URR Vascular
all of the following describe AV malformation except A. direct connection between a single artery and vein B. pulsatile venous outflow C. dilated venous collaterals adjacent to the AVM D. low resistance arterial flow
A.
which of the following is a sign of a normally functioning hemodialysis graft? A. pain or pallor in the hand B. palpable thrill over the graft C. presence of a water hammer pulse D. absence of a palpable thrill over the graft
B.
if there is a left subclavian steal, which brachial artery evaluation will be abnormal? A. left bracial will have a higher BP and a triphasic waveform B. right brachial will have a higher BP and a blunted/monophasic waveform C. left bracial will have a lower BP and a blunted/monophasic waveform D. right brachial will have a lower BP and a blunted/monophasic waveform
C.
you identify flow moving toward the transducer in the left opthalmic artery and flow moving away from the transducer in the right opthalmic artery. which of the following explains these findings? A. critical stenosis in the left ACA B. critical stenosis in the distal left ICA C. critical stenosis in the right ACA D. critical stenosis in the distal right ICA
D.
which of the following can lead to systolic flow reversal in the hepatic veins? A. significant tricuspid regurgitation B. portal HTN C. Budd Chiari syndrome D. IVC thrombus at the level of the renal veins
A
All of the following are related to acute DVT except A. wet ulceration B. engorged, noncompressible vein C. swelling D. calf pain
A.
All of the following are sonographic findings of chronic DVT, except: A. engorged vein with increased echogenicity in the lumen B. flattened, collapsed vessel with increased echogenicity of the wall C. incomplete compressibility of the vein D. valvular insufficiency
A.
Which of the following statements is true regarding doppler flow evaluation of a rejected renal allograft? A. rejected allograft waveforms will demonstrate high resistance flow B. rejected allograft waveforms will demonstrate low resistance flow C. rejected allograft waveforms will demonstrate low RI and PI values D. renal allograft waveforms normally demonstrate arterial flow that varies with respiration
A.
__________ cause primary varicose veins, while ______________ causes secondary varicose veins A. incompetent valves, elevated deep venous pressures B. elevated deep venous pressures, elevated arterial pressures C. elevated deep venous pressures, incompetent valves D. incompetent valves, incompetent perforators
A.
a carotid doppler exam demonstrates an occlusion of the left ICA, but the distal ICA demonstrates retrograde flow. the ECA demonstrates increased diastolic flow. the ophthalmic artery on the left side demonstrates flow moving away from transducer. where is the collateral flow most likely coming from? A. ECA to ICA collateralization B. cross over collateralization through the ACA C. vertebrobasilar collateralization D. opthalmic to opthalmic collateralization
A.
a proximal femoral artery stenosis will cause the ______ A. acceleration time to increase B. acceleration time to decrease C. velocity to increase D. reynolds number to decrease
A.
a tardus parvus waveform is the result of A. significant proximal arterial stenosis B. partial venous obstruction C. <50% proximal arterial stenosis D. distal arterial obstruction
A.
all of the following are risk factors for venous disease except? A. hyperlipidemia B. polycythemia vera C. excessive sitting D. excessive standing
A.
all of the following are symptoms related to ICA/MCA disease except: A. dysphagia B. unilateral visual disturbances C. receptive aphasia D. expressive aphasia
A.
all of the following correctly describes Buerger disease except A. most commonly presents as multiple painless, wet, oozing ulcers of the feet and ankles B. associated with males that are heavy smokers C. commonly associated with collagen disease D. also known as thromboangiitis obliterans
A.
an abnormality in all of the following vessels could potentially be related to vasculogenic impotence except? A. external iliac artery B. internal iliac artery C. aorta D. common iliac artery
A.
an occlusion of the proximal left subclavian artery will lead to abnormal flow changes in all of the following except? A. left innominate artery B. left vertebral artery C. left brachial artery D. left ulnar artery
A.
if the physician is having trouble visualizing the needle on the ultrasound screen during a thrombin injection, how can you help to improve the visualization of the needle? A. use electronic steering to increase the incident angle between the US beam and the long axis needle to be closer to 90 degrees B. use electronic steering to reduce the incident angle between the US beam and the long axis needle to be loser to 0 degrees C. increase the output power to the maximum setting D. use a lower frequency probe
A.
if the tibioperoneal trunk is occluded, flow in which calf vessel(s) will not be decreased? A. anterior tibial artery B. posterior tibial artery C. peroneal artery D. posterior tibial artery and peroneal artery
A.
nutcracker syndrome is defined as A. abnormal compression of the LRV by the SMA and aorta B. abnormal compression of the celiac axis with respiration C. entrapment of the subclavian artery by structures in the shoulder/neck D. entrapment of the popliteal artery seen most commonly in runners
A.
the most common location of valvular insufficiency is A. great saphenous and common femoral vein junctions B. short saphenous vein C. popliteal vein D. superficial and deep fem vein junction
A.
which of the following acronyms refers to the standard image file storage format used in medical facilities in the united states? A. DICOM B. MPEG C. AVI D. JPEG
A.
which of the following causes an increase in the (RI) of the distal common carotid artery? A. proximal ICA stenosis B. proximal CCA stenosis C. valsalva maneuver D. aortic valve insufficiency
A.
which of the following is a characteristic of the doppler waveform obtained distal to the site of stenosis in an ICA that demonstrates string flow on color doppler? A. blunted waveform B. spectral window C. increased diastolic flow D. decreased acceleration time
A.
which of the following is a common occurrence post endarterectomy? A. neointimal hyperplasia B. intracranial hemorrhage C. intimal dissection D. CHF
A.
which of the following statements regarding venous ulceration is false? A. venous ulcerations are usually very painful B. venous ulcerations are usually wet and oozy C. venous ulcerations are most commonly located on the medial calf-ankle area D. most venous ulcers can be treated and resolved.
A.
which of the following transducers would be preferred for a lower extremity DVT evaluation on an average sized patient? A. 5-7 MHz linear B. 5-7 MHz curvilinear C. 10-12 MHz linear D. 7-10 MHz sector
A.
which of the following ultrasound findings is least likely to be seen with PHACE syndrome? A. paraganglioma between the ECA and ICA on the left B. abberant origin of the left ICA C. basilar artery stenosis D. absence of the right ICA
A.
you are performing a TCD exam to assess collateral flow with a right ICA occlusion. You identify flow moving away from the transducer at 90cm/s with decreased pulsatility in the right opthalmic artery. the left opthalmic artery demonstrates flow moving toward the transducer with a velocity of 45cm/s. what is indicated by these findings? A. ECA to ICA collateralization B. normal flow parameters, no collateralization present C. posterior to anterior collateralization D. cross over collateralization
A.
all of the following are risk factors for developing a thrombus in a deep vein except A. anemia B. obesity C. oral contraceptive pills D. polycythemia vera
A>
all of the following correctly describe Hereditary hemorrhagic telangiectasia that affects the liver, except A. autosomal recessive disorder B. can be associated with an arteriovenous AVM in the liver C. can cause mesenteric angina from steal phenomenon D. can be associated with an portovenous AVM in the liver
A>
budd chiari syndrome refers to acute or chronic obstruction of which vessel? A. hepatic veins B. hepatic artery C. splenic artery D. splenic veins
A>
which of the following can lead to an increase in the frequency shift detected in the common femoral artery? A. 80% stenosis of the CFA B. proximal superficial femoral artery occlusion C. 80% stenosis of the superficial femoral artery D. decreased probe frequency
A>
which of the following statements is true regarding a partial venous obstruction? A. may cause continuous flow B. may cause phasic flow C. can result in flow reversal during Valsalva maneuver D. may cause increased volume of flow seen with distal augmentation
A>
if the left ICA occlusion is present, which of the following statements is true? A. the right opthalmic artery will demonstrate decreased or absent flow B. the left MCA will demonstrate decreased or absent flow C. the right MCA flow will be decreased or absent with flow reversal in the right internal carotid siphon D. the right MCA flow will be decreased or absent with normal flow in the right internal carotid siphon
B
when performing a carotid exam, the prox ICA is limited in color and doppler evaluation by heavy calcification of the arterial wall. the mid ICA segment demonstrates biphasic flow with the main component of flow moving in retrograde fashion. which of the following describes the CCA pattern that will be identified? A. increased velocity with decreased resistance B. triphasic flow with decreased velocity C. triphasic flow with increased velocity D. normal appearance due to distal collateral flow in IVA
B
which of the following is true regarding the difference between fibromuscular dysplasia and atherosclerosis of the internal carotid artery? A. FMD usually leads to aneurysm formation while atherosclerosis leads to stenosis B. atheroma formation usually occurs in the proximal segment while FMD usually affects the more distal segments of the ICA C. atherosclerosis forms within the adventitia of the vessel while FMD is caused by overproliferation of the intima D. atherosclerosis forms within the intima of the vessel while FMD is caused by overproliferation of the adventitia
B
a bilateral decrease in the femoral pulses can be related to A. DVT formation B. aortic coarctation C. occlusion of the deep femoral artery D. occlusion of the popliteal artery
B,.
All of the following describe ways to differentiate lymphedema from edema caused by acute DVT, except? A. lymphedema causes non-pitting edema, acute DVT causes pitting edema B. lymphedema always affects both legs, while acute DVT only affects one leg C. elevating the leg will have no effect on the swelling, but can reduce swelling associated with acute DVT D. lymphedema does not normally cause skin discoloration, while acute DVT can be associated with warmth and redness
B.
In order to validate test results, 450 patients underwent Ascending Venography and a lower extremity venous doppler ultrasound to evaluate patients for DVT. 300 veins were correctly diagnosed as having a normal flow or negative for DVT. 100 veins were correctly diagnosed as a thrombus present or positive for DVT. 35 veins were incorrectly diagnosed with DVT by ultrasound and 15 veins were incorrectly diagnosed as negative for DVT by ultrasound. what is the sensitivity of a venous ultrasound for this group of patients? A. 300/315=95% B. 100/115= 87% C. 100-135= 74% D. 300/335= 90%
B.
all of the following are potential acute complications that can occur with a recent liver transplant except A. portal vein thrombosis B. hepatic artery atherosclerosis C. hepatic vein thrombosis D. biloma
B.
if new research shows that the minimum velocity criteria used to diagnose >60% renal artery stenosis is actually 225cm/s, not 180cm/s, how will this affect the negative predictive value of the exam? A. increase by 4.5% B. decrease will vary with patient population C. no effect on the negative predictive value, only affects accuracy D. decrease by 4.5%
B.
the bernoulli principle explains the A. increase in pressure seen with increased blood flow velocity B. decrease in pressure seen with increased blood flow velocity C. decrease in pressure seen with decreased blood flow velocity D. decrease in resistance seen with increased blood flow velocity
B.
the diagnosis of AAA is made once the aorta AP or width dimension exceeds A. 2.5cm B. 3.0 cm C. 3.5 cm D. 4.0 cm
B.
what is the minimum % ICA stenosis that is considered hemodynamically significant and treatment is recommended? A. 80% B. 70% C. 95% D. 75%
B.
which of the following conditions can cause cardiac pulsatility to occur in the leg veins? A. bradycardia B. congestive heart failure C. DVT D. tachycardia
B.
which of the following correctly describes the negative predictive value(NPV) of a testing technique? A. the ability of a test to detect disease when it IS present B. if the test result is negative, NPV is the probability that the patient does not have disease C. if the test result is positive, NPV is the probability that the patient actually has the disease D. the ability of a test to rule out disease when it is NOT present
B.
which of the following correctly describes the specificity of a testing technique? A. the ability of a test to detect disease when it IS present B. the ability of a test to rule out disease when it IS NOT present C. if the test result is positive, specificity is the probability that the patient actually has the disease D. if the test result is negative specificity is the probability that the patient does not have disease
B.
which of the following describes a normal result for uniformity testing of the ultrasound system? A. images taken of the same structure with different probes of the same frequency demonstrate uniform echo amplitude between the compared images B. TGC set to produce an image with equal echo amplitude across the screen and then when the function is turned off, the echoes in the far field are reduced to amplitude C. all images in a randomly selected exam demonstrate a constant mechanical index D. all images in a randomly selected exam demonstrate a constant thermal index
B.
which of the following describes the path of an embolus? A. a small piece of thrombus breaks off from a thrombus in the left ventricle and floats towards the lungs B. a small piece of soft plaque breaks off from the carotid bulb and floats towards the brain C. a small piece of soft plaque breaks off from the carotid bulb and floats towards the lungs D. a small piece of thrombus breaks off from a thrombus in the right ventricle and floats towards the brain
B.
which type of aortic aneurysm is associated with an infection of the arterial wall? A. berry B. mycotic C. ectatic D. saccular
B.
A research project produced 16 true positive results and 4 false positive results along with 24 true negative and 6 false negative results from the total of 50 patients evaluated. what is the specificity of the exam technique? A. 95% B. 86% C. 27% D. 73%
B. 86%- (24+4);24/28=0.86
which of the following is associated with spectral broadening? A. blunted waveform B. increased bandwidth C. pulsatile flow D. laminar flow
B. increased bandwidth
a pulsatility index of >1.2 in the cerebral vessels indicates: A. normal flow resistance B. vasospasm C. mildly decreased resistance D. severely decreased resistance
B. vasospasm causes increased resistance in vessels
which of the following is a cause for deep venous HTN? A. Klippel Trenaunay Webber syndrome B. aortic coarctation C. CHF D. diffuse atherosclerotic disease
C
Broca's aphasia can be defined as A. inability to swallow solid food B. inability to understand speech, speak, or follow directions C. inability to speak but can understand and follow directions D. inability to swallow liquids
C.
a patient presents with a prior history of popliteal DVT and a recent history of intermittent mild leg pain with increasing appearance of small varicosities on the calf. which statement below best describes his condition? A. there is most likely a clot in the gastrocnemius veins of the calf B. there is msot likely a bakers cyst in the popliteal fossa causing extrinsic compression C. the patient is suffering from secondary varicose vein formation D. the patient most likely has a recurrent acute DVT
C.
a patient with aortic coarctation distal to the left subclavian artery origin will demonstrate: A. increased bilateral ABIs B. no change in ankle pressures with exercise C. systemic HTN with increased brachial pressures D. bounding pedal pulses
C.
a research project produced 16 true positive results and 4 false positive results along with 24 true negative and 6 false negative results from the total of 50 patients evaluated. what is the negative predictive value of the exam technique? A. 20% B. 40% C. 80% D. 95%
C.
a research project produced 16 true results and 4 false positive results along with 24 true negative and 6 false negative results from the total of 50 patients evaluated. what is the positive predictive value of the exam technique? A. 20% B. 50% C. 80% D. 95%
C.
all of the following signs/symptoms are commonly associated with a venous stasis ulcer, except A. discoloration of the affected area B. oozing C. severe pain D. located in the medial malleolus
C.
in order to validate test results, 450 patients underwent ascending venography and a lower extremity venous doppler ultrasound to evaluate patients for DVT. 300 veins were correctly diagnosed as having a normal flow or negative DVT. 100 veins were correctly diagnosed as a thrombus present or positive for DVT. 35 veins were incorrectly diagnosed with DVT by ultrasound and 15 veins were incorrectly diagnosed as negative for DVT by ultrasound. what sit he positive predictive value of the venous ultrasound exam for this group of patients? A. 300/335= 90% B. 100/115= 87% C. 100/135= 74% D. 300/315= 95%
C.
proximal to a dvt in the femoral vein, the flow appears very slow and visible on 2D imaging. the blood cells appear lined up or stacked in rolls. what is this phenomenon called? A. raynaud phenomenon B. May-Thurner syndrome C. rouleau formation D. phlegmasia cerulea dolens
C.
the doppler tracing demonstrates electrical noise. how can you reduce or eliminate the artifcat? A. decrease the PRF B. extend the cord to move the mcahine as far from the electrical outlet as possible C. increase the wall filter settings D. decrease wall filter settings
C.
when considering the effectiveness of the carotid doppler exam at your lab, the negative predictive value is 88%, the positive predictive value is 95%, the sensitivity is 85% and the specificity is 90%. Using those parameters, which of the following could be the value for the accuracy of the testing technique? A> 92% B. 96% C. 89% D. 84%
C.
which of the following describes cerebral cross-over collateralization? A. left ICA flow through posterior communicator to left vertebral B. flow from the left MCA to the right MCA through a cross over collateral vessel C. flow from the left ACA through the anterior communicating artery D. flow from the right MCA to the left MCA through a cross over collateral vessel
C.
which of the following imaging parameters is responsible for the ability to resolve the wall thickness of an artery? A. contrast rsolution B. dynamic range C. axial resolution D. lateral resolution
C.
which of the following is a characteristic of the doppler waveform obtained at the site of stenosis in an ICA with >70% stenosis? A. decreased acceleration time B. blunted waveform C. increased diastolic flow D. spectral window
C.
which of the following is a congenital vascular abnormality that commonly causes decreased ankle pressures bilaterally? A. Bud Chiari Syndrome B. CHF C. coarctation of the aorta D. thoracic outlet syndrome
C.
which of the following statements is true regarding the aorta? A. the most common location for an aortic dissection is at the iliac bifurcation. B. the majority of the aortic branches that lead to abdominal organs are lateral branches C. rupture is the most common complication of an aortic aneurysm D. suprarenal AAAs normally do not affect the arterial flow to the kidneys
C.
which transducer should be selected for a renal artery doppler examination for a patient that is 5'5" and 150lbs? A. 3.5 MHz phased array B. 2.5 MHz curvilinear array C. 3.5 MHz curvilinear array D. 3.5 MHz linear array
C.
while performing a TCD exam using the left transtemporal window, you identify flow moving away from the transducer with a mean velocity of 95cm/s in the A1 segment of the left anterior cerebral artery. from the right temporal window, the A1 segment of the right anterior cerebral artery demonstrates flow moving toward the transducer with a mean flow velocity of 30cm/s. which of the following explains these findings? A> occlusion of the left A1 segment at its origin from the ICA B. normal flow direction and velocities are demonstrated C. occlusion of the right A1 segment and its origin from the ICA D. occlusion of the anterior communicator artery
C.
why would exposure to cold increase symptoms of lower extremity arterial stenosis? A. increased resistance due to vasoconstriction and blood becomes less viscous with cold exposure B. blood becomes less viscous with cold exposure C. increased resistance due to vasoconstriction D. increased resistance due to vasodilation
C.
The most common location of a bakers cyst is: A. inguinal canal B. anterior patellar space C. medial popliteal fossa D. medial antecubital fossa
C. Medial popliteal fossa
what statement describes a TIA? A. stroke symptoms lasting 24 hours -2 weeks B. stroke symptoms lasting 24-72 hours C. stroke symptoms lasting 24 hours or less D. stroke symptoms lasting 2-4 weeks
C. TIA=24 hours or less RIND= 24-72 hours CVA= lasting more than 72 hours
a patient presents for a carotid ultrasound. the chart states a history of 2 recent episodes of amaurosis fugax. which statement best describes amaurosis fugax? A. dizziness upon standing B. spot flashing in front of eyes C. monocular blindness D. bilateral blindness for more than 24 hours
C. black shade coming down over their eyes
A curvilinear transducer can be used to better evaluate: A. flow in the distal posterior tibial artery B. flow in the anterior tibial artery C. varicosities covering a large area D. deep veins in obese patients
D.
a patient complains of bilateral pain and color changes in the legs. when he lies down, both legs become pale. when he sits up on the edge of the bed, both legs become reddened. what is the most likely cause of these color changes? A. deep venous reflux B. normal arterial flow C. significant venous obstruction D. significant aortic stenosis
D.
all of the following are symptoms of a patient with chronic venous disease except A. spider veins B. discoloration of the "gaitor zone" C. varicose veins D. recent onset of limb swelling
D.
all of the following are true regarding venous insufficiency, except A. most common complication of DVT B. most commonly occurs at the saphenofemoral junction at the groin C. most common venous disease of the extremities D. most commonly occurs due post-phlebitic syndrome
D.
all of the following correctly describe compartment syndrome, except A. can occur in the leg or arm B. most commonly occurs due to trauma C. prevents blood flow in an d out of surrounding tissues D. all forms of compartment syndrome are considered an emergency
D.
congestive heart failure causes increased pulsatility in all of the following except? A. iliac veins B. portal vein C. hepatic veins D. superficial femoral artery
D.
congestive heart failure is more commonly seen with _________, while distal ischemia is more commonly seen with _____________. A. distal AV fistula, proximal AV fistula B. AV malformation, AV fistula C. AV fistula, hemodialysis fistula D. proximal AV fistula, distal AV fistula
D.
ten days post right hip replacement surgery, the patient presents with recent onset of right calf and thigh swelling. which of the following should be considered a potential finding on the ultrasound exam? A. AV malformation B. popliteal entrapment syndrome C. internal iliac vein thrombosis D. AV fistula
D.
the difference between the reflected and transmitted frequency refers to A. resistive index B. doppler frequency C. dynamic range D. doppler shift
D.
when evaluating the doppler waveform at a focal stenosis in the prox ICA, which of the following doppler characteristics will be demonstrated? A. decreased peak systolic velocity, increased end diastolic velocity B. increased peak systolic velocity, increased diastolic flow reversal C. increased peak systolic velocity, decreased end diastolic velocity D. increased peak systolic velocity, increased end diastolic velocity
D.
which component of the duplex ultrasound system processes the doppler shift information to provide the doppler waveform? A. quadrature phase detector B. quadrature phase detector and fast fourier transformer C. demodulator D. fast fourier transformer
D.
which of the following correctly describes the positive predictive value (PPV) of a testing technique? A. the ability of a test to detect disease when it IS present B. if the test result is negative PPV is the probability that the patient does not have disease C. the ability of a test to rule out disease when it IS NOT present D. if the test result is positive, PPV is the probability that the patient actually has the disease
D.
which of the following describes chronic lower extremity DVT? A. pulsatile flow pattern B. varicocele formation C. vein is completely non-compressible D. echogenic vein walls
D.
which of the following describes why there is no aliasing on CW doppler? A. CW probes are always lower frequency than PW probes B. CW doppler does not require a sample volume to produce a doppler waveform C. CW doppler does not require beam steering to produce a doppler waveform D. the PW transducer uses a single element and the CW transducer uses two elements
D.
which of the following imaging parameters is responsible for the ability to resolve two atheromas that are side by side in an artery? A. dynamic range B. axial resolution C. contrast resolution D. lateral resolution
D.
which of the following is a characteristic of an ICA waveform with 50-69% stenosis? A. decreased diastolic flow with EDV less than 20cm/s B. diastolic flow reversal C. clear spectral window D. increased peak systolic velocity <230cm/s
D.
which of the following is least likely to be a complication caused by a Bakers cyst? A. pain B. thrombosis due to extrinsic compression C. swelling D. thrombosis due to valvular insufficiency
D.
which of the following statements is true regarding the signs and symptoms of lower extremity arterial disease? A. significant ischemic disease in the leg will lead to pallor with dependency B. significant ischemic disease in the leg will lead to rubor with elevation C. significant ischemic disease in the leg will lead to cyanosis upon elevation D. significant ischemic disease in the leg will lead to pallor upon elevation and rubor with dependenvy
D.
which of the following vessels supplies blood to a carotid body tumor? A. MCA B. ICA C. subclavian D. ECA
D.
which type of image resolution makes it possible to differentiate the intimal media thickness from the outer arterial wall? A. temporal B. elevational C. lateral D. axial
D.
vessel wall and plaque morphology is best evaluated in 2D when the beam is at what incident angle to the vessel? A. 0 degrees B. 45 degrees C. 60 degrees D. 90 degrees
D>
which of the following describes abnormal lower extremity venous flow response to distal augmentation? A. augmentation causes increased flow toward heart followed by flow normalization B. augmentation causes increased flow toward heart followed by at least 3 seconds of flow reversal toward feet C. augmentation causes increased flow toward feet followed by flow reversal >0.5 sec toward heart D. augmentation causes increased flow toward heart followed by flow reversal >0.5sec toward feet
D>
which of the following indicates a significant SMA stenosis? A. pain in the abdomen when hungry that is relieved by eating/digestion B. PSV>200cm/s C. dilated inferior mesenteric artery that is easily visualized sonographically D. mesenteric-aortic ratio>2.5
c.
