RCES FINAL Exam Questions with All Correct Answers

Loss of spectral window with pulsed doppler ultrasound occurs with a. flow turbulence b. parabolic flow c. laminar flow d. all of the above e. none of the above a. flow turbulence what must be present in order for flow to occur? a. stenosis b. resistance c. pressure gradient d. kinetic energy e. potential energy c. pressure gradient a severe unilateral neurological deficit which is not reversible is classified as a. stroke b. reversible (resolving), ischemic neurological deficit c. transient ischemic attack d. stenosis e. bruit a. stroke which of the following is NOT related to atherosclerosis a. cerebral aneurysm b. subclavian steal c. carotid body tumor, fibromuscular dysplasia d. intraplaque hemorrhage e. atheroma emboli c. carotid body tumor, fibromuscular dysplasia the normal subclavian artery waveform pattern is described as a. low resistance b. high resistant c. multiphasic d. a & c e. b & c e. b & c occlusion of which of the following will not cause amaurosis fugax a. common carotid artery b. innominate artery c. internal carotid artery proximal to origin of opthalmic artery d. proximal internal carotid artery immediately after the carotid bulb e. middle cerebral artery e. middle cerebral artery ________ artery supples penis and is a branch of ______ artery a. internal thoracic artery, internal iliac artery b. pudenal artery, internal iliac artery c. pudenal artery, external iliac artery d. pudenal artery, dorsal artery b. pudenal artery, internal iliac artery when visualizing the carotid bifurcation using duplex ultrasound, MRI or angiography, the best way to determine whether you are looking at the inter carotid artery is the fact that a. the internal carotid has a bulb and external carotid does not b. the external carotid has branches and internal carotid does not in the neck c. the internal carotid has branches near the bifurcation and external does not d. the external has a larger lumen than internal e. the internal tapers at bifurcation b. the external carotid has branches and internal carotid does not in the neck change in ________ causes the biggest change in blood flow in a vessel a. radius of the vessel b. viscosity of the blood c. direction of flow of blood d. length of the vessel e. potential energy within the walls of the vessel a. radius of the vessel in the intracranial circulation, which vessel is involved in the most important collateral pathway (cross over) with an occluded ICA a. anterior communicating artery b. vertebral artery c. common carotid artery d. posterior cerebral artery e. basilar artery a. anterior communicating artery where is the carotid siphon located a. distally in the cranium b. at the common carotid bifurcation c. at the proximal portion of ECA where the superior thyroid artery originates d. proximal to the origin of the ophthalmic artery e. at the level where the external carotid artery enters the face a. distally in the cranium what happens when resistance is increased a. flow increases b. flow decreases c. pressure remains unchanged d. potential energy and kinetic energy remains same e. flow remains unchanged b. flow decreases venous refilling time by photoplethysmography was 10 second without a tourniquet applied and 25 seconds with a tourniquet applied to the lower thigh. the diagnosis is most likely a. deep and superficial valvular insufficiency b. deep valvular insufficiency c. superficial venous valvular insufficiency d. superficial venous thrombosis e. deep venous thrombosis c. superficial venous valvular insufficiency a duplex image of the carotid bifurcation that demonstrates a goblet- like configuration of the internal and external branches curving around a highly vascularized mass suggest carotid body tumor the most common arterial puncture site for all forms of angiography (including cerebral) is the common femoral artery which of the following statements regarding abdominal aortic aneurysm is false a. AAAs are most commonly infra-renal b. computerized tomography and MRI are common modalities used for diagnosis of AAA c. ultrasound imaging is the most frequently used modality for diagnosis of AAA d. abdominal aortic aneurysms pose a significant risk of rupture if > 6 cm in diameter e. most pre- rupture AAAs are discovered because of severe abdominal pain or distal emboli e. most pre- rupture AAAs are discovered because of severe abdominal pain or distal emboli which of the following statement about portal vein is true is bidirectional b. the vessel carries 50% of what the hepatic artery carries into liver c. the vessel is formed by confluence of hepatic vein and spleic vein d. flow is hepatopetal d. flow is hepatopetal in using doppler with spectral analysis to assess the internal carotid artery which of the operator induced errors would most likely result in a falsely low frequency shift a. increasing the doppler signal gain b. allowing the signal beam to overlap both artery and vein c. changing a higher frequency transducer d. leaving the wall filter low e. increasing the beam angle to 70 degree e. increasing the beam angle to 70 degree doppler waveform of the subclavian or axillary artery in a normal individual would typically resemble a common femoral or superficial femoral artery waveform We have an expert-written solution to this problem! all of the following will help distinguish the aorta from the inferior vena cava EXCEPT a. the aorta lies more midline b. color flow or duplex doppler imaging will show respiratory changes in the inferior vena cava c. the inferior vena cava is normally to the right of the aorta d. the inferior vena cava normally compressible while the aorta is not e. the aorta has branches arising posteriorly. e. the aorta has branches arising posteriorly. pre injection blood flow in the penile arteries has a _______ resistance and post injection blood flow assumes _______ resistance High , Low which of the following is not a useful color flow adjustment in an effort to detect slow flow in a possibly occluded internal carotid artery a. increase color flow gain b. increase color flow PRF c. decrease color flow PRF d. decrease color flow wall filter e. increase sample volume size of the vessel b. increased color flow PRF We have an expert-written solution to this problem! which of the following vessel courses posterior to the inferior vena cava right renal artery you are scanning a patient in which the right ICA is totally occluded. how will the blood flow to the under perfused right MCA from contralateral arterial hemisphere aorta - left CCA - left ICA- left ACA - ACoA - right ACA - right MCA during the expiration the intra-abdominal pressure decreases, therefore the doppler signal from the common femoral vein should increase A symptom of vertebrobasilar insufficiency is: Diplopia: double vision the following arteries have low resistance flow characteristics ICA, postprandial SMA, renal arteries a left arm blood pressure that is 40 mmHg lower than the right arm can be a result of any of the following except a. thoracic outlet syndrome b. innominate artery occlusion c. subclavian steal syndrome d. coarctation of aortic arch e. axillary artery embolus b. innominate artery occlusion focal anechoic region visualized within an atherosclerotic plaque may represent intraplaque hemorrhage which of these patients would most likely be at high risk for a stroke a. 62 year old woman with fractured hip b. 36 year old man with hodgkins disease c. 75 year old woman admitted for TIA d. 18 year old male recovering from multiple injuries sustained in motor accident e. 72 year old overweight woman with CHF c. 75 year old woman admitted for TIA as an arterial stenosis becomes hemodynamically significant, which statement is true about the hemodynamics in the stenosis a. flow volume increases, peak systolic velocity decreases b. pressure energy decreases, peak systolic velocity decreases c. pressure energy decreases, peak systolic velocity increases d. kinetic energy decreases peak systolic velocity increases c. pressure energy decreases, peak systolic velocity increases not correct regarding greater saphenous vein a. it passes superiorly on the lateral side of the knee b. it is longest vein in body c. it enters the CFV d. a number of veins drains in to GSV at SFV junctions e. it has more valves in calf then in the thigh a. it passes superiorly on the lateral side of the knee normally venous flow in the calf is from the superficial to the deep veins through perforating veins. however this flow might be reverse when deep vein obstruction is present most likely reason that a patient might have pulsatile flow in the CFV the patient has history of congestive cardiac failure explains this finding a 40 year old male present with history of hypertension, smokes 3-5 packs a day, and has patchy areas of ulceration on his fingers bilaterally. buergers disease on doppler assessment a patient with a swollen left leg has an augmented venous flow during valsalva maneuver from left femoral vein. the asymptomatic leg has spontaneous flow in the right femoral vein, which augments with distal compression. these findings are consistent with left left venous dysfunction the examiner images the popliteal vein and notes that the venous color flow display lights up blue with calf compression, than turns to red for 4-5 seconds on release this suggest venous insufficiency there are several conditions that have symptoms which mimic DVT. one of these is a. atherosclerosis b. claudication c. lymphedema d. subclavian steal e. TIA c. lymphedema Virchow's triad includes Stasis, Hypercoagulability, and intimal injury mrs k is 25 year old female who is 32 weeks pregnant and complaining of swelling of her left lower extremity. what might be the continuous (non phasic) venous flow in the common femoral vein signify a more proximal acute DVT extrinsic compression which vessel does the anterior tibial vein drain into popliteal an obese patient on oral contraceptives presents with bilateral lower extremity edema and hematuria. thrombus is suspected at which level. IVC a patient presents with acute pronounced bright red discoloration and edema of the skin and superficial tissue along the anterior calf. the most likely diagnosis cellulitis all may be found in the clinical presentation of pulmonary embolism except a. chest pain b. difficult breathing c. coughing up blood d. sweating e. positive lower extremity venous ultrasound e. positive lower extremity venous ultrasound A patient with symptoms of claudication would most likely present with A. Pain in toes when sleeping B. Pain in calf when walking two blocks and then subsides with rest C. Decrease pain with prolonged exercise D. Red, hot, painful leg E. Swelling of ankle B. Pain in calf when walking two blocks and then subsides with rest While performing segmental pressure on a lower extremity, you note a pressure gradient difference between two cuffs is 10 mm of Hg .What does this finding indicate? A. Normal results B. Stenosis in the arterial segment proximal to the lowest cuff C. Total occlusion of the arterial segment D. Stenosis in the arterial segment distal to the lowest cuff A. Normal results ABPI is obtained by dividing the A. Higher of the two brachial pressures by ankle pressure B. Lower of the two brachial pressures by ankle pressure C. Ankle pressure by the lower brachial pressure D. Ankle pressure by the higher brachial pressure E. Ankle pressure by the average brachial pressure D. Ankle pressure by the higher brachial pressure One of the following artery normally has a lowest pulse amplitude than the others A) Iliac artery B) Aorta C) Popliteal artery D) Femoral artery C) Popliteal artery The bifurcation of the common femoral artery into superficial and deep femoral arteries occurs at about the same level as A. The sephanofemoral junction B. The sephanopopliteal junction C. The internal iliac bifurcation D. The inguinal ligament E. The adductor canal A. The sephanofemoral junction Demonstration of vein-wall coaptation (Compression of vein) in the extremities is best performed A. In longitudinal plane with the color flow documenting cephalad flow B. In the longitudinal plane without color flow C. In transverse plane with color flow documenting patency D. In transverse plane without color E. Coaptation is seldom diagnostic in duplex imaging D. In transverse plane without color Right arm 140/100mm/hg Left arm 130/80mm/hg Right High Thigh 172mm/hg Right above knee 165mm/hg Right below knee 122 mm /hg Right ankle 109 mm/hg what vessel segment is diseased on right side? A. Aorto-iliac B. Distal Femoral-popliteal C. Profunda Femoris D. Anterior tibial Posteriortibial B. Distal Femoral-popliteal