& Answers | Guaranteed Success, Exams of
Clinical Medicine
During a duplex venous exam, which of the following findings is the least likely to be associated
with acute deep venous thrombosis?
a. continuous venous flow
b. stationary echoes within the vein
c. homogeneous intraluminal echoes
d. venous reflux
e. enlarged incompressible vein d. venous reflux
Of the following techniques, which would be the least effective in detecting significant DVT?
a. photoplethysmography
b. duplex ultrasound
c. impedance plethysmography
d. pneumoplethysmography
e. strain-gauge plethysmography a. photoplethysmography
Most often, the settings for venous color flow imaging of the lower extremities:
a. are the same as those for peripheral arterial studies
b. are the same as those for abdominal arterial scanning
c. are the same as those for carotid scanning
d. are the same as those for abdominal venous scanning
e. are different from any of the above e. are different from any of the above
When performing lower extremity venous Doppler assessment in normal patient, cephalad flow
diminishes:
a. during Valsalva maneuver
b. during inspiration
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,c. during expiration
d. during proximal compression
e. all but c e. all but c
On CW Doppler assessment, a patient with a swollen left leg has loud, continuous flow signals
from the left greater saphenous vein. The asymptomatic leg has nonspontaneous flow in the
right greater saphenous vein, which augments with distal compression. These findings are
consistent with:
a. normal venous flow
b. right-left DVT
c. left-leg DVT
d. bilateral DVT
e. these findings are not helpful diagnostically c. left-leg DVT
The Valsalva maneuver:
a. increases pressure in the thoracic cavity, decreases pressure in the abdominal cavity
b. decreases pressure in the thoracic cavity, increases pressure in the abdominal cavity
c. slows down or stopes venous flow everywhere in the body
d. increases venous flow everywhere in the body
e. affects arterial, not venous, flow c. slows down or stops venous flow everywhere in the
body
Which of the following is NOT one of the commonly assessed characteristics of CW venous
Doppler?
a. spontaneity
b. gaiety
c. augmentation
d. competence
e. phasicity b. gaiety
A patient presents with a swollen right lower extremity. Duplex imaging demonstrates patency
of the femoral, popliteal, and veins. However, Doppler at the common femoral level on the right
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,is continuous, not changing with respiration, while Doppler of the left common femoral vein is
phasic. These findings might suggest:
a. thrombosis of the profunda femoris vein
b. right iliac thrombosis
c. left iliac thrombosis
d. vena cava thrombosis
e. this is not a diagnostically useful finding b. right iliac thrombosis
The optimal patient position for imaging of the lower extremity veins is:
a. semi-Fowler's position
b. Trendelenburg's position
c. reverse Trendelenburg's position
d. supine, leg elevated
e. answers a and c e. answers a and c
Demonstration of vein-wall coaptation in the extremities is best performed:
a. in a longitudinal plane with the color flow documenting cephaloid flow
b. in a longitudinal plane without color flow
c. in a transverse plane with the color flow documenting patency
d. in a transverse plane without color flow
e. coaptation is seldom diagnostic in duplex imaging d. in the transverse plane without
color flow
The examiner uses color flow to assess for competence at the common femoral vein level. With
Valsalva maneuver, there is red flow lasting approximately half a second, then blue flow on
release of Valsalva.
a. this finding is within normal limits
b. this finding is equivocal for significant valvular incompetence
c, this finding confirms significant valvular incompetence
d. this finding suggests AV fistula
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, e. this finding confirms deep vein thrombosis b. this finding id equivocal for significant
valvular incompetence
Signs on duplex venous imaging of acute rather than chronic deep vein thrombosis include all
EXCEPT:
a. bright intraluminal echoes
b. distended vein
c. dark intraluminal echoes
d. slightly compressible (spongy) character to thrombus
e. presence of a "tail" suggesting poor adherence to wall a. bright intraluminal echoes
Limitations of handheld CW Doppler venous assessment include all EXCEPT:
a. there may be bifid superficial femoral or popliteal veins
b. non-occluding thrombus may not be detected
c. a collateral vein may be mistaken for the vein of intended assessment
d. exact extent cannot be determined for follow-up studies
e. valvular incompetence cannot be assessed with CW Dopper e. valvular incompetence
cannot be assessed with CW Doppler
The examiner scans the femoral veins and notes a very small venous lumen, with bright,
thickened venous walls along most of the thigh. These findings suggest:
a. acute DVT
b. AV fistula
c. chronic thrombosis
d. congenitally hypoplastic veins
e. arterial, not venous, insufficiency c. chromic thrombosis
Thrombosis that appears on duplex scan to be dark, homogeneous in character, and poorly
attached to the venous wall suggests:
a. old, partially recanalized thrombosis
b. acute thrombosis
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