Vascular Intervention Flashcards
The tibial pulse is felt where?
Just posterior to the lateral malleolus
At the top of the foot
Behind the knee
Just posterior to the medial malleolus
Just posterior to the MEDIAL malleolus
What is used to enlarge an entry site and provide smoother, safer access for multiple exchanges and difficult catheter manipulations?
Glide wires
Sheaths
Dilators
Peel aways
Sheaths
Who or what allows a last image to be displayed after the exposure has stopped?
Digital fluoroscopy
The interventional radiologist
Use of rapid filming
The selected film medium
Digital fluoroscopy
What process allows the VI suite personnel to recall a stored image and manipulate it?
DICOM process
PACS process
Post procedural subtraction
Temporal subtraction
Post procedural subtraction
In an older VI suite that uses CRT monitors, what are the two available scan modes?
1) progressive
2) repeating
3) interlaced
4) dynamic
1, 2
1, 4
2, 3
1, 3
1) Progressive
3) Interlaced
What process converts the video image from the TV chain into a digital format?
ADC
VDC
VDP
TVD
ADC
True or false…
DSA takes the image received by the intensifier in analog format, converts it to digital information, then is processed by the computer for storage and display.
True
DSA uses _____ to average together several frames to reduce electronic and quantum noise.
Temporal subtraction
A high contrast medium
Television/digital image chain
Frame integration
Frame integration
True or false…
DSA allows window and level adjustments to manipulate pre-procedural images.
False. You can only manipulate POST-procedural images.
DSA signal to noise (SNR) should be:
30-60 frames per second
1024 x 768
1000:1
640 x 480
1000:1
What feature uses a pre-contrast mark and a contrast filled image to produce a subtracted image?
Image reversal
Temporal subtraction
Temporal filtering
Post procedural subtraction
Temporal subtraction
What process adds a small amount of the mask back into the subtracted image but not enough to affect the image?
Land marking
Edge enhancement
Image re-masking
Window adjustment
Land marking
Images to be archived and stored may be sent to:
1) Digital disks 2) recorders 3) PACS 4) printed to hard copy media
1, 2
1, 2, 3
2, 4
All of the above
All of the above
Of the 3 most common injection formats, which is the one used mainly in the US?
1) fixed flow rate injector 2) air compression injector 3) pressure dependent injector
1
2
3
None of the above
3) pressure dependent injector
True or false….
The primary function of the pressure injector safety is to prevent damage to the injector and the selected catheter.
False. The pressure injector safety feature is to prevent damage to the injector, the selected catheter, AND THE PATIENT’S SAFETY AS WELL.
What forms of patient identification must be made and verified before any procedure is performed on a patient?
1) MRN 2) DOB 3) name 4) written doctors orders that match request
1, 2
1, 3
1, 2, 3
All of the above
All of the above
True or false…
Educating the patient about their proposed procedure will have little or no effect on the outcome of the exam.
False. Educating the patient pre-procedure makes the patient MORE COMPLIANT AND COMFORTABLE WITH WHAT THEY MAY EXPECT.
It is the job of the _____ to check that all emergency equipment is present and functioning in their procedure room.
Engineer
Nurse
Radiologist
VI radiographer
VI radiographer
True or false…
When a patient is to be sedated for a procedure, the nurse along with monitoring the patient, can and should act as a circulator as well.
False. The nurse’s SOLE DUTY when a patient is sedated is to monitor the payment only, and nothing else.
What forms of patient identification must be made and verified before any procedure is performed on a patient?
{MRN, DOB, name, and written doctor’s order correlates with request}
MRN and DOB
MRN and name
MRN, DOB, and name
All of the above
All of the above
What form of consent is essential prior to performing any exam or procedure on a patient?
oral
written
blanket
informed
informed
True or false…
An H&P must be available and include all the body systems listed prior to performing any invasive procedure.
True
Normal values for BUN and creatinine would fall in which range, respectively?
13, 0.8
13, 2.6
26, 0.8
26, 2.6
13, 0.8
A patient’s drug absorption rate may be affected by?
1) age 2) food in the stomach 3) body weight
1, 2
2, 3
1, 3
All of the above
All of the above
Your patient’s discomfort during the injection of contrast media is mostly contributed to the contrasts?
Toxicity
Osmolality
Viscosity
Volume
Osmolality
Severe allergic reaction to a contrast agent may result in shock, which is characterized by?
1) rapid breathing 2) high pulse rate 3) possible loss of consciousness
1, 2
1, 3
2, 3
All of the above
2) high pulse rate 3) possible loss of consciousness
A patient’s vasovagal reaction is characterized by?
1) sweating 2) increased blood pressure 3) nausea
1, 2
1, 3
2, 3
All of the above
1) sweating 3) nausea
To enhance demonstration of the portal venous system, which of the following drugs may be injected prior to angiography?
Pitressin
Epinephrine
Tolazoline
Heparin
Tolazoline
Which of the following types of emboli would specifically be associated with trauma in a long bone?
Fat
Air/gas
Pulmonary
Tumor
Fat
What possible results may lidocaine mixed with contrast media exhibit?
1) may make the exam less painful
2) make decreased irritability and prevent PVCs
3) is permissible for arterial examination of upper extremities
1, 2
1, 3
2, 3
All of the above
1) may make the exam less painful
2) make decreased irritability and prevent PVCs
The dorsal pedal pulses somewhere?
At the dorsum of the foot
Just posterior to the medial malleolus
At the top of the foot around the 1st and 2nd metatarsals
At the anterior portion of the below
At the top of the foot around the 1st and 2nd metatarsals
_____ is the degree of stickiness or thickness of the contrast agent.
Toxicity
Osmolality
Viscosity
Volume
Viscosity
The ability of a contrast to be solvent with blood to thwart embolization is?
Toxicity
Osmolality
Viscosity
Miscibility
Miscibility
Vascular stenting is used in conjunction with angioplasty to?
Hold down the intimal flaps
Prevent restenosis
Hold the vessel open
At as a sheath
Hold down intimal flaps
True or false…
Angioplasty is always performed prior to stenting to expand the vessel.
False. PTA is almost always done POST stent placement, but optional pre stent placement.
True or false…
Caval filters may only be placed in the IVC.
False. Caval filters are placed in both the inferior and superior vena cava. When there is a clot present either in both iliac arteries or extending up to the renal veins, the filter is usually placed via a jugular approach in a supra renal location so as not to include the renal veins.
The most common problem associated with catheterization is?
Anaphylactic reaction to the contrast media
Nephrotoxicity
Cholesterol embolization
Bleeding at the puncture site
Bleeding at the puncture site
When the catheter is being threaded over the guide wire, it is the radiographer’s responsibility to?
1) Keep the wire held taught (clotheslining)
2) Keep enough slack to be able to advance the wire, if needed
3) Be sure the end of the guide wire remains within the sterile field
1, 2
1, 3
1, 2, 3
2, 3
1, 2, 3
Using a catheter with only a single end hole and no side holes may result in?
1) A stronger stream of contrast
2) Less catheter recoil
3) Transient narrowing of the vessel just beyond the catheter tip
1, 2
1, 2, 3
2, 3
1, 3
1) A stronger stream of contrast
3) Transient narrowing of the vessel just beyond the catheter tip
Which of the following blood pressure measurements would contraindicate angiography?
90/60
110/80
120/90
150/100
150/100
Which of the following may be used to relax the walls of arteries during angiography?
Benadryl
Nitroglycerin
Demerol
Pitressin
Nitroglycerin
Because contrast media is _____. The BUN and creatinine should be within normal range before exam is begun.
Viscous
Nephrotoxic
Electrolytic
Dynamic
Nephrotoxic
Patients who present with a decreased red blood cell count, hemoglobin, and hematocrit level may be diagnosed with?
Anemia
Leukemia
Erythema
Erythemia
Anemia
Dilation of an artery is termed?
Clot
Thrombus
Aneurysm
Embolus
Aneurysm
A potentially life-threatening condition where blood fills the intima of an artery is?
Coarctation of the artery
Dissection of the artery
Saccular aneurysm of the artery
Fusiform aneurysm of the artery
Dissection of the artery
Which of the following medications could be used to optimize visualization during a splenic arteriogram?
Vasopressin
Pituitrin
Dopamine
Priscoline
Priscoline
Which of the following medications would be used to reverse an overdose of morphine or sublimaze?
Nifedipine
Narcan
Pitressin
Priscoline
Narcan
Normal oral temperature is?
35°C
36°C
37°C
38°C
37°C
Which of the following are symptoms of a diabetic patient who is taken insulin but has not eaten?
1) Clammy, cool skin
2) Nervousness and irritability
3) Fruity smelling breath
1, 2
1, 3
2, 3
1, 2, 3
1) Clammy, cool skin
2) Nervousness and irritability
Which of the following statements regarding the cation portion of the contrast medium molecule is true?
1) it is the positive portion
2) it provides to the solubility
3) Provides the radiopaque portion
1, 2
1, 3
2, 3
1, 2, 3
1) it is the positive portion
2) it provides to the solubility
The antecubital vein is often _____.
1) Easily found
2) The access site used for short term IV solutions
3) The access site for contrast media injections
1, 2
1, 3
2, 3
1, 2, 3
1) Easily found
3) The access site for contrast media injections
True or false…
Fentanyl (sublimaze) is weaker than morphine and longer acting.
False. Fentanyl (sublimaze) is 100 times STRONGER than morphine and SHORTER acting.
Demerol (meperidine) is used in the angiography suite usually to help with shaking that can be caused when given what medication?
Activase
TPA
Priscoline
Urikinase
Urikinase
Amiodarone and other similar types of medications that control premature atrial or ventricular contractions, supraventricular tachycardia, atrial flutter or fibrillation are what class of medication?
Antiarrhythmics
Analgesics
Anti-emetic
Emergency medications
Antiarrhythmics
What class of drugs does aspirin, Pletal, Plavix, and ReoPro fall under?
Anxiolytics
Anti-emetic
Anticoagulants
Antiplatelets
Antiplatelets
Of the following medications, which one offers a relaxing and amnesia effect on the patient?
Valium
Ativan
Versed
Narcan
Versed
To reverse overmedication of Versed, Valium, or Ativan, which is the proper counter agent?
Flumazenil (Romazicon)
Narcan (naloxone)
Atropine sulfate
Epinephrine
Flumazenil (Romazicon)
True or false…
Epinephrine should not be given to relieve bronchospasm, laryngospasm, or anaphylaxis. The correct drug in this situation should be Benadryl.
False. Epinephrine SHOULD BE given to relieve bronchospasm, laryngospasm, or anaphylaxis. Benadryl is an antihistamine and is given for allergic reactions.
To open a clotted vessel, catheter, or other device which has been clotted for a relatively short duration, thrombolytic drugs may be given. Which of the following is not an example of a thrombolytic drug?
Urikinase
Glassorvase
Streptokinase
Tenecteplase
Glassorvase
Glucagon is an effective relaxant of smooth muscle structures, and is used primarily in which procedure?
Nephrostomy tube placement
Chest tube placement
Percutaneous gastrostomy tube placement
Biliary tube placement
Percutaneous gastrostomy tube placement
True or false…
The injection of medications falls under the scope of the radiologist, radiographer, and the nurse.
False. Injection of medications falls into the scope of the radiologist, and the nurse. Radiographers’ scope of medication administration include contrast media ONLY.
The angular portion of the needle tip is the?
Bevel
Cannula
Gauge
Hub
Bevel
During an interventional procedure your patient begins to show symptoms of dyspnea, chest pain, tachycardia, hypotension, agitation, disorientation, and cyanosis. What did the patient possibly acquire?
Anaphylaxis
Cardiac arrhythmias
Hemothorax
Air embolism
Air embolism
_____ is a serious allergic reaction, whose signs and symptoms may be urticaria, faintness or consciousness, swelling, asthmatic symptoms, death. You should administer _____ via IV is soon as possible.
Air embolism, epinephrine
Anaphylaxis, adrenaline
Tachycardia, Demerol
Anaphylaxis, epinephrine
Anaphylaxis, adrenaline
Vasovagal response is characterized by what symptoms?
1) Fainting or black out
2) warm and sweaty
3) nausea and pale skin coloration
1, 2
2, 3
1, 3
1, 2, 3
1, 2, 3
The method by which needle entry is made into an artery is known as the _____ technique.
Feldbaum
Seldinger
Dilinger
Single wall needle
Seldinger
Which of the following are criteria for performing a vascular interventional bedside procedure?
Body habitus exceeds the state guidelines for your interventional labs equipment
Peripheral access for emergency medication included ministration is poor or nonexistent, and the patient’s condition is not conducive to transport to the original lab
Chest tube insertion or emergency bedside dialysis is needed on an emergency basis
All of the above
All of the above
True or false…
Informed consent and pre-procedure labs within normal limits are not required for interventional procedures.
False.
The left and right hepatic duct join to become the?
Common bile duct
Hepatic artery
Common hepatic duct
Portal duct
Common hepatic duct
Which of the following does the celiac artery not supply?
stomach
intestines
liver
spleen and pancreas
Intestines
_____ is a term describing a group of symptoms (pain, vomiting, cramping after eating, diarrhea, weight loss) caused by chronic poor blood flow.
Intestinal angina
Bowel obstruction
PMS
Colitis
Intestinal angina
What supplies blood to the small intestines, cecum, ascending aorta, hepatic flexure, and the right half of the transverse colon?
SAM
SMA
GDA
IMA
SMA
What supplies blood to the left half of the transverse colon, splenic flexure, descending colon, and rectosigmoid area?
HGA
SMA
IDA
IMA
IMA
The _____ is formed by the union of the superior mesenteric vein and the splenic vein.
Hepatic vein
Inferior mesenteric vein
Portal vein
Diaphragmatic vein
Portal vein
True or false…
The splenic artery branches from the right side of the celiac access and supplies the spleen and pancreas.
False. The splenic artery branches from the LEFT side of the celiac access and supplies the spleen and pancreas.
The walls of arteries have three layers, which of the following are listed in the correct order from outside to the inside layers:
Adventitia, intima, media
Adventitia, media, intima
Intima, media, adventitia
Media, intima, adventitia
Adventitia, media, intima
Both the contrast filled vessel and item being introduced into the vessel are displayed together when _____ is utilized.
Roadmapping
Pixel shifting
Land marking
Mask image utilization
Roadmapping
True or false…
The aortic arch is best visualized with a 45° right anterior oblique (RAO) position.
False. The aortic arch is best for last with a 45° LEFT anterior oblique LAO position.
Various methods of revascularization are available. Which method is the most frequently used?
Laser
Atherectomy
Percutaneous transluminal angioplasty (PTA)
Stenting
Percutaneous transluminal angioplasty (PTA)
PTA can be applied to almost any vessel, but is most commonly performed on all the following arteries except?
Iliac
Femoral
Cerebral
Renal
Cerebral
Anterior cerebral artery
2
Internal carotid artery
1
Middle cerebral artery
3
Pericallosal artery
4
Anterior parietal artery
5
Posterior parietal artery
6
Ophthalmic artery
7
Anterior internal frontal artery
8
Middle internal frontal artery
9
Vertebral artery
1
Basilar artery
2
Posterior cerebral artery
3
Posterior inferior cerebellar artery
4
Anterior inferior cerebellar artery
5
Superior cerebellar artery
6
Parieto-occipital artery
7
Calcarine artery
8
Celiac trunk
1
Common hepatic artery
3
Left gastric artery
2
Right gastric artery
5
Gastroduodenal artery
4
Cystic artery
9
Right hepatic artery
8
Left hepatic artery
7
Middle hepatic artery
10
Portal vein
1
Cystic duct
7
Common bile duct
2
Abdominal aorta
1
Internal iliac artery
2
Common iliac artery
3
External iliac artery
4
Common femoral artery
5
Profunda femoris artery
6
Superficial femoral artery
7
Popliteal artery
8
Anterior tibial artery
9
Posterior tibial artery
10
Dorsalis pedis
11
Plantar arch
12
Abdominal aorta
1
Celiac trunk
2
Splenic artery
3
Common hepatic artery
4
Proper hepatic artery
5
Left hepatic artery
6
Right hepatic artery
7
Cystic artery
8
Gastroduodenal artery
9
Transverse pancreatic artery
10
Superior mesenteric artery
11
Left renal artery
12
Inferior mesenteric artery
13
Ascending aorta
1
Subclavian artery
2
Axillary artery
3
Brachial artery
4
Radial artery
5
Abdominal aorta
6
Common iliac artery
7
Femoral artery
8
Popliteal artery
9
Brachiocephalic artery
1
Right subclavian artery
2
Axillary artery
3
Brachial artery
4
Radial artery
5
Ulnar artery
6
Celiac trunk
7
Right renal artery
8
Superior mesenteric artery
9
Inferior mesenteric artery
10
Abdominal aorta
11
Splenic artery
12
Descending thoracic aorta
13
Left subclavian artery
14
External carotid artery
1
Facial artery
2
Occipital artery
3
Middle meningeal artery
4
Superficial temporal artery
5
Maxillary artery
6
Posterior auricular artery
7
Aortic arch
1
Brachiocephalic artery
2
Left common carotid artery
3
Left subclavian artery
4
Right subclavian artery
5
Internal thoracic artery
6
Right common carotid artery
7
Right vertebral artery
8
Right internal carotid artery
9
Inferior vena cava
J
Iliac vein
D
Deep femoral vein
B
Femoral vein
F
Great saphenous vein
H
Popliteal vein
C
Great saphenous artery
E
Anterior tibial vein
A
Posterior tibial vein
G
Peroneal vein
I
Abdominal aorta
J
Common iliac artery
D
Internal iliac artery
B
Common femoral artery
F
Deep femoral artery
H
Superficial femoral artery
C
Popliteal artery
E
Posterior tibial artery
A
Anterior tibial artery
G
Peroneal artery
I
Dorsalis pedis artery
K
Direct puncture of the _____ artery should only be considered when a patient has no femoral, dorsalis pedis, or posterior tibial pulses, cannot lie flat or has other symptoms precluding femoral punctures.
Brachial
Cerebral
Axillary
Carotid
Carotid
True or false…
Catheterization is less dangerous than direct punctures.
True.
Direct stick of the carotid artery because a resulting pressure on the carotid sinus. This may result in all of the following except?
Bradycardia
Tachycardia
Hypotension
SA node effect
Tachycardia
When planning to perform any invasive procedure on a patient, labs obtained should include which of the following?
1) PT INR
2) CBC
3) platelets
1, 2
1, 3
2, 3
All of the above
All of the above
When performing a bedside or any invasive procedure, you must verify all of the following?
1) Signed consent
2) Appropriate lab results
3) Written doctors order
1, 2
1, 3
2, 3
All of the above
All of the above
Routine angiographic examination of the cerebral arteries is known as _____ vessel cerebral angiography.
2
3
4
6
4
My normal routing of arterial blood in the brain has blocked, what structure maintains blood flow to the affected area?
Semi-circle branches
Circle of Gillis
Subclavian steal
Circle of Willis
Circle of Willis
The right and left vertebral arteries merge at the posterior base of the brain to form?
Posterior cerebral artery
Superior cerebellar artery
Basilar artery
Posterior inferior cerebellar artery
Basilar artery
True or false…
The common carotid arteries bifurcate into the internal and external vertebrals.
False. Common carotid arteries bifurcate into the internal and external CAROTIDS.
The four portions of the internal carotid artery are?
Cervical, facial, cavernous, and cerebral
Cervical, petrous, cavernous, and cerebral
Cervical, maxillary, cavernous, and cerebral
Cervical, superficial temporal, cavernous, and cerebral
Cervical, petrous, cavernous, and cerebral
Angiography of the intracranial and extracranial circulation includes examination and understanding of the arteries of the _____, neck, and vertebral vessels.
Brachiocephalic
Vertebral
Aortic arch
Innominate
Aortic arch
True or false…
The most common anatomical variant in the aortic arch is called the “bovine arch“. It is where the left common carotid artery shares its origin of the innominate artery.
True
Epistaxis embolization is performed to alleviate hemorrhaging from the?
Ear
Mouth
Nose
Orbital area
Nose
An AVM is a web of dilated blood vessels that disrupt normal blood flow in the brain by pulling blood within its dense center or _____.
Fundus
Abnormus
Niculus
Nidus
Nidus
FMD (fibromuscular dysplasia) a disease (found most commonly in Caucasian females) commonly results in stenosis or occlusion of one or both renal arteries, resulting in renovascular hypertension. Which area I can use disorder also occur?
1) Internal carotid artery unilaterally
2) Internal carotid arteries bilaterally
3) Vertebral artery unilaterally
4) Vertebral arteries bilaterally
1, 3
2, 4
2
4
2, 4
FMD has a _____ appearance angiographically. Lesions caused by fibromuscular dysplasia usually respond well to angioplasty.
String sign
String of beads
Constricted
Serpentine
String of beads
_____ is a giant-cell necrotizing arteritis that principally affects the aorta and it’s major branches. It often affects the pulmonary arteries, and the proximal portion of the brachiocephalic vessels. Cerebral vessels rarely are affected.
Harimoto’s arteritis
Benewa’s arteritis
Takayasu’s arteritis
Nelson’s arteritis
Takayasu’s arteritis
Symptoms of carotid dissection may appear as all of the following except?
1) Unilateral headache, neck pain
2) Loss of superficial temporal artery poles with common carotid artery involvement
3) Hearing and vision loss
4) Aphasia, with unilateral facial weakness
1
2
3
4
3) Hearing and vision loss
True or false…
Subclavian steal syndrome is caused by a blockage of the subclavian artery, near the carotid artery resulting in backflow of blood. This is compensated for via the Circle of Willis.
False. Subclavian steel syndrome is caused by blockage of the subclavian artery, near the VERTEBRAL artery resulting in backflow of blood. This is compensated for via the circle of Willis.
True or false…
In the presence of subclavian steal syndrome, blood is shunted past the brain through the Circle of Willis to the vertebral and subclavian arteries to supply the active muscles in the upper limb involved. Flow is actually reversed in the vertebral artery. There will usually be no differences in blood pressure readings in the left and right upper limbs.
False. There will usually be MARKED DIFFERENCES in blood pressure readings in the left and right upper limbs.
True or false…
Amaurosis fugax is an occurrence of transient binocular blindness caused by temporary ischemia.
True
True or false…
Vasopressin (Pitressin) is an anti-diuretic hormone that causes constrIction of the arteries and is used to control visceral bleeding.
True
Patient receiving vasopressin should be ECG monitored because it can cause _____.
Tachycardia
Bradycardia
Myocardial infarcts
Cardiac ischemia
Myocardial infarcts
Vasopressin is used mostly in G.I. bleeding cases of the?
1) SMA bleeding
2) IMA bleeding
3) Celiac bleeding
1
2
1, 2
1, 2, 3
1, 2, 3
Permanent embolic agents may include all of the following except?
Detachable balloons
Polymers and coils
Ethanol or absolute alcohol
Gelfoam
Gelfoam
Which of the following does the celiac artery not supply?
1) Stomach
2) Intestines
3) Liver
4) Spleen and pancreas
1
2
3
4
2) Intestines
What supplies blood to the left half of the transverse colon, splenic flexure, descending colon, and rectosigmoid area?
HGA
SMA
IDA
IMA
IMA
Embolization in the lower gastrointestinal tract carries a _____ risk of bowel ischemia.
Low
High
High
True or false…
The choice of embolic agent depends on the size of the patient, the desired outcome (hemostasis or infarction, temporary or permanent), and ease of catheter placement.
False. The choice of embolic agent was depends on the size of the TRAGEDY VESSEL, the desired outcome (hemostasis or infarction, temporary or permanent), and ease of catheter placement.
Upper gastrointestinal bleeding will usually be managed with Pitressin or Gelfoam for _____ term management, or the use of coils for _____ term management.
Short, long
Long, short
Short, long
DSA roadmapping is _____ useful when working with embolic materials.
Never
Always
Sometimes
Questionably
Always
When there is a _____ pressure in the portal system, blood in the liver may flow backward, causing variceal bleeding in the esophagus and stomach.
Decreased
Increased
Increased
Thoracic outlet syndrome is a compression of the?
1) Brachial plexus
2) Subclavian artery
3) Vein between the clavicle and first rib
1, 2
2, 3
1, 3
1, 2, 3
1, 2, 3
Arteries are _____ accompanied by vein of the same name.
Sometimes
Never
Always
Always
True or false…
The celiac artery (also referred to as the celiac axis or trunk) is the first major branch of the abdominal aorta, arising posteriorly at the level of the T12-L1 interspace.
False. The celiac artery (also referred to as celiac access or trunk) is the first major branch of the abdominal aorta, arriving ANTERIORLY at the level of the T12-L1 interspace.
The SMA arises anteriorly off the aortic wall at _____ and descends to _____.
L2, L5 – S1
T12, L5 – S1
L1, L5 – S1
L2, L4
L1, L5 - S1
Renal angiography may be performed along with, renal vein _____ sampling which is useful in determining if hypertension has a renovascular origin.
Cortosin
Renin
Biopsy
Amino
Renin
True or false…
Excess renin production stimulates angiotensin and aldosterone production, which in turn causes sodium and fluid retention, resulting in low blood pressure.
False. Excess renin production stimulates angiotensin and aldosterone production, which in turn causes sodium and fluid retention, resulting in HIGH blood pressure.
HTN (high blood pressure) may be caused by strictures of one or both of the renal arteries. Sometimes a common occurrence related to _____ which is more prevalent in young white females.
Ostial structure
Atherosclerosis
AVM
FMD (fibromuscular dysplasia)
FMD (fibromuscular dysplasia)
The left renal vein passes under the origin of the _____ and it is more posterior than the right renal vein, and a slightly longer than the right renal vein, allowing the left kidney to be more frequently chosen for renal organ transplantation.
Superior mesenteric artery
Inferior mesenteric artery
Celiac artery
Left renal artery
Superior mesenteric artery
True or false…
Wilms’ tumor is a non-malignant tumor of the kidney that occurs in pediatric patients, usually before the age of five.
False. Wilms’ tumor is a MALIGNANT tumor of the kidney that occurs in pediatric patients, usually before the age of five.
_____ and _____ or vasodilator sometimes use for selective renal and geography.
Nitroglycerin, epinephrine
Lidocaine, nitroglycerin
Procardia (nifedipine), nitroglycerin
Pitressin, TKN
Procardia (nifedipine), nitroglycerin
TIPS is the abbreviation for?
Transcaval intrahepatic pectosystemic shunt
Transjugular intrahepatic portosystemic shut
Transesophageal intracaval pancrealsystemic shunt
Transjugular intra-abdominal portosystemic shunt
Transjugular intrahepatic portosystemic shunt
Anatomical variants in hepatic vein anatomy exist in _____ of the population. The variants add to the challenge of performing a TIPS procedure.
1/3
2/3
1/2
1/4
1/3
True or false…
The usual path of access for TIPS formation is right IJ to SVC to RA to IVC to right hepatic vein, then through the liver parent, to the portal vein.
True
True or false…
The TIPS procedure is a method of decompressing hypertension in the portal venous system.
False.
Indications for uterine artery embolization include which of the following?
1) Menorrhagia with associated anemia
2) Pain
3) Bulk symptoms
4) Infertility
1, 2
1, 2, 3
All of the above
1, 4
All of the above
Fibroid treatment options include?
1) Hormonal therapy
2) Uterine fibroid embolization
3) Myomectomy
4) Hysterectomy
1, 2
All of the above
1, 2, 3
1, 4
All of the above
A significant amount of discomfort results from a UAE procedure; patients are usually returned to the room with what?
A mild analgesic
A warm compress
A dose of Tylenol
A morphine pump
A morphine pump
The purpose of an IVC filter is to trap emboli arising from deep leg veins and prevent travel to the?
1) Pulmonary arteries
2) Heart
3) Brain
1, 3
2, 3
1, 2
All of the above
1, 2
Indications for IVC filter placement include?
1) As a prophylactic prior to a surgery
2) Patients with a higher risk of clot formation
3) When normal medication therapy for thromboembolism is contra indicated
1, 2
2, 3
1, 3
All of the above
All of the above
What is pain from the lower limbs with cramps and the calves caused by poor circulation of the blood?
Ischemic leg syndrome
Reynaud’s syndrome
Compartment syndrome
Claudication syndrome
Claudication syndrome
_____ and _____ involve the lower extremities; it often progresses in severity from claudication to ischemic pain at rest, and finally to tissue necrosis presenting as gangrene.
1) Arteriosclerotic occlusive disease AOD
2) Ischemia
3) Compartment syndrome
4) Peripheral vascular disease PVD
All of the above
1, 2
1, 4
1, 3,
4
1, 4
True or false…
Indications for peripheral interventions include gangrene, rest pain, nonhealing wound, quality of life limiting claudication, but not surgery.
False. Indications for peripheral interventions include gangrene, rest pain, nonhealing wound, quality of life limiting claudication, but not surgery. SURGERY IS A VIABLE MODE OF PERIPHERAL INTERVENTIONS AS WELL.
True or false…
Excimer laser recanalization is performed only on short segment total occlusions of the superficial femoral artery.
False. Excimer laser recanalization is performed on short AND LONG segment total occlusion of the superficial femoral artery.
True or false…
Excimer laser recanalization is always performed in conjunction with vessel stenting.
False… Excimer laser recanalization is performed in conjunction with vessel stenting OR WITHOUT STENTING.
True or false…
The cryoplasty procedure was designed to improve the outcome of PTA by combining dilation with simultaneous freezing of the artery.
True
True or false…
Biopsies and drainages are only performed outside the interventional suite, in CT, or ultrasound departments.
False. Biopsies in drainages are performed outside AND INSIDE the interventional suite, in CT, or ultrasound departments.
TIP procedure is used to manage patients with severe _____ accompanied by intractable _____ bleeding that may be due to cirrhosis of the liver, hepatitis, or congenital liver conditions.
Hepatic vein hypertension, variceal
Systemic hypertension, rectal
Systemic hypertension, variceal
Portal hypertension, variceal
Portal hypertension, variceal
The most serious complication associated with TIPS, intraperitoneal hemorrhage requires immediate _____ intervention.
Radiological vascular
Surgical
Thrombolytic
Embolization/coil
Surgical
True or false…
A fusiform aneurysm denotes bulging of half the circumference of the vessel wall.
False. A fusiform aneurysm denotes bulging of the WHOLE circumference of the vessel wall.
True or false…
A dissecting aneurysm involves only one side of the wall. A saccular aneurysm is present if there is disruption of the intima (inner layer) where blood enters the wall of the aorta and separates its layers.
False. A SACCULAR aneurysm involves only one side of the wall. A DISSECTING aneurysm is present if there is disruption of the intima (inner layer) where blood enters the wall of the aorta and separates it’s layers.
True or false…
Marfan’s syndrome is an inherited condition with excess length of the bones, associated with changes in the circulatory system, including abnormal connective tissue and tearing of the aorta (dissection).
True
True or false…
Coarctation of the aorta is a congenital defect causing stenosis of the thoracic aorta resulting in decreased pressure on the side effected and increased pressure on the opposite side.
False. Coarctation of the aorta is a congenital defect causing stenosis of the thoracic aorta resulting in INCREASED pressure on the side effected and DECREASED pressure on the opposite side.
True or false…
Leriche syndrome is a gradual blockage of the suprarenal abdominal aorta, associated with atherosclerotic disease.
False. Leriche syndrome is a gradual blockage of the INFRARENAL abdominal aorta, associated with atherosclerotic disease.
Abdominal and aortography is usually perform to evaluate which of the following?
1) Aneurysms
2) Atherosclerotic disease
3) Aortic stenosis
4) Bleeding
1, 2
2, 3
3, 4
All of the above
All of the above
Complications possible with angiography are?
1) Thrombosis
2) Hemorrhage
3) Embolization
4) Pseudoaneurysm formation
1, 2
2, 3
3, 4
All the above
All of the above
The subclavian artery’s become _____ arteries as they pass the first rib, and then become the _____ arteries in the upper arm region.
Basilic, ulnar
Axillary, basilic
Axillary, brachial
Axillary, cephalic
Axillary, brachial
True or false…
The left subclavian artery branches off the brachiocephalic (innominate) artery.
False. The left subclavian artery branches off the AORTIC ARCH.
True or false…
The right subclavian arises directly from the aortic arch.
False. The right subclavian arises from the BRACHIOCEPHALIC (INNOMINATE) ARTERY.
The classic signs and symptoms of acute arterial insufficiency can be remembered by the five “_____”s.
M
O
P
R
P
True or false…
The IVC is the largest vein in the body and carries deoxygenated blood into the right atrium of the heart. It is formed by the coupling of the two common iliac veins.
True
True or false…
The inferior vena cava parallels the aorta on the left side of the body.
False. The inferior vena cava parallels the aorta on the RIGHT side of the body.
True or false…
PTA is performed to increase blood flow, with hopes of maintaining long-term vessel patency.
True
True or false…
Digital subtraction roadmapping or metallic markers on the PTA catheter are used to accurately position a balloon.
True
True or false…
When performing a PTA cutting balloon procedure, the balloon should be rapidly inflated and deflated.
True
True or false…
Restenosis is a primary limiting factor of PTA. For this reason, adjunct procedures like lasers, stents, and nonsurgical artherectomy are often used in conjunction with PTA to increase the success rate.
True
True or false…
Thrombolytic therapy is contraindicated only in the presence of brain metastasis.
False. Thrombolytic therapy is contraindicated in the presence of brain metastasis, RECENT BRAIN SURGERY WITHIN 10 DAYS, BLEEDING DIATHESIS AMONG OTHER REASONS.
Patients who will receive thrombolytic therapy should go where after the interventional procedure is completed?
Sent home for follow up
To the room with the train to nursing person at her bedside
Intensive care unit
On bed rest in their room
Intensive care unit
True or false…
The IVC filter is always placed superior to the renal veins to avoid risking renal vein thrombosis.
False.
True or false…
If the lesion is very long, stents may be placed in succession, but never with an overlap.
False
True or false…
When placing an intravascular stent, PTA may be performed prior to stent placement and always performed after.
True
True or false…
The common bile duct passes along side the pancreatic duct, and opens up into the duodenum.
False
True or false…
Patients with uncontrolled hypertension, thrombocytopenia, or coagulopathy are good candidates for PBD (percutaneous biliary drainage).
False. Patients with uncontrolled hypertension, thrombocytopenia, or coagulopathy our POOR candidates for PBD (percutaneous biliary drainage).
Complete internal stenting of the biliary tract is usually indicated for patients with a limited lifespan. This procedure is referred to as?
Plasmapheresis
Nephroprosthesis
Hydroprosthesis
Endoprosthesis
Endoprosthesis
True or false…
The right kidney is usually higher than the left due to the presence of the liver.
False. The right kidney is usually LOWER than the left due to the presence of the liver.
True or false…
Hydronephrosis may be caused by large stones (above 3 cm), malignant obstruction, or ureteral obstruction and can only be treated in a retrograde fashion.
False. Hydronephrosis may be caused by large stones (above 3 cm), malignant obstruction, or ureteral obstruction and can be treated in a retrograde fashion in the OR or ANTEGRADE IN THE INTERVENTIONAL SUITE.
True or false…
Chemoembolization and yttrium 90 (Y-90) embolization (SIR-Spheres, TheraSpheres) are procedures performed to therapeutically treat malignant liver tumors and is only performed under CT.
False. Chemoembolization and yttrium 90 (Y-90) embolization (SIR-Spheres, TheraSpheres) are procedures performed to therapeutically treat malignant liver tumors and is only performed IN THE INTERVENTIONAL SUITE.
Chemo embolization delivers a mixture of all the following to the target liver tumor except?
1) Embolic particles (i.e. PVA, Gelfoam)
2) Ethiodol
3) Chemotherapeutic medication
4) Coils
1
2
3
4
4) Coils
Chemoembolization kills liver tumors by which mechanisms?
1) Interruption of blood supply to the tumor cuts the timer source of oxygen and nutrients
2) Delivery of potent chemo directly into the liver allows a higher dose of chemo to be given to the tumor with less systemic side effects
3) Cutting off the blood supply to the tumor is also allows the chemo to dwell in the tumor for longer periods of time because blood flow does not carry it away
1, 2
2, 3
1, 3
All of the above
All of the above
Cysts visualize during what phase of a renal angiogram?
Arterial
Nephrogram
Venous
None of the above
Nephrogram
The technique used by a radiologist performing a percutaneous nephrostomy (PCN) in which one needle is left in place to correct the angulation while introducing a second needle is?
Tandem
Sampling
Seldinger
Embolization
Tandem
Indications for a percutaneous nephrostomy tube placement include?
1) To create an external renal drain in the presence of a renal fistula
2) To create a pathway for direct infusion of litholytic medication
3) To create a tract for decompression of obstructions
1, 2
1, 3
2, 3
1, 2, 3
1, 2
Which of the following embolization agents can be classified as permanent?
1) Coils
2) Autologous clot
3) Detachable balloons
1, 2
1, 3
2, 3
1, 2, 3
1, 3
The main objectives of transcatheter embolization include?
1) Pre-surgical hemostasis
2) Hemostasis of active bleeding sites
3) Hemostasis of disease areas
1, 2
1, 3
2, 3
1, 2, 3
1, 2, 3
The puncture site for percutaneous nephrostomy should be?
Above the 10th rib
Between the 10th and 11th ribs
Between the 11th and 12th ribs
Below the 12th rib
Below the 12th rib
The desired results of transcatheter embolization therapy may include hemostasis of?
1) Active bleeding sites
2) Disease or malformed areas
3) A particular area of the body prior to surgery
1, 2
1, 3
2, 3
1, 2, 3
1, 2, 3
The length of a ureteral stent corresponds with the distance between?
The renal pelvis in the ureter
The renal pelvis and the bladder
The renal pelvis in the urethra
The bladder in the urethra
The renal pelvis and the bladder
The primary risk in percutaneous nephrostomy is?
Hemorrhage
Sepsis
Ureteral and colonic perforation
Hydrothorax
Hemorrhage
The inferior mesenteric artery arises from the aorta at the level of?
T11
L1
L3
S1
L3
In advanced alcoholic cirrhosis, the hepatic angiography may demonstrate?
1) Enlarged, spiral shaped arteries
2) Venous peripheral occlusions
3) Venous branches at acute angles
1, 2
1, 3
2, 3
1, 2, 3
1, 2
Of the following conditions, which are best revascularized with percutaneous transluminal angioplasty (PTA)?
1) Fibromuscular dysplasia (FMD)
2) Arterial thromboemboli
3) Takayasu’s arteritis
1, 2
1, 3
2, 3
1, 2, 3
1, 3
Which of the following defines a potentially life-threatening condition in which disruption of the intima permits blood to enter the wall of the aorta and separates it’s layers?
Saccular aneurysm
Fusiform aneurysm
Congenital coarctation
Dissection of the aorta
Dissection of the aorta
If a piece of the catheter fragmented and broke loose into the vascular system, retrieval may be accomplished using a?
1) Snare loop catheter
2) Multiple side whole catheter
3) Helical loop basket
1, 2
1, 3
2, 3
1, 2, 3
1, 3
Two balloons or “kissing“ balloons would most likely be used in the percutaneous angioplasty treatment of lesions in which area?
Cerebral
Renal
Aortoiliac bifurcation
Extremity
Aortoiliac bifurcation
The largest vein in the body is formed by the union of the?
Right and left brachiocephalic veins
The right and left spermatic veins
Two common iliac veins
The external iliac veins
Two common iliac veins
