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arterial: duplex imaging

Total questions: 192

Worksheet time: 2hrs 57mins

Name
Class
Date
1.

What does the Aorta terminate into at the branches of Common Iliac?

a)

CIA (Common Iliac Artery)

b)

Femoral Artery

c)

Renal Artery

d)

Subclavian Artery

2.

during an organ transplant the TRAM flap( transverse rectus abdominus myocutnaeous flap) , the epigastric artery and _______ are harvested to reconstruct the breast

a)

section of tissue in anterior abdomen

b)

section of tissue in posterior thigh

c)

section of tissue in lateral abomen

d)

section of tissue in anterior thigh

3.

during a properative mapping, _____ artery is used as a coronary artery bypass graft or hemodylasis access. must perform allen test to eval patency of planar arch. must have normal Doppler signals free of abnormalies and atleast 2mm

a)

A. radial

b)

B. ulnar

c)

C. brachial

d)

A and C

4.

What is a common complication of an arteriovenous fistula that is close to the heart and large?

a)

Increased risk of stroke

b)

Increased risk of CHF (Congestive Heart Failure)

c)

Increased risk of hypertension

d)

Increased risk of diabetes

5.

What is an arteriovenous fistula?

a)

A communication between artery and vein

b)

A blockage in the vein

c)

A narrowing of the artery

d)

A rupture in the capillary

6.

What is the hemodynamic characteristic of a proximal artery to an arteriovenous fistula (AVF)?

a)

Decreased diastolic flow

b)

Increased diastolic flow

c)

Normal diastolic flow

d)

Turbulent low velocity

7.


What is the hemodynamic characteristic of a distal artery to an arteriovenous fistula (AVF)?

a)

Decreased diastolic flow

b)

Increased diastolic flow

c)

Normal diastolic flow

d)

Turbulent low velocity

8.

What is the hemodynamic characteristic the fistula in an arteriovenous fistula (AVF)?

a)

Decreased diastolic flow

b)

Increased diastolic flow

c)

Normal diastolic flow

d)

Turbulent low velocity

9.

What is the hemodynamic characteristic of the proximal vein in an arteriovenous fistula (AVF)?

a)

Decreased diastolic flow

b)

Increased diastolic flow

c)

Normal diastolic flow

d)

Turbulent low velocity

e)

pulsatile

10.

Which artery is used as a recipient site for TRAM flap in breast reconstruction?

a)

Epigastric artery

b)

Internal mammary artery

c)

Radial artery

d)

Femoral artery

11.

_____ are the superficial veins are used in grafts for bypass (coronary/arterial or hemodialysis), the diameter should also be at a minimum of 2mm

a)

Only GSV, SSV, cephalic, or basilic

b)

Only femoral and jugular veins

c)

Only hepatic and portal veins

d)

Only renal and iliac veins

12.

Normal transplants should have normal organ flow patterns, which is characterized by ______ resistance in the artery.

a)

low

b)

high

c)

variable

d)

moderate

13.

how would you know if there is liver transplant rejection

a)

pv thrombosis

b)

hepatofugal flow

c)

hepatopetal flow

d)

low RI hepatic artery

e)

high RI hepatic artery

14.

how would you know if there is renal transplant rejection

a)

Low RI renal artery

b)

high RI renal artery

c)

renal vein thrombosis

d)

monophasic or low resistive waveform

15.

What is a sign of rejection in organ transplants according to the interpretation section?

a)

Feeding artery HIGH resistance (decrease or loss of EDV)

b)

Increased hepatopedal flow

c)

increase organ size

d)

thrombosis of vein

e)

altered echogenicity and fluid

16.

Which arteries are assessed in the technique for kidney perfusion?

a)

Segmental artery

b)

Interlobar artery

c)

Arcuate artery

d)

All of the above

17.

What is the renal disease that affects kidney perfusion?

a)

Kidney stones

b)

Nephrosclerosis

c)

Glomerulonephritis

d)

Pyelonephritis

18.

What symptom is NOT associated with anterior compartment syndrome?

a)

Paresthesia

b)

Muscle weakness

c)

Increased arterial perfusion

d)

Foot drop

19.

What is the result of blunt force or penetrating trauma in terms of vascular injury?

a)

Intimal injury(flap) leading to dissection and thrombosis

b)

Immediate healing of the vessel

c)

Decreased risk of arterial occlusion

d)

Increased blood flow

20.

What is the treatment for compartment syndromes?

a)

Fasciotomy

b)

Angioplasty

c)

Bypass surgery

d)

Thrombectomy

21.

swelling within fascial compartments causing compression and increased pressure to capillary vascular beds. tibial artery is compressed.

a)

compartment syndromes

b)

trauma

c)

avf

d)

graft

22.

Fill in the blank: Normal kidney perfusion is indicated by low resistance, EDR end diastolic ratio > ____, and RI (Poucelot’s resistivity index) < 0.7.

a)

0.2

b)

0.5

c)

0.7

d)

1.0

23.

Increased resistance in kidney perfusion is associated with nephrosclerosis.

a)

True

b)

False

24.

Which vessels are referred to as 'splanchnic vessels' in the technique for mesenteric ischemia?

a)

Renal artery

b)

Celiac, SMA, IMA

c)

Femoral artery

d)

Pulmonary artery

25.

what are some symptoms of mesenteric ischemia?

a)

abdominal pain 15-30mins after eating

b)

cramping 15-30mins after eating

c)

malnourished

d)

underweight

e)

all of the above

26.

what is the proper technique for a mesenteric ischemic duplex exam ?

a)

high frequency curvilinear (5-6MHz)

b)

fasting

c)

prandial

d)

post prandial

e)

high frequency linear (5-6MHz)

27.

Match the following waveform characteristics with the correct vessel:

a)

Celiac - Low resistance, High EDV

1.

Celiac - Low resistance, High EDV

b)

SMA - Fasting: High resistance, Low EDV; Post-prandial: Low resistance, Increased/doubled EDV

2.

SMA - Fasting: High resistance, Low EDV;

c)

3.

IMA - Not easily seen; if imaged and hig

28.

What is the PSV (Peak Systolic Velocity) threshold for the celiac artery indicating abnormality?

a)

≥100cm/s

b)

≥200cm/s

c)

≥275cm/s

d)

≥70cm/s

29.


What is the PSV (Peak Systolic Velocity) threshold for the SMA indicating abnormality?

a)

≥100cm/s

b)

≥200cm/s

c)

≥275cm/s

d)

≥70cm/s

30.

Fill in the blank: 2 out of 3 abnormal findings in waveform interpretation indicate ________ Mesenteric Ischemia.

a)

Chronic

b)

Acute

c)

Transient

d)

Reversible

31.

Celiac band syndrome

MOST COMMON: young athletic women

only compressed during EXPIRATION, normalizing w/ inspiration.

due to compression of celiac by median arcuate ligament of the diaphragm

a)

True

b)

False

32.

Which vessels are involved in liver and renal organ transplant techniques?

a)

A) Hepatic artery, portal vein, hepatic veins for liver; Renal artery and vein for renal

b)

B) Femoral artery for liver; Jugular vein for renal

c)

C) Hepatic artery for renal; Portal vein for liver

d)

D) Renal artery for liver; Hepatic vein for renal

33.

low resistance in kidney perfusion is associated with nephrosclerosis.

a)

true

b)

false

34.

match the proper areas that should be evaluated in a bypass graft

a)inflow artery
b)prox anast
c)body
d)dist anast
e)outflow artery
1
2
3
4
5
1)
2)
3)
4)
5)
35.

which of these areas should NOT be evaluated during a bypass graft duplex study

a)

inflow/outflow artery

b)

proximal anastamosis

c)

graft body

d)

distal anastomosis

e)

native. veing proximal to native artery

36.

Which of the following is NOT an important area to be evaluated in a bypass graft?

a)

inflow artery

b)

proximal anastomosis

c)

graft body

d)

distal anastomosis

e)

pulmonary vein

37.

Fill in the blank: The technique for a bypass graft involves connecting artery to artery to reroute blood flow in presence of significant extensive arterial _________.

a)

obstruction

b)

dilation

c)

infection

d)

calcification

38.

Which type of arterial bypass graft uses PTFE and requires evaluation of anastomosis sites for possible leakage?

a)

Synthetic

b)

In situ saphenous vein graft

c)

Reversed saphenous vein graft

39.

In situ saphenous vein graft (autologous) requires the vein to be removed from the venous system and flipped upside down.

a)

true

b)

false

40.

Fill in the blank: In reversed saphenous vein graft (autologous), the vein is removed and ______ upside down.

a)

flipped

b)

twisted

c)

stretched

d)

compressed

41.

Match the following types of arterial bypass grafts with their key evaluation concern:

a)

anastamosis sites for possible leakage

1.

synthetic

b)

body due to risk of AVF from branches or stenosis from residual valves

2.

in situ saphenous vein graft

c)

prox anastomosis due to small size

3.

Reversed saphenous vein graft

42.
Question Image

all successful bypasses must start ______ , _______ and end ____

a)

above disease(patent flow)

1.

1

b)

patent conduit (graft)

2.

2

c)

after any disease (patent outflow)

3.

3

43.

the capabilities and limitations of duplex lower extremities include evaluation of location & severity of _____

a)

stenosis

b)

occlusion

c)

%DR

d)

aneursym

e)

bypass graft & stent surveillance

44.

_______ is included for a duplex of the lower extremities.

a)

native arteries

b)

prox arteries

c)

distal arteries

d)

mid arteries

e)

B-mode, color, dopppler

45.

in regards to duplex lower extremities, one of its techniques is a

_____ graft : connect artery to artery to reroute blood Flow in presence of significant extensive arterial obstruction.

a)

fistula

b)

stent

c)

anastamosis

d)

bypass

46.

Which artery provides blood to the lower extremities and terminates at the inguinal ligament?

a)

EIA (External Iliac Artery)

b)

CIA (Common Iliac Artery)

c)

SFA (Superficial Femoral Artery)

d)

PFA (Profunda Femoris Artery)

47.

In the cross-section diagram, what does label 1 represent?

a)

GSV (Great Saphenous Vein)

b)

Femoral Artery

c)

Popliteal Vein

d)

Tibial Nerve

48.

What does 'Anterior' mean in relational anatomy?

a)

A) Closer to the back

b)

B) Closer to the front of body AKA superficial

c)

C) Towards the feet

d)

D) Towards the head

49.

What does 'Posterior' mean in relational anatomy?

a)

Closer to the back AKA deep

b)

Closer to the front of body

c)

Towards the head

d)

Towards the feet

50.

What does 'Superior' mean in relational anatomy?

a)

Towards the feet

b)

Closer to the middle

c)

Towards the head AKA Cephalad

d)

Closer to the side

51.

in regards of abnormal findings in a fistula graft, Perigraft fluid is a sign of ______, with clinical signs including red, warm, and tender.

a)

infection

b)

ischemia

c)

thrombosis

d)

hematoma

52.

In regards of abnormal findings in a fistula graft, Steal syndrome is defined as reversal of flow in the ______ artery.

a)

distal

b)

radial

c)

ulnar

d)

brachial

53.

What does 'Inferior' mean in relational anatomy?

a)

Towards the feet AKA Caudal

b)

Closer to the heart

c)

Closer to the back

d)

Towards the head

54.

What does 'Medial' mean in relational anatomy?

a)

Closer to the middle

b)

Closer to the side

c)

Closer to the heart

d)

Away from the heart

55.

What does 'Lateral' mean in relational anatomy?

a)

A) Closer to the middle

b)

B) Towards the side

c)

C) Towards the feet

d)

D) Closer to the heart

56.

What does 'Proximal' mean in relational anatomy?

a)

Closer to the heart, flow comes from

b)

Away from the heart, flows goes to

c)

Towards the feet

d)

Closer to the back

57.

What does 'Distal' mean in relational anatomy?

a)

Closer to the heart, flow comes from

b)

Away from the heart, flows goes to

c)

Towards the head

d)

Closer to the middle

58.

What is the sequence of blood flow in the vascular system?

a)

Arteries >> Arterioles >> Capillaries >> Venules >> Veins

b)

Veins >> Venules >> Capillaries >> Arterioles >> Arteries

c)

Capillaries >> Arterioles >> Arteries >> Veins >> Venules

d)

Venules >> Veins >> Arteries >> Arterioles >> Capillaries

59.

Which vessels are known as the smallest arteries and are vessels of resistance?

a)

Arterioles

b)

Venules

c)

Capillaries

d)

Aorta

60.

The scanning plane for aorta must be along axis or perpendicular to aorta, and outer to outer measurement equals true lumen.

a)

True

b)

False

61.

What is the most vital part of the circulatory system?

a)

Heart

b)

Arteries

c)

Veins

d)

Capillaries

62.

Hemodialysis Access Graft is also known as Surgical AVF (fistula graft).

a)

True

b)

False

63.

The structure of the intima layer in blood vessels is described as:

a)

A single layer of endothelial cells

b)

Multiple layers of smooth muscle cells

c)

A thick layer of connective tissue

d)

A layer of nerve fibers

64.

The function of the vasa vasorum is to:

a)

supply blood to the walls of large blood vessels

b)

transport oxygen to the brain

c)

regulate blood pressure

d)

filter waste from the blood

65.

What is one of the capabilities of duplex upper extremities?

a)

hemodialysis access graft surveillance

b)

localize stenosis

c)

localize occlusion

d)

localize anuerysm

66.

Retrograde flow in native artery at distal anastomosis is NORMAL.

a)

true

b)

false

67.

What are the capabilities and limitations of Duplex Upper Extremities?

a)

Localize stenosis/occlusion/aneurysm

b)

Hemodialysis access graft surveillance

c)

Both A and B

d)

None of the above

68.

An aneurysm is defined as an increase in diameter greater than ____%. peripherally most likely seen in pop.

a)

50

b)

25

c)

75

d)

100

69.

Pseudoaneurysm is most likely to occur post procedure. What must be documented?

a)

Connecting channel or neck

b)

Diameter reduction

c)

Platelet aggregation

d)

None of the above

e)

to and fro flow (bidirectional)

70.

Fill in the blank: Dissection is identified by visualization of ______ flap in the aorta.

a)

intimal

b)

adventitial

c)

muscular

d)

serosal

71.

(hypertension)

Which of the following is the correct order for the clinical progression of renal artery stenosis?

a)

Renal artery stenosis > renin > renal ischemia > angiotensinogen > angiotensin

b)

Renal artery stenosis > renal ischemia > renin > angiotensinogen > angiotensin

c)

Renal artery stenosis > angiotensinogen > renin > renal ischemia > angiotensin

d)

Renal artery stenosis > angiotensin > renin > renal ischemia > angiotensinogen

72.

which arteries should be interogated during a renal duplex exam?

a)

aorta

b)

ivc

c)

renal artery

d)

prox , mid, list, renal artery

e)

segmental arteries

73.

f the aorta velocity is <40cm/s or >90cm/s, can you use Renal/Aorta ratio (RAR) for diagnosis?

a)

yes

b)

no

74.

Fill in the blank: Renal/Aorta ratio ≥ ______ is considered ≥60% diameter reduction (DR).

a)

3.5

b)

2.0

c)

4.0

d)

2.5

75.

Tardus Parvus distally is indicative of segmental artery disease.

a)

True

b)

False

76.

Intraoperative US (12-15MHz): Which of the following is NOT a main focus during intraoperative ultrasound?

a)

A) Patency of anastomosis sites

b)

B) Intimal flaps

c)

C) Platelet aggregation

d)

D) Blood pressure measurement

77.


Intraoperative US (12-15MHz): Which of the following IS a main focus during intraoperative ultrasound?

a)

A) Patency of anastomosis sites

b)

B) Intimal flaps

c)

C) Platelet aggregation

d)

D) Blood pressure measurement

78.

what is the proper technique for a duplex graft/fistula?

a)


A. 7-9Mhz linear array transducer

b)

B. arm extended laterally & 45degr. to body = pledge body

c)

C. check for thrill = high velocity = patent hemo access

d)

A and B

e)

all of these

79.

What is the recommended transducer frequency for abdominal imaging in patients with deeper or large body habitus?

a)

3-5 MHz

b)

7-10 MHz

c)

1-2 MHz

d)

10-15 MHz

80.

Fill in the blank: In abdominal imaging, superficial/thinner patients require ______ frequency transducers compared to deeper/large body habitus.

a)

higher

b)

lower

c)

equal

d)

variable

81.

What is the connection between in a hemodialysis access graft?

a)

Connection between artery and vein

b)

Connection between two veins

c)

Connection between two arteries

d)

Connection between artery and capillary

82.

Fill in the blank: The connection between artery and vein in a hemodialysis access graft allows for greater _______ flow as needed with hemodialysis.

a)

volume

b)

pressure

c)

oxygen

d)

nutrient

83.

What type of hemodialysis access graft is described as 'Brescia-Cimino. Radial a to Cephalic v'?

a)

Autologous

b)

Synthetic

c)

Temporary

d)

Permanent

84.

Which of the following is an autologous type of hemodialysis access graft?

a)

A. Brescia-Cimino (Radial a to Cephalic v)

b)

B. Synthetic (straight or looped)

c)

Both A and B

d)

None of the above

85.

In the technique for duplex upper extremities, what position should the arm be extended to?

a)

45 deg to body = pledge position

b)

90 deg to body = T position

c)

180 deg to body = straight position

d)

0 deg to body = resting position

86.

What is the normal resistance pattern for native arteries?

a)

Triphasic or biphasic

b)

Monophasic

c)

Quadriphasic

d)

Flatline

87.

Which of the following is a sign of graft or preocclusion occlusion?

a)

Low resistance in prox artery

b)

Thumping high resistance in prox artery

c)

Low velocity dampened, continuous flow

d)

Focal elevated velocity

88.

What does focal elevated velocity indicate in a fistula graft?

a)

Graft stenosis

b)

Normal flow

c)

Infection

d)

Thrombosis

89.

The normal flow in a graft is described as:

a)

a continuous and unobstructed flow of blood through the graft.

b)

an intermittent flow with occasional blockages.

c)

a reverse flow from the graft to the artery.

d)

a turbulent flow causing vibrations in the graft.

90.

What is steal syndrome in the context of fistula grafts?

a)

Reversal of flow in the distal artery

b)

Increased blood flow to the distal artery

c)

Blockage in the fistula graft

d)

Infection at the graft site

91.

Fill in the blank: All successful bypasses must start above disease (patent inflow), have a patent conduit (graft), and end after any disease (patent ________).

a)

outflow

b)

inflow

c)

conduit

d)

artery

92.

Which of the following is a type of arterial bypass graft?

a)

Synthetic

b)

In situ saphenous vein graft

c)

Reversed saphenous vein graft

d)

All of the above

93.

In a reversed saphenous vein graft, why are valves kept in place?

a)

To prevent leakage

b)

To allow blood to move in the right direction

c)

To increase blood pressure

d)

To reduce stenosis

94.

What is the normal waveform pattern in vascular interpretation?

a)

Normal - triphasic or biphasic.

b)

Abnormal - monophasic.

c)

Normal - quadriphasic.

d)

Abnormal - biphasic.

95.

Fill in the blank: Native arteries with normal high resistance are described as ______ or biphasic.

a)

triphasic

b)

monophasic

c)

quadriphasic

d)

polyphasic

96.

According to the stenosis velocity criteria, what is the diameter reduction for a 2:1 ratio?

a)

≥50% diameter reduction, PSV doubles at stenosis

b)

<50% diameter reduction, PSV quadruples at stenosis

c)

≥70% diameter reduction

d)

No diameter reduction

e)

≥75% diameter reduction, PSV quadruples at stenosis

97.

What is the minimum diameter for an abdominal aortic aneurysm (AAA) according to the interpretation criteria?

a)

>2cm

b)

>3cm

c)

>4cm

d)

>5cm

98.

This criteria applies to both NATIVE arteries and ________.

a)

BYPASSES

b)

VEINS

c)

CAPILLARIES

d)

VALVES

99.

According to the stenosis velocity criteria, what is the diameter reduction for a 4:1 ratio?

a)

≥50% diameter reduction, PSV doubles at stenosis

b)

<50% diameter reduction, PSV quadruples at stenosis

c)

≥70% diameter reduction

d)

No diameter reduction

e)

≥75% diameter reduction, PSV quadruples at stenosis

100.

Which of the following is NOT a criteria for stenosis in native arteries?

a)


Velocity criteria

b)

Qualitative profile

c)

Knowledge of normal vs obstructive waveform contours

d)

Focally elevated VEL and PST

101.

What is the significance of a velocity greater than 400cm/s in stenosis velocity criteria?

a)

≥75% diameter reduction

b)

<50% diameter reduction

c)

50-69% diameter reduction

d)

70-99% diameter reduction

102.

Any velocity greater than ____ cm/s is considered to be ≥75% diameter reduction (DR).

a)

400

b)

200

c)

300

d)

500

103.

Additional bypass surveillance criteria: Which of the following is NOT a change to look for from past study?

a)

Decrease of 30cm/s in the same graft segment

b)

Increase in ABI >0.15

c)

Change or deterioration in waveform quality

d)

Decrease in ABI >0.15

104.

Additional bypass surveillance criteria: Which of the following IS a change to look for from past study?

Answer choices

a)

Decrease of 30cm/s in the same graft segment

b)

Increase in ABI >0.15

c)

Change or deterioration in waveform quality

d)

Decrease in ABI >0.15

105.

According to the normal hemodialysis waveforms in a fistula/graft a prox vein(outflow) will have ____

a)

pulsatile flow

b)

triphasic flow

c)

high resistance flow

d)

variable flow

106.

T/F

normal flow in graft is high velocity & turbeulent

a)

true

b)

false

107.

Match the abnormal findings for fistula graft

a)

Thumping high resistance in prox artery or graft

1.

graft occlusion

b)

Focal elevated velocity

2.

graft stenosis:mostly loc. outflow vein

c)


Low velocity dampened, continuous flow

3.

proximal inflow problem

108.

Which of the following is an abnormal finding for a fistula graft?

a)

Thumping high resistance in prox artery or graft

b)

Low velocity dampened, continuous flow

c)

Focal elevated velocity

d)

All of the above

109.

List one additional bypass surveillance criterion.

a)

Criterion A

b)

Criterion B

c)

Criterion C

d)

Criterion D

110.

The main focus of intraoperative ultrasound (12-15MHz) is:

a)

diagnosing heart conditions

b)

guiding surgical procedures

c)

monitoring fetal development

d)

detecting bone fractures

111.

What is the condition associated with abdominal aortic aneurysm or aortoiliac stenosis?

a)

Abdominal aortic aneurysm / aortoiliac stenosis

b)

Hypertension

c)

Coronary artery disease

d)

Peripheral artery disease

112.

Which of the following is a technique for scanning the aorta?

a)

Measure in transverse view

b)

Measure in sagittal view

c)

Measure in coronal view

d)

Measure in oblique view

113.

What is the clinical significance of renal artery stenosis?

a)

Hypertension

b)

Diabetes

c)

Asthma

d)

Arthritis

114.

What is the interpretation if the Renal/Aorta ratio is greater than or equal to 3.5?

a)

≥60% DR

b)

<30% DR

c)

40-50% DR

d)

No significant DR

115.

The significance of Tardus Parvus distally in renal artery interpretation is:

a)

It indicates proximal renal artery stenosis.

b)

It suggests normal renal artery function.

c)

It shows increased blood flow velocity.

d)

It implies distal renal artery occlusion.

116.

Which arteries are involved in the technique for kidney perfusion?

a)

Segmental artery, Interlobar artery, Arcuate artery

b)

Renal artery, Hepatic artery, Splenic artery

c)

Coronary artery, Pulmonary artery, Aorta

d)

Femoral artery, Brachial artery, Radial artery

117.

Which of the following is an indication for Duplex Abdomen?

a)

Abdominal aortic aneurysm / aortoiliac stenosis

b)

Renal artery stenosis and kidney perfusion

c)

Mesenteric ischemia

d)

Organ transplants

e)

Pulmonary embolism

118.

Which of the following is NOT an indication for Duplex Abdomen?

a)

Abdominal aortic aneurysm / aortoiliac stenosis

b)

Renal artery stenosis and kidney perfusion

c)

Mesenteric ischemia

d)

Organ transplants

e)

Pulmonary embolism

119.

What is the EDR end diastolic ratio for normal kidney perfusion?

a)

Greater than 0.2

b)

Less than 0.2

c)

Equal to 0.2

d)

Approximately 0.5

120.

What clinical symptoms are associated with mesenteric ischemia?

a)

Abdominal pain and cramping 15-30 min after eating, malnourished, underweight

b)

Frequent headaches and dizziness

c)

Joint pain and swelling

d)

Skin rashes and itching

121.

What is the condition called when there is compression of the celiac by the median arcuate ligament of the diaphragm?

a)

Celiac band syndrome

b)

Irritable bowel syndrome

c)

Peptic ulcer disease

d)

Gastroesophageal reflux disease

122.

What are the vessels involved in liver organ transplants?

a)

Hepatic artery, portal vein, hepatic veins

b)

Renal artery, renal vein, ureter

c)

Coronary artery, aorta, vena cava

d)

Pulmonary artery, pulmonary vein, trachea

123.

Which artery is used in the TRAM flap for breast reconstruction?

a)

Epigastric artery

b)

Femoral artery

c)

Brachial artery

d)

Carotid artery

124.

What is the minimum diameter required for the internal mammary artery when used as a recipient site for TRAM flap?

a)

2mm

b)

1mm

c)

3mm

d)

4mm

125.

Which test must be performed to evaluate the patency of the palmar arch before using the radial artery for coronary artery bypass graft?

a)

Modified Allen test

b)

Doppler ultrasound

c)

Ankle-brachial index

d)

Treadmill test

126.

What are the superficial veins used in grafts for bypass?

a)

GSV, SSV, cephalic, or basilic

b)

Femoral, popliteal, or tibial

c)

Radial, ulnar, or brachial

d)

Iliac, renal, or hepatic

127.

What is an arteriovenous fistula?

a)

A communication between artery and vein

b)

A type of heart disease

c)

A form of cancer

d)

A type of blood clot

128.

Fill in the blank: Proximal artery to AVF results in ______ diastolic flow.

a)

Increased

b)

Decreased

c)

Unchanged

d)

Variable

129.

Fill in the blank: distal artery goes back to____ resistance during normal hemodialysis waveform

a)

high

b)

low

c)

variable

d)

pulsatile

130.

Fill in the blank: the fistula part of a normal hemodialysis waveform is ____ resistance/or _____ PSV ____ EDV

a)

Low

b)

variable

c)

pulsatile

d)

high

131.

Fill in the blank: In a normal hemodialysis waveform, the fistula has low resistance, high PSV, and high ______.

a)

EDV

b)

MAP

c)

CVP

d)

SVR

132.

Fill in the blank: Proximal artery (inflow) in normal hemodialysis waveform has ______ resistance and increased EDV.

a)

low

b)

high

c)

moderate

d)

variable

133.

Duplex upper extremities uses PW doppler. What does PW stand for in this context?

a)

Pulsed Wave

b)

Power Wave

c)

Phase Wave

d)

Pressure Wave

134.

What is the treatment for compartment syndromes?

a)

Medication

b)

Surgery

c)

Faciotomy

d)

Physical therapy

135.

T/F

the measurements should be perpendicular to the aorta

a)

true

b)

false

136.

this is an image of

a)

aortic aneurysm

b)

thrombus

c)

aortic aneurysm w/ thrombus

d)

atherosclerosis

137.

what occurs when there is a smaller lumen?

a)

higher velocity & more thrombus

b)

low velocity & more thrombus

c)

higher velocity & less thrombus

d)

low velocity & small thrombus

138.


what occurs when there is a larger lumen?

a)

higher velocity & more thrombus

b)

low velocity & more thrombus

c)

higher velocity & less thrombus

d)

low velocity & less thrombus

139.

a reverse saphenous vein graft is attached to the artery how?

a)

ligation/removal of branches

1.

1

b)

reversed before anastomosis

2.

2

c)

small end of vein - prox artery

large end of vein to dist artery

3.

3

d)

once vein is connected vein dilates equally

4.

4

e)

valves remain in place since flow is going that direction

5.

5

140.

in-situ vein graft of the GSV consist of

a)

removal of the valves and branches

b)

only branches are removed

c)

only valves are removed

d)

neither are removed/ligated

141.

where should you evaluate a PTFE aka synthetic graft?

a)

proximal anastamosis only

b)

distal anastamosis only

c)

mid graft only

d)

both anastamotic sites due to possible creation of pseudoanerusyms

142.

the ultrasonic image is representing what?

a)

proximal anastamosis pseudoaneurysm of bypass graft aka anastomotic aneurysm

b)

distal anastamosis pseudoaneurysm of bypass graft aka anastomotic aneurysm

c)

mid bypass graft pseudoaneurysm

d)

none of these

143.

what place within the graft should be evaluated in a in-situ bypass graft due to risk of AVF

a)

patent branches

b)

valve residuels creating obstruction

c)

prox anastamosis

d)

distal anastamosis

144.

Match the following

a)

1.

long stenosis: ^ turbulent , 100cm/s-300

b)

2.

veloc. quadrupled: >75% or equal to sten

c)

3.

>50%hemodynamic signif. stenosis,Postste

d)

4.

rounded peak, prox disease , tardus parv

e)

5.

abn 265cm/s, no spec broad:smooth steno

145.

this image represents

a)

proximal to an occlusion

b)

distal to an occlusion

c)

at occluson

d)

proximal to mild stenosis

146.

an increase in velocity from prestenosis to the actual stenosis area of >100% suggest a ratio of

a)

2.1 or ≥\ge 50% diameter reduction

b)

4:1 ratio or ≥\ge 75% diameter reduction

c)

>400cm/s = 75% diameter reduction

d)

none of these

147.

an increase in velocity from prestenosis to the actual stenosis area of ≥\ge 400% suggest a

a)

2:1 ratio or ≥50% diameter reduction

b)

4:1 ratio or ≥75% diameter reduction

c)

>400cm/s = 75% diameter reduction

d)

none of these

148.

significant stenosis and occlusions are cmmon in

a)

adductors canal

b)

distal superficial femoral artery

c)

prox popliteal artery

d)

mid femoral artery

149.

a decrease in a graft of 30cm/s PSV indicates

a)

stenosis

b)

occlusion

c)

blockage

d)

AVF

150.

this is an image of

a)

popliteal aneurysm

b)

pseudonauersym of the aorta

c)

bakers cyst

d)

atherosclerosis

151.

an aneurysm is characterized as an increase of _____ in diameter greater than the native artery

a)

50%

b)

25%

c)

30%

d)

80%

152.

match the following vessels to its location

a)LRA
b)accessory LRA
c)aorta
d)RRA
1
2
3
4
1)
2)
3)
4)
153.

match the following u/s structures

a)splenic vein
b)LRV
c)AORTA
d)SMA
1
2
3
4
1)
2)
3)
4)
154.

MATCH THESE

a)ivc
b)aorta
c)MRA
d)INTERLOBULAR
e)SEGMENTAL
1
2
3
4
5
1)
2)
3)
4)
5)
155.

match

a)RRA
b)IVC
c)AO
d)LRV
e)LRA
1
2
3
4
5
1)
2)
3)
4)
5)
156.

the cause of dampened waveforms distal to an occlusion/stenosis could be due to

a)

collateralization

b)

loss in vessel diameter

c)

increase in velocities

d)

none of these

157.

a change in _____ , ____ & _____ upon assessing bypass graft indicates occlusion or stenosis or any abnormality.

a)

decrease in velocity >30cm /s

b)

triphasic - biphasic change

c)

biphasic - monophasic change

d)

triphasic - monophonic change

e)

decrease in ABI >0.15

158.

a normal finding upon assessing the distal artery in a vein bypass graft is:

a)

PSV of >45cm/s

b)

PSV<45cm/s

c)

PSV of <30cm/s

d)

high resistance

e)

low resistance

159.

abnormal findings in a intraoperative(During SURGERY) assessment of a bypass graft includes revision if

a)

PSV >180cm/s

b)

velocity ratio >2.5

c)

platelet/thrombus formation w/ PSV >300cm/s

d)

Low PSV : assess inflow

160.

the most frequent complication of a an aneurysm includes

a)

rupture

b)

embolization

c)

narrowing

d)

enlargment

161.

Match the following occurences in order upon narrowing of the renal artery it reduces blood flow which causes ____ , ____ ,___ , ____ , _____

a)

renin

1.

1

b)

angiotensinogen

2.

2

c)

angiotensin II

3.

3

d)

sodium

4.

4

e)

fluid retention

5.

5

162.

this image represents

a)

AVF

b)

traumatic AVF bypass

c)

duplicate renal veins

d)

duplicate renal arteries

163.

match the following normal renal arterial perfusion flow

a)

1.

normal renal A flow

b)

2.

aortic normal pre renal branch flow

c)

3.

aortic normal post renal branch flow

164.

aortic flow is usually high resistant unless

a)

obtained pre renal branch area

b)

obtained post renal branch area

c)

obtained within iliac area

d)

obtained within the brachiocephalic and aortic arch area

165.

how do you obtain the renal aortic ratio (RAR)

a)

renal artery PSV / aortic PSV

b)

aortic PSV / renal artery PSV

c)

distal aortic PSV / renal artery EDV

d)

none of these

166.

normal renal aortic ratio (RAR) :

a)

>3.5

b)

<3.5

c)

<40

d)

>90-100

167.

RAR(renal aortic ratio) cannot be accurate in the presence of ____ or when PSV of the aorta are

a)

aneurysm

b)

atherosclerosis

c)

<40cm/s

d)

>90-100cm/s

e)

>40

168.

what is the normal kidney size ?

a)

8-12cm

b)

6-12cm

c)

5-12cm

d)

12-13cm

169.

a normal EDR/PRR of the kidney is ≥\ge 0.2 anything less is abnormal & it is obtained by:

a)

PSV - PSV / mean

b)

EDV / PSV

c)

EDV - EDV / mean

d)

PSV - EDV / PSV

170.

another way of identifying normal kidney resistance is by using pourcelots ratio/ resistive index which normally is <0.7 anything greater is ABNORMAL you obtain it by ______

a)

PSV - EDV / PSV

b)

PSV - PSV / mean

c)

EDV / PSV

d)

PSV - PSV / EDV

171.

pourcelots resistive index of the kidney is normal when greater than or equal to 0.7

a)

true

b)

false

172.

a kidney ___ of ≥\ge 100msec indicates ≥\ge 60% stenosis proximal stenosis

a)

acceleration time

b)

EDR

c)

RAR

d)

RI

173.

this is an image of

a)

renal artery occlusion

b)

FMD

c)

stenosis

d)

coarctation

174.

a ___ is the slope of the doppler velocity waveform . and is calculated between the onset of systole and the systolic peak divided by acceleration time.

a)

EDR

b)

RI

c)

RAR

d)

AI

175.

a ≥____ cm/sec AI is considered a >60% diameter reduction in the kidneys perfusion or arterial flow

a)

≥291cm/sec

b)

≥3.5cm/sec

c)

≥0.7cm/sec

d)

≤0.2cm/sec

176.

mesenteric ischemia is also known as ______

a)

mesenteric necrosis

b)

mesenteric angina

c)

mesenteric gangrene

d)

mesenteric death

177.

MATCH THE MESENTERIC VESSELS

a)CA
b)HA
c)SA
1
2
3
1)
2)
3)
178.

In a fasting state the ____ is high resistant , after eating(post prandial) the flow changes to low resistant and the PSV elevates and the EDV doubles

a)

SMA

b)

celiac

c)

internal iliac arteries

d)

external iliac arteries

179.

these images were taken of the SMA & IMA A(preprandial) and B(Postprandial) describe the images to the best of your knowledge

a)

abnormal , due to remaining high resistant which indicates proximal ischemia disease

b)

abnormal , due to remaining high resistant which indicates disal ischemia disease

c)

normal due to high resistance which indicates patent flow

d)

normal due to doubling of the end diastolic velocity and elevated peak systolic velocity

180.

the celiac artery _____ post prandial

a)

remains the same

b)

has elevated PSV and EDV

c)

has elevated PSV with doubling of the EDV

d)

Has higher resistance

181.

this image represents

a)

normal celiac artery

b)

70% stenosis of the celiac artery

c)

stenosis of the SMA

d)

normal inferior mesenteric artery

182.

this image represents what mesenteric presence in a fasting patient?

a)

sma ischemia , >70% stenosis

b)

celiac ischemia >70% stenosis

c)

aortic ischemia >70% stenosis

d)

normal limits

183.

a normal celiac artery velocity is

a)

>200cm/s

b)

>275cm/s

c)

110-177cm/s

d)

50-160cm/s

184.

is flow reversal in the SMA normal in a fasting patient?

a)

yes

b)

no

185.

is flow reversal in the SMA of a postprandial patient normal?

a)

yes

b)

no

186.

does celiac artery have flow reversal at any point?

a)

no

b)

yes

187.

During celiac band syndrome/ reversal celiac artery stenosis: there is an audible auscultating ____ and can also be seen on color doppler as a color ____

a)

bruit

b)

swirl

c)

trill

d)

turbulence

188.

normal portal vein size should be

a)

1-1.5cm

b)

2-2.5mm

c)

3-3.35cm

d)

1-1.9cm

189.

postoperative complications of organ transplants ALSO include allograft rejection and pseudoaneurysms

a)

true

b)

false

190.
Question Image

during renal transplants (allograft) match the anastamosis connections

a)

end to end anastamosis

1.

artery - internal iliac artery

b)

end to side anastamosis

2.

artery - external iliac artery

c)

donor ureter

3.

directly into bladder

d)

renal venous anastamosis

4.

external iliac vein

191.

this occurs due to

a)

fatty liver

b)

renal transplant failure

c)

portal hypertension

d)

hepatic artery thrombosis

192.

this is an image of

a)

portal hypertension

b)

portal stenosis

c)

portal thrombosis

d)

aliasing portal vein w/ flow reversal

e)

normal flow

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