SONOSIM DVT EXAM QUESTIONS
AND ANSWERS
A 29-year-old patient, who is 34 weeks pregnant, presents complaining of progressive
left leg pain for three days. Her entire left leg is markedly edematous and pale, in
comparison to her right leg. Ultrasound examination of the proximal segment of the left
common femoral vein and left popliteal vein does not reveal a discrete, visible
thrombus, but the vessels do not collapse upon transducer compression. Which of the
following conditions is the most likely diagnosis? - Correct Answers -A. Chronic DVT
B. Extensive thrombosis of superficial and deep venous outflow of left leg
C. Phlegmasia alba dolens (Correct Answer)
D. Phlegmasia cerulea dolens
An 80-year-old patient presents for evaluation of a swollen leg with normal color and
capillary refill. A proximal compression ultrasound exam found that the patient's femoral
vein did not compress upon transducer pressure; the image shown is from the exam.
Based upon the exam findings and associated image, what is the most appropriate next
intervention? - Correct Answers -A. Inform the patient that she has a superficial venous
thrombus and does not require anticoagulation.
B. Inform the patient that she has a chronic DVT and does not require anticoagulation.
C. Inform the patient that she has a chronic DVT and initiate discussion regarding risks
versus benefits of anticoagulation therapy.
(Correct Answer)
D. Inform the patient that she has a chronic DVT and refer patient for immediate
thrombectomy.
This 24-year-old patient presents for an ultrasound examination of her swollen left lower
extremity. Which of the following actions is warranted based upon the sonographic
findings evident in this accompanying greyscale compression ultrasound image taken
along the left proximal thigh? - Correct Answers -A. Image structure of interest in
orthogonal plane to better delineate anatomy. (Correct Answer)
B. Diagnose patient with left common femoral vein DVT.
C. Initiate anticoagulation treatment.
, D. Recommend that patient apply warm soaks every 4 hours to the proximal thigh and
return for another ultrasound examination in 10 days.
A 50-year-old patient presents for evaluation of recurrent swelling of his right leg. He
had a prior common femoral vein DVT in the same leg 10 years ago, which resolved
following anticoagulation. Upon ultrasound inspection, the common femoral vein does
not fully collapse, no discrete thrombus is visualized, and the transverse diameter of the
common femoral vein is increased by 6 mm as compared to his prior scan taken at the
time of his original diagnosis. Based on these exam findings, what is the most
appropriate next intervention? - Correct Answers -A. Inform the patient the ultrasound
exam was inconclusive and discuss alternative imaging methods, such as
plethysmography.
B. Inform the patient he has a recurrent DVT and recommend continued surveillance
with a follow-up examination in one week.
C. Inform the patient he has a recurrent DVT and initiate discussion regarding risks
versus benefits of anticoagulation therapy. (Correct Answer)
D. Inform the patient he has a recurrent DVT and refer patient for emergent
thrombectomy.
Which of the following characteristics is the most reliable criterion for identifying a DVT?
- Correct Answers -A .Loss of augmentation of venous flow
B. Increased lumenal diameter at the site of the suspected thrombus
C. Loss of phasic variation of venous blood flow
D. Loss of venous segment collapsibility with transducer pressure (Correct Answer)
Which of the following statements correctly characterizes proximal lower extremity
venous anatomy? - Correct Answers -A. The common femoral vein typically lies medial
to the common femoral artery. (Correct Answer)
B. The common femoral vein typically lies lateral to the common femoral artery.
C. The external iliac vein typically has a direct anastomosis with the profunda femoris
vein.
D. The internal iliac vein typically has a direct anastomosis with the profunda femoris
vein.
Which of the following structures is indicated in this greyscale ultrasound image
acquired along the right proximal thigh of this patient? - Correct Answers -A. Common
femoral vein (Correct Answer)
B. Femoral artery
C. Femoral vein
D. Profunda femoris vein
AND ANSWERS
A 29-year-old patient, who is 34 weeks pregnant, presents complaining of progressive
left leg pain for three days. Her entire left leg is markedly edematous and pale, in
comparison to her right leg. Ultrasound examination of the proximal segment of the left
common femoral vein and left popliteal vein does not reveal a discrete, visible
thrombus, but the vessels do not collapse upon transducer compression. Which of the
following conditions is the most likely diagnosis? - Correct Answers -A. Chronic DVT
B. Extensive thrombosis of superficial and deep venous outflow of left leg
C. Phlegmasia alba dolens (Correct Answer)
D. Phlegmasia cerulea dolens
An 80-year-old patient presents for evaluation of a swollen leg with normal color and
capillary refill. A proximal compression ultrasound exam found that the patient's femoral
vein did not compress upon transducer pressure; the image shown is from the exam.
Based upon the exam findings and associated image, what is the most appropriate next
intervention? - Correct Answers -A. Inform the patient that she has a superficial venous
thrombus and does not require anticoagulation.
B. Inform the patient that she has a chronic DVT and does not require anticoagulation.
C. Inform the patient that she has a chronic DVT and initiate discussion regarding risks
versus benefits of anticoagulation therapy.
(Correct Answer)
D. Inform the patient that she has a chronic DVT and refer patient for immediate
thrombectomy.
This 24-year-old patient presents for an ultrasound examination of her swollen left lower
extremity. Which of the following actions is warranted based upon the sonographic
findings evident in this accompanying greyscale compression ultrasound image taken
along the left proximal thigh? - Correct Answers -A. Image structure of interest in
orthogonal plane to better delineate anatomy. (Correct Answer)
B. Diagnose patient with left common femoral vein DVT.
C. Initiate anticoagulation treatment.
, D. Recommend that patient apply warm soaks every 4 hours to the proximal thigh and
return for another ultrasound examination in 10 days.
A 50-year-old patient presents for evaluation of recurrent swelling of his right leg. He
had a prior common femoral vein DVT in the same leg 10 years ago, which resolved
following anticoagulation. Upon ultrasound inspection, the common femoral vein does
not fully collapse, no discrete thrombus is visualized, and the transverse diameter of the
common femoral vein is increased by 6 mm as compared to his prior scan taken at the
time of his original diagnosis. Based on these exam findings, what is the most
appropriate next intervention? - Correct Answers -A. Inform the patient the ultrasound
exam was inconclusive and discuss alternative imaging methods, such as
plethysmography.
B. Inform the patient he has a recurrent DVT and recommend continued surveillance
with a follow-up examination in one week.
C. Inform the patient he has a recurrent DVT and initiate discussion regarding risks
versus benefits of anticoagulation therapy. (Correct Answer)
D. Inform the patient he has a recurrent DVT and refer patient for emergent
thrombectomy.
Which of the following characteristics is the most reliable criterion for identifying a DVT?
- Correct Answers -A .Loss of augmentation of venous flow
B. Increased lumenal diameter at the site of the suspected thrombus
C. Loss of phasic variation of venous blood flow
D. Loss of venous segment collapsibility with transducer pressure (Correct Answer)
Which of the following statements correctly characterizes proximal lower extremity
venous anatomy? - Correct Answers -A. The common femoral vein typically lies medial
to the common femoral artery. (Correct Answer)
B. The common femoral vein typically lies lateral to the common femoral artery.
C. The external iliac vein typically has a direct anastomosis with the profunda femoris
vein.
D. The internal iliac vein typically has a direct anastomosis with the profunda femoris
vein.
Which of the following structures is indicated in this greyscale ultrasound image
acquired along the right proximal thigh of this patient? - Correct Answers -A. Common
femoral vein (Correct Answer)
B. Femoral artery
C. Femoral vein
D. Profunda femoris vein
