Venous Non Imaging Testing

Question 1

Finding the presence/absence of venous insufficiency and determine if superficial vs deep insufficiency describes the capabilities of what

Answer 1

Venous PPG

Question 2

Where is the PPG placed for venous PPG

Answer 2

above the medial malleolus

Question 3

> 20 sec is

a) normal VRT
b) abnormal VRT

Answer 3

a) normal VRT

Question 4

< 20 sec is

a) normal VRT
b) abnormal VRT

Answer 4

b) abnormal VRT

Question 5

If the initial reading comes back normal what do this mean

Answer 5

There is no venous insufficiency

Question 6

If the initial reading comes back abnormal what is the next step

Answer 6

Repeat with a tourniquet

-purpose of the tourniquet is to cut off influence of the superficial system

Question 7

If the reading normalizes with the tourniquet applied what does this mean

Answer 7

There is superficial insufficiency

Question 8

If the reading never normalizes when the tourniquet is applied what does this mean

Answer 8

There is deep insufficiency

Question 9

If the tourniquet is placed above the knee and the reading comes back normal what does this mean

Answer 9

GSV insufficiency

Question 10

If the tourniquet is placed below the knee and the reading comes back normal what does this mean

Answer 10

SSV insufficiency

Question 11

What study can quantify venous reflux and measure venous function

Answer 11

Venous air plethysmography

Question 12

An ejection fraction of what % is considered normal for a venous air plethysmography study

Answer 12

> 60%

Question 13

What study can detect the presence/absence of venous insufficiency and detect the presence of an DVT

Answer 13

CW doppler

Question 14

What study cant not choose vessel or sampling depth and has no imaging only waveform contour reading

Answer 14

CW doppler

Question 15

A test that seems negative but there is really disease describes

a) false negative
b) false positive

Answer 15

a) false negative

Question 16

Partial non-occlusive DVT, venous collaterals, and bifid systems are examples of

a) false negative study
b) false negative study

Answer 16

a) false negative study

Question 17

A test that has an abnormal reading but really is normal describes

a) false positive study
b) false negative study

Answer 17

a) false positive

Question 18

Extrinsic compression, severe PAD, CODP, and incorrect doppler or tech error are examples of

a) false negative study
b) false positive study

Answer 18

b) false positive

Question 19

For a CW doppler study what position is the patient placed in

Answer 19

Revered trendelenburg. (limb lower than the heart)

• Increased hydrostatic pressure encourages venous filling and allows for easier evaluation of the lower extremity veins

Question 20

__________ naturally occurring and occurs in most larger deep veins

Answer 20

spontaneity

Question 21

Name 3 veins non spontaneous flow should be seen in

Answer 21

1) tibials
2) superficial veins
3) radial/ulnar

Question 22

_________ flows with respiration

Answer 22

Phasicity

Question 23

Phasicity is normally seen in what veins

Answer 23

Peripheral

Question 24

If there is non-phasic or continuous flow where is the obstruction at

a) proximal
b) distal

Answer 24

a) proximal

Question 25

______ flow is normal for veins close to the heart

Answer 25

pulsatile

Question 26

Name 3 veins that have pulsatile flow

Answer 26

1) IVC
2) subclavian
3) IJV

Question 27

CHF, tricuspid regurgitation, and fluid overload are seen in what type of veins

Answer 27

peripheral

Question 28

Augmentation with distal compression or proximal release is considered

a) normal flow
b) abnormal flow

Answer 28

a) normal

Question 29

During proximal compression or valsalva what should happen to the flow

Answer 29

should halt or stop

Question 30

If there is augmentation during proximal compression or valsalva what does this mean

Answer 30

there is valvular incompetence

Question 31

In CW doppler reflux testing, what is a normal result

a) cessation of flow during proximal compression, augmentation on release
b) cessation of flow during distal compression, augmentation on release
c) augmentation of flow during proximal compression, cessation on release
d) augmentation of flow during distal compression, cessation on release

Answer 31

a) cessation of flow during proximal compression, augmentation on release

Question 32

Posterior tibial and peroneal veins are found to be non-spontaneous but augment with distal compression. How is this interpreted?

a) distal obstruction
b) normal finding
c) proximal obstruction
d) partial obstruction

Answer 32

b) normal finding

Question 33

Which of the following techniques is best for demonstrating spontaneous venous flow

a) hyperflexion and extension of the foot
b) proximal compression
c) patient breathing quietly
d) distal compression

Answer 33

c) patient breathing quietly

-Spontaneous means naturally occurring. There should be no need to induce the flow, it should be there as the patient is breathing normally

Question 34

What technique is best utilized to test for valvular incompetence during duplex testing?

a) flexion and extension of the foot
b) patient breathing quietly
c) distal compression
d) proximal compression

Answer 34

d) proximal compression

Question 35

A venous PPG is performed on a patient with complaints of swelling and brawny discoloration. Her initial VRT is 10 sec and 12 sec after tourniquet is placed above the knee. How are these findings interpreted?

a) within normal limits
b) GSV insufficiency
c) deep venous insufficiency
d) SSV insufficiency

Answer 35

c) deep venous insufficiency

-A VRT that never normalizes with the tourniquet= deep venous insufficiency.

normal = >20
abnormal= <20

Question 36

What clinical finding would be a contraindication to venous air plethysmography

a) pain and swelling
b)brawny discoloration
c) ischemic ulcers
d) lipodermatosclerosis

Answer 36

a) pain and swelling

Question 37

What is the most likely findings in a patient with post thrombotic syndrome

a) initial VRT < 20 and > 20 with tourniquet
b) initial VRT >20 and < 20 with tourniquet
c) VRT > 20 with and without tourniquet
d) VRT < 20 with and without tourniquet

Answer 37

d) VRT < 20 with and without tourniquet

-Post-thrombotic syndrome is chronic deep venous insufficiency due to previous DVT
Normal VRT > 20
superficial venous insufficiency VRT <20 that normalizes with the tourniquet
Deep venous insufficiency VRT < 20 that never normalizes