RVT Practice Test

how can you acquire the specificity of a diagnostic exam?

# of true negatives / all negative diagnoses

how many valves are in the IVC

0

depth to find MCA

30-60 mm

+ vasospasm characteristics

MCA velocity >120 cm/s Lindegaard ratio >3.0

First branch of aortic arch

brachiocephalic artery

Which description represents the type of waveform morphology demonstrated in this image? a) Pre-steal b) To and Fro c) Pulsus Bisferiens d) Tarvus-Parvus

c) pulsus bisferiens

ABI ______ after exercise

increases

where is arterial PPG recorded from

surface of the skin

why do we use the lindegaard ratio

to differentiate increased volume flow from decreased diameter when high velocities are encountered in the MCA or ICA

a dissection of an artery occurs between which vessel layers

tunica media and tunica intima

helical flow

twisting type of blood flow

normal claudication range

0.5 - 0.8

in the presence of ICA occlusion, name all of the potential collateral pathways to perfuse the ipsilateral cerebral hemisphere

1. contralateral ICA through reversed flow in the ipsilateral ACA 2. vertebrobasilar system through the PCA 3. ipsilateral ECA through the orbit to the ophthalmic artery

Mild MCA vasospasm mean velocities

120-149 cm/sec

Moderate MCA vasospasm mean velocities

150-199 cm/sec

celiac axis/trunk

1st branch off aorta usually found withing first 2cm; divides into 3 arteries: Hepatic, splenic & left gastric

how many brachiocephalic veins and arteries are there

2 veins and 1 artery on the right side

cuff should be ____ wider than limb diameter

20%

veins hold what % of the bodies blood volume

25 - 40%

depth to find ACA

60-75 mm

depth to find PCA

60-75 mm

depth to find Vertebral A

60-90 mm

depth to find Basilar A

70-120 mm

normal toe-brachial index

>0.8

Severe MCA vasospasm mean velocities

>200 cm/sec

normal hemodialysis graft

>800 mL/min

most common anatomic variant of the aortic arch

A common origin of the innominate and left CCA

Renal artery stenosis is mainly caused by 2 things

Atherosclerosis and medial fibromuscular dysplasia

what is the name of the radiocephalfc dialysis graft

Brescia-cimino

Celiac artery occlusion causes retrograde flow in which artery a) ima b) sma c) splenic artery d) common hepatic artery

D) common hepatic artery

in the presence of a carotid body tumor, what happens to the ECA

ECA resistance will decrease

median arcuate ligament syndrome causes celiac artery PSV to increase during

Exhalation

vein with the most valves

GSV

Which characteristics best describes the Doppler wavefrom seen in this image of Posterior Tibial Artery without obstruction? a) Pulsus Bisferiens b) Tardus parvus c) Hyperemic d) High Resistance

Hyperemic

a patient returns to the hospital two days after a liver transplant c/o severe abdominal pain, which can you expect to see on ultrasound

IVC thrombus

pulsatility index equation

PI = Systolic - diastolic / mean velocity

what is known as a "pulseless" disease

Takayasu's arteritis

Which description represents the type of waveform morphology demonstrated in this image? a) Pre-steal b) To and Fro c) Pulsus Bisferiens d) Tarvus-Parvus

Tardus-Parvus

Which description represents the type of waveform morphology demonstrated in this image? a) Pre-steal b) To and Fro c) Pulsus Bisferiens d) Tarvus-Parvus

To and Fro (pseudo)

proximal ICA waveform with a distal ICA occlusion

abnormal high resistance

what is the most common anomaly of the circle of willis

absence or hypoplasia of one or both of the communicating arteries

dicrotic notch indicates what

aortic valve closing

an arterial spectral Doppler indentation on the PSV in the CCA is caused by what

aortic valve closure

arteries that course above the renal pyramids

arcuate arteries

an ulcer on the bone prominence indicates what

arterial insufficiency

if a patient has fibromuscular dysplasia, they're at most risk for what

artery dissection

portal hypertension causes

ascites and esophageal varices

what is the effect of increasing sample volume depth on the Doppler system a) SPL increases b) time interval between pulses is longer c) attenuation decreases d) PRF is higher

b) time interval between pulses is longer

right and left vertebral arteries divide into the

basilar artery

bruit

blowing, swooshing sound heard through a stethoscope when an artery is partially occluded

Which finding on preoperative vein mapping would likely make AVF creation unsuccessful? a) Presence of prior AV graft b) Presence of prior AV Fistula c) Vein diameter less than 2 mm d) Arterial diameter less than 3 mm

c) vein diameter less than 2 mm

in a patient with portal hypertension, you notice a network of varices on the abdominal wall, this is described as

caput medusae

your patient has erythema (redness) & edema along his anterior tibial regions, this is

cellulitis

during a treadmill test, a patient experiences decreased ankle pressures bilaterally, this suggests

claudication (induced by exercise)

waveform distal to occlusive DVT

continuous venous flow, reduced phasicity

which vessel is most likely to be enlarged in the presence of vertebral artery occlusion

contralateral vertebral artery

first branch of ascending aorta

coronary artery

which of the following arteries does NOT arise from the intracranial ICA a) MCA b) PCA c) ACA d) ascending pharyngeal artery

d) ascending pharyngeal artery

Which flow change will occur as a result of an acute ICA occlusion? a) Ipsilateral vertebral artery flow velocity will double b) Ipsilateral vertebral artery flow velocity will retrograde c) Ipsilateral CCA velocity will become dampened d) Ipsilateral CCA velocity will become high resistance / triphasic

d) ipsilateral CCA velocity will become high resistance / triphasic

A 65 yo PT was referred or amaurosis fugax on the Left side. The symptoms are most likely due to lesion in which artery? a) Ipsilateral ECA b) Ipsilateral vertebral c) Ipsilateral carotid d) Ipsilateral MCA

d) ipsilateral MCA

Which vein will exhibit pulsatile flow as a normal variant? a) Common Femoral b) Popliteal c) Radial d) Subclavian

d) subclavian vein

during the valsalva maneuver, what happens to venous flow?

decreases or stops venous flow in the body

when a patient exhales

diaphragm raises and thoracic pressure increases

abnormal, resistive, and blunted waveform in the vertebral artery indicates

distal disease

high resistance, low velocity in vertebral artery suggests:

distal occlusion

median arcuate ligament syndrome also known as

dunbar syndrome

in the lower extremity, maximum flow return in the venous system is present with

exhalation

normal plethysmography waveforms

exhibit a dicrotic notch

ICA string sign

extensive plaque causing narrowing of the vessel or occluded ICA

three major branches of ophthalmic artery

frontal, supraorbital, and nasal arteries

how do we calculate the lindegaard ratio (hemisphere index)?

highest MCA divided by highest ICA

how to calculate ABI

highest systolic pressures at ankle level divided by the higher of the two brachial pressures

less reflection occurs for PPGs for which types of blood flow?

increased blood flow

hypogastric artery = ________

internal iliac artery

which of the following is NOT a collateral for ICA obstruction

intersegmental to arcuate branches

a 48-year old male presents with retrograde flow in the left vertebral artery, which vessel is most likely to be occluded and what is this phenomenon called?

left or ipsilateral (same side) subclavian artery and this is termed subclavian steal syndrome

plaque build up in the arteries is an accumulation of what

lipoprotein

a patient has a resting ABI of 0.76, this is indicative of

mild disease

a patient has a resting ABI of 0.57, this is indicative of

moderate disease

what is the most common anatomic variant of the renal arteries

multiple renal arteries

which branch of the ECA provides a collateral pathway to the vertebral artery a) lingual artery b) facial artery c) occipital artery d) superficial temporal artery

occipital artery (think its closer to the back of the neck)

thump artifact

occurs when ICA is occluded

thrill

palpable vibration felt outside of the body

TIA is characterized by

paralysis (focal weakness), paresthesia (numbness), amaurosis fugax (TIA of the eye), and aphasia (difficulty speaking)

Which description represents the type of waveform morphology demonstrated in this image? a) Pre-steal b) To and Fro c) Pulsus Bisferiens d) Tarvus-Parvus

pre-steal

tardus parvus waveform in distal ICA suggests:

proximal occlusion

waveform proximal to occlusive DVT

pulsatile venous flow (unless patient has CHF in which pulsatile venous flow occurs bilaterally)

a non-invasive test that can be used to augment a subclavian steal from hesitant stages to complete stages so it can be more easily recognized

reactive hyperemia

progression of arterial disease

reduced claudication, toenail thickening, discolored and scaly skin

distal CCA occlusion can cause

retrograde flow in ECA and dampened monophonic waveforms in the ICA

what type of artifact will mimic an artery dissection

reverberation

Calculate ABI if: right left brachial artery 152 146 posterior tibial artery 112 158 dorsalis pedis artery 108 154

right ABI: 0.74 left ABI: 1.0

basilar artery divides into

right and left posterior cerebral arteries

Brachiocephalic artery divides into

right common carotid artery and right subclavian artery

if you see retrograde or "hesitant" flow in the right vertebral artery, what side of of the subclavian is affected?

right subclavian (ipsilateral side)

a patient with mild claudication has a normal ABI of 1.09, what should you perform next?

stress test

Via which of the following vessels does the external carotid artery provide an anastomotic link to the internal carotid artery?

superficial temporal artery

what is a contraindication for pseudoaneurysm closure?

the width of the pseudoaneurysm neck is 2 - 3 cm

an ulcer on the medial malleolus indicates what

venous insufficiency