diagnosis of fibromuscular dysplasia in the carotid artery system should lead to follow-up evaluation of
which vessel(s)?

a. subclavian arteries
b. renal arteries
c. intracranial vessels
d. aorta

A

B

64
Q

Which of the following describes a vessel diameter measuring >200% of the diameter of a normal section of the ICA or >150% of the CCA?

a. true aneurysm of carotid vessels
b. large carotid bulb
c. normal carotid bulb
d. pseudoaneurysm

A

A

65
Q

Why is it important to thoroughly evaluate the vessel wall of the artery where a perforation led to a pseudoaneurysm?

a. Aliasing is very likely at the area of the perforation.
b. Dissection may occur along the vessel wall.
c. Thrombosis is likely to occur in that area.
d. Plaque is often present in that area.

A

A

66
Q

A 62-year-old female presents to the vascular lab a pulsatile mass in her neck, and hoarseness in her voice is noticed. What would you suspect?

a. carotid body tumor
b. spontaneous dissection
c. fibromuscular dysplasia
d. common carotid artery aneurysm

A

D

67
Q

Why is it crucial to survey the entire visible length of the vessel when evaluating the superficial temporal artery for signs of temporal arteritis?

a. The inflamed area is not continuous.
b. The vessel is often tortuous.
c. Dissections are often present locally.
d. Areas of dilatation are present locally.

A

A

68
Q

A 60-year-old female presents to the vascular lab with history of headaches and tenderness in the temporal area as well as jaw claudication. What would you suspect?

a. Takayasu’s disease
b. carotid body tumor
c. giant cell arteritis
d. spontaneous dissection

A

C

69
Q

A 75-year-old male with long-lasting history of COPD presents in the vascular lab for evaluation of his carotid arteries. An incidental mass is visualized at the carotid bifurcation on the right side, splaying the internal and external carotid arteries. What would you suspect?

a. spontaneous dissection
b. carotid body tumor
c. giant cell arteritis
d. Takayasu’s disease

A

B

70
Q

You are asked to evaluate a pulsatile neck mass in an 80-year-old female with recent placement of a central line in the right internal jugular vein. What would you suspect?

a. a pseudoaneurysm
b. an enlarged lymph node
c. a carotid body tumor
d. a dissection

A

A

71
Q

In which of the following patients would an abdominal aortic aneurysm most likely be found?

a. a 69-year-old male
b. a 75-year-old female
c. a 37-year-old male
d. a 28-year-old female

A

A

72
Q

To visualize the deep vessels of the abdomen, what transducer frequency is most commonly used?

a. 7to10MHz
b. 2to5MHz
c. 5to8MHz
d. 1to2MHz

A

B

73
Q

What is the most common location for abdominal aortic aneurysms?

a. suprarenal
b. at the level of the superior mesenteric artery
c. infrarenal
d. proximal aorta just as it passes through the diaphragm

A

C

74
Q

At what diameter is the abdominal aorta considered aneurysmal?

a. 1cm
b. 2cm
c. 3cm
d. 3mm

A

C

75
Q

What shape are most aortic aneurysms?

a. fusiform
b. saccular
c. mycotic
d. dissecting

A

A

76
Q

As an abdominal aortic aneurysm enlarges, what does it also tend to do?

a. elongate
b. foreshorten
c. straighten
d. constrict

A

A

77
Q

To get the most accurate diameter measurement of the abdominal aorta, how should the technologist align the transducer to the vessel?

a. parallelly
b. obliquely
c. perpendicularly
d. sagittally

A

C

78
Q

When viewing the abdominal aorta in transverse, which dimension provides the most accurate diameter measurement?

a. anterior to posterior
b. right to left lateral
c. superior to inferior
d. All are equally accurate.

A

A

79
Q

During an aortoiliac duplex examination, the distal aorta measures 2.5 cm in diameter. What are these findings consistent with?

a. normal aortic dimension
b. aortic ectasia
c. aortic aneurysm
d. aortic dissection

A

B - ectasia < 3cm and aneurysm > or = 3cm

80
Q

What landmark is used to determine the end of the common iliac artery and beginning of the external iliac artery?

a. inguinal ligament
b. origin of internal iliac artery
c. umbilicus
d. iliac crest

A

B

81
Q

What is an important reason to follow up with patients after aortoiliac intervention with duplex ultrasound?

a. Follow-up and treatment of restenosis may improve patency rates.
b. Occlusion is easier to manage than stenosis.
c. Angioplasty and stenting do not have significant restenosis rates.
d. Duplex ultrasound is not used for follow-up

A

A

82
Q

When evaluating a stent within the aortoiliac system, which of the following is FALSE?

a. Stent alignment should be visualized.
b. Full deployment of stent should be documented.
c. Relationship of stent to vessel wall is needed.
d. Evaluation of the vessel distal to the stent is not needed

A

D

83
Q

A 65-year-old male presents to the vascular lab for evaluation of the abdomen after involvement in a car accident. During the duplex examination, an asymmetric outpouching is identified in the mid to distal aorta. What do these findings represent?

a. fusiform aneurysm
b. saccular aneurysm
c. aortic dissection
d. aortic stenosis

A

B

84
Q

Upon duplex evaluation of a known abdominal aortic aneurysm, homogeneous echoes with smooth borders are visualized with the aneurysm sac. What do these findings suggest?

a. calcifications
b. atherosclerotic plaque
c. thrombus formation
d. vessel dissection

A

C

85
Q

During Doppler evaluation of the abdominal aorta, two flow channels are noted. What do these findings suggest?

a. fusiform aneurysm
b. saccular aneurysm
c. aortic dissection
d. aortic stenosis

A

C

86
Q

A 76-year-old female patient presents to the vascular lab with left hip and buttock claudication. During the duplex evaluation, velocities in the distal common iliac artery are 72 cm/s, whereas velocities in the proximal external iliac artery are 302 cm/s. Which of the following has occurred?

a. >50% stenosis in the proximal external iliac artery
b. <50% stenosis in the
c. proximal external iliac artery >50% in the distal common iliac artery
d. external iliac artery dissection

A

A

87
Q

What is the goal of EVAR?

a. Reduce the size of the aortic lumen.
b. Occlude the aorta to avoid aortic rupture.
c. Exclude the aneurysm sac from the general circulation.
d. Increase the size of the aorta to treat stenosis

A

C

88
Q

Which of the following is the most frequently deployed stent graft device?

a. bifurcated
b. straight tube
c. uni-iliac graft
d. fenestrated grafts

A

A

89
Q

During the evaluation of an aortic stent graft, the vascular technologist notes a hyperechoic signal along the anterior and posterior walls of the aortic lumen just below the level of the renal arteries. What does this finding suggest?

a. kinking of the stent graft
b. normal findings of the proximal attachment site
c. endoleak at the proximal graft site
d. graft bifurcation at the distal attachment site

A
90
Q

Which of the following is NOT an indication of aneurysm sac instability after EVAR?

a. increase in sac size
b. pulsatility of the sac
c. decrease in size of aneurysm sac
d. areas of echolucency within the sac

A

C

91
Q

An 80-year-old male presents for follow-up after endovascular treatment of his AAA. During the evaluation, the stent graft is identified and appears to be in a correct position by B-mode; however, the aortic diameter is 5.5 cm compared to 4.9 cm on previous examination. Doppler evaluation is then performed, and flow is identified along the posterior aorta outside the stent graft material. What is the likely cause of these findings?

a. kinking of the stent graft material
b. stent graft endoleak
c. migration of the stent graft causing stenosis
d. normal findings after stent graft placement

A

B

92
Q

What is the normal length measurement of the kidney?

a. 4to5cm
b. 8to13cm
c. 10to15cm
d. 5to7cm

A

B

93
Q

What are the triangular-shaped structures within the inner portion of the kidney that carry urine from the cortex to the renal pelvis?

a. nephrons
b. columns of Bertin
c. renal pyramids
d. renal calyces

A

C

94
Q

The right renal artery initially courses ________________ from the aorta, then passes ________________ to the inferior vena cava.

a. posterolateral, anterior
b. posterior, superior
c. anterolateral, lateral
d. anterolateral, posterior

A

D

95
Q

In which of the following renal artery segments does atherosclerotic disease in the renal artery typically occur?

a. origin to proximal third
b. distal renal artery just before entering the kidney c. mid-to-distal segment
d. interlobar arteries within the renal parenchyma

A

A

96
Q

Which of the following patients would be suspected of fibromuscular dysplasia in the renal artery?

a. an 85-year-old diabetic male
b. a 66-year-old female with a history of well-controlled hypertension and
c. smoking a 25-year-old male with chronic asthma
d. a 32-year-old female with poorly controlled hypertension

A

D

97
Q

At which level is a spectral Doppler waveform with peak systolic velocity needed from the aorta for use in the renal–aortic ratio?

a. proximal, at the level of the celiac and superior mesenteric arteries
b. mid, at the level of the renal arteries
c. distal, at the level of the inferior mesenteric artery
d. distal, at the level of the common iliac bifurcation

A

A

98
Q

To identify the renal artery ostia from a midline approach, an image is obtained from which location?

a. transverse, at the level of the celiac artery
b. sagittal, at the level of the celiac artery
c. transverse, slightly inferior to the superior mesenteric artery
d. sagittal, slightly superior to the left renal vein

A

C

99
Q

Using which angle of insonation are flow patterns within the kidney parenchyma typically obtained with a spectral Doppler?

a. 60 degrees
b. 90 degrees
c. 0 degrees
d. 45 degrees

A

C

100
Q

When comparing renal length from side to side, how much of a difference suggests compromised flow in the smaller kidney?

a. 1cm
b. 2mm
c. 3mm
d. 3cm

A

A - says in the slides

101
Q

Which of the following describe normal spectral Doppler waveform characteristics in the renal artery?

a. high-resistance, minimal diastolic flow with velocities in the range of 90 to120 cm/s
b. low-resistance, high-diastolic flow with velocities in the range of 90 to 120 cm/s
c. low-resistance, minimal diastolic flow with velocities in the range of 10 to 120 cm/s high-resistance
d. high-diastolic flow with velocities in the range of 50 to 70 cm/s

A

B

102
Q

A patient presents to the vascular laboratory for a renal artery duplex evaluation. During the examination, velocities in the right renal artery origin reach 175 cm/s with no evidence of poststenotic turbulence. Velocities on the left were 100 cm/s. What do these findings suggest?

a. right renal artery stenosis <60%
b. left renal artery stenosis <60%
c. right renal artery stenosis >60%
d. left renal artery stenosis >60%

A

A - velocity is less than 180 cm/s which indicates < 60% stenosis

103
Q

Which of the following spectral Doppler waveform changes will NOT occur distal to a hemodynamically significant stenosis of the renal artery?

a. delayed systolic upstroke
b. loss of compliance peak
c. decreased peak systolic velocity
d. increased peak systolic velocity

A

D

104
Q

Which of the following findings within the kidney are consistent with renal artery occlusion?

a. kidney length of >10 cm, velocities less than 10 cm/s in the renal cortex
b. kidney length of <9 cm, velocities less than 10 cm/s in the renal cortex
c. kidney length >13 cm with no detectable flow within the renal parenchyma
d. kidney length <9 cm, velocities greater than 20 cm/s in the renal cortex

A

B

105
Q

What is measured to determine acceleration time?

a. onset of systole to the early systolic peak
b. onset of systole to the end of diastole
c. onset of diastole to the early systolic peak
d. end diastole to end systole

A

A

106
Q

During a renal artery duplex exam, proximal aortic velocities of 100 cm/s, proximal right renal artery velocity of 200 cm/s, and proximal left renal artery velocities of 400 cm/s were found. Which of the following describes these findings?

a. right RAR = 2.0, <60% stenosis; left RAR = 0.4, <60% stenosis
b. right RAR = 0.2, >60% stenosis, left RAR = 0.4, >60% stenosis
c. right RAR = 2.0, <60% stenosis; left RAR = 4.0, >60% stenosis
d. right RAR = 0.2, >60% stenosis; left RAR = 4.0, <60% stenosis

A

C
the RAR for >60% is greater than or equal to 3.5
> 60% stenosis is >180cm/s
<60% stenosis is 100-180cm/s

107
Q

Under which conditions is the renal to aortic ratio likely inaccurate?

a. The abdominal aortic velocities are between 75 and 90 cm/s
b. The abdominal aortic velocities are over 100 cm/s or below 40 cm/s
c. The renal artery velocities exceed 300 cm/s
d. The renal artery velocities are below 100 cm/s

A

B

108
Q

During renal duplex evaluation, the left renal vein near the hilum is noted to have continuous, nonphasic low-velocity flow. What do these findings suggest?

a. renal artery stenosis
b. normal renal vein findings
c. proximal renal vein thrombosis
d. distal renal vein thrombosis

A

C - scanning at the hilum, blood is flowing towards IVC which is AWAY from the hilum. Thrombus must be proximal TO THE BODY as there is still flow at the hilum.

109
Q

Which of the following vessels extends as the external iliac vein?

a. common iliac vein
b. great saphenous vein
c. common femoral vein
d. inferior vena cava

A

C

110
Q

In well-hydrated patients, what is the mean diameter of the inferior vena cava at the level of the renal veins?

a. 17to20mm
b. 10to15mm
c. 2to3cm
d. 3to5cm

A

A

111
Q

Where does the left-sided IVC in a duplicate system typically terminate?

a. splenic vein
b. right renal vein
c. superior mesenteric vein
d. left renal vein

A

D

112
Q

Upon ultrasound examination, the hepatic veins are noted to drain directly into the right atrium. What does this finding suggest?

a. normal findings in the hepatic veins
b. congenital absence of the inferior vena cava
c. membranous obstruction of the intrahepatic IVC
d. duplicate inferior vena cava syndrome

A

B

113
Q

From a coronal plane in the left lateral decubitus position, what landmark can be used to identify the confluence of the common iliac veins to create the IVC?

a. superior pole of the right kidney
b. left lobe of the liver
c. inferior pole of the right kidney
d. inferior pole of the left kidney

A

C

114
Q

What is the most common pathologic finding in the IVC and iliac veins?

a. tumor extension from renal cell carcinoma
b. thrombus extension from deep venous thrombosis in the legs
c. isolated thrombosis of the IVC
d. venous dissection through the iliac veins

A

B

115
Q

Newly formed thrombus appears virtually _______________, whereas more advanced thrombus appears _______________.

a. hyperechoic, anechoic
b. hyperechoic, hypoechoic
c. hypoechoic, hypoechoic
d. anechoic, hyperechoic

A

D

116
Q

From what do intraluminal tumors in the inferior vena cava most commonly arise?

a. pancreatic carcinoma
b. colon carcinoma
c. renal cell carcinoma
d. bladder carcinoma

A

C

117
Q

In what ways can color-flow Doppler be particularly useful in identifying tissue bruits and pulsatile flow?

a. filter perforation
b. deep venous thrombosis
c. tumor extension
d. aortocaval fistula

A

D

118
Q

During spectral Doppler analysis of the iliac system, continuous flow is noted in the common iliac veins bilaterally. What does this finding suggest?

a. obstruction in the common iliac veins
b. obstruction in the common femoral veins
c. obstruction in the inferior vena cava
d. normal findings in the common iliac veins

A

C - continuous flow denotes a PROX obstruction. What is proximal to the common iliac veins?

119
Q

What is the condition that occurs when the left common iliac vein is compressed between the overlying right common iliac artery and underlying vertebral body?

a. May–Thurner’s syndrome
b. Raynaud’s syndrome
c. Arcuate ligament syndrome
d. Paget–Schroetter’s syndrome

A

A

120
Q

What is filter placement in the inferior vena cava designed to prevent?

a. thrombus extension from the lower extremities
b. pulmonary embolus
c. thrombus extension from the intrahepatic inferior vena cava
d. tumor extension from the renal veins

A

B

121
Q

Which of the following is a dependable marker for ultrasound identification of the level of the renal veins for IVC filter placement?

a. superior mesenteric artery
b. superior mesenteric vein
c. left renal vein
d. right renal artery

A

D

122
Q

On sonographic evaluation, which of the following describes the appearance of an IVC filter?

a. hypoechoic, circular rings within the IVC lumen
b. hyperechoic, circular rings within the IVC lumen
c. echogenic lines that converge to a point
d. hypoechoic lines that converge to a point

A

C

123
Q

Which of the following large deep veins are commonly bifid?

a. the profunda and popliteal veins
b. the femoral and popliteal veins
c. the external iliac and femoral veins
d. the common femoral and popliteal veins

A

B

124
Q

Which vessels are NOT routinely evaluated in a lower extremity venous duplex examination?

a. femoral vein
b. great saphenous vein
c. anterior tibial veins
d. small saphenous vein

A

C

Vascular Sonography (17 decks)

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