RVT URR Prep & Reporting
arterial occlusion. Remember the 6 "P" of acute arterial occlusion: pain, pulselessness, pallor, polar,
paresthesia, and paralysis.
D-dimer levels are most accurate for predicting:
A. the absence of DVT
B. the risk of pulmonary embolism
C. the presence of DVT
D. the risk of clot formation - A. the absence of DVT
When evaluating a pregnant patient for DVT, the patient should be placed in the ___ position.
A. supine
B. right oblique or decubitus
C. trendelenburg
D. left oblique or decubitus - D. left oblique or decubitus
The uterus can compress the IVC causing flow changes that lead to false results in the extremities.
Placing the patient in the left oblique or decubitus position will reduce uterine pressure on the IVC.
A patient presents for a dedicated TCD exam to rule out an AVF. What should you do first?
A. send the patient to MRI department instead
B. start with the MCA on the opposite side from the suspected abnormality
C. consult the radiologist regarding the inability to visualize the abnormality on TCD
D. start with the MCA on the affected side - C. consult the radiologist regarding the inability to
visualize the abnormality on TCD
TCD does not provide image, only doppler waveforms. This makes diagnosis of an AVF very difficult if not
impossible. Anytime the procedure cannot evaluate the suspected disorder, you should clarify the order
with the radiologist or referring physician before proceeding.
, A 58yo male presents with an order for a Lower extremity arterial doppler exam and the reason for the
order is "follow-up". The patient states that he had another exam done last week at a local facility. He
suffered from severe right leg pain with pallor and numbness/weakness of the lower leg. The doctor put
him on streptokinase and he feels so much better today. You attempt to get the report from the prior
study, but are unsuccessful. These findings are most suggestive of:
A. presence of newly formed collateral arterial pathways
B. evidence of resolving arteritis due to buerger disease
C. recanalization of an acute arterial occlusion
D. recanalization of an acute DVT - C. recanalization of an acute arterial occlusion
Streptokinase is a lytic agent used to treat an acute arterial occlusion and significant, extensive acute
DVT. The exam was most likely ordered as an arterial exam to evaluate the recanalization of an acute
D-dimer levels are most accurate for predicting the absence of DVT. D-dimer levels can be elevated for
many reasons including DVT, cancer and other diseases. If DVT is suspected but the D-dimer levels are
low, DVT is most likely not present.
When preparing for a patient with suspected thoracic outlet syndrome, what other information should
you review for pertinent information?
A. lab results for hematocrit levels
B. aortogram
C. chest x-ray
D. CT of he brain - C. chest X-ray
A chest X-ray could demonstrate the cervical rib that is a common cause for TOS.
When evaluating a suspected stenosis in the lower extremity arterial system, the peak systolic velocity is
documented on the waveform obtained. What other two factors should be reported to determine the
severity of the stenosis?
A. resistive index and velocity ratio
B. resistive index and diastolic flow direction
C. velocity ratio and diastolic flow direction
D. pulsatility index and velocity ratio - C. velocity ratio and diastolic flow direction
The velocity ratio is used to compare the PSV proximal to the stenosis to the PSV at the stenosis. A ratio
greater than 2 indicates stenosis. A triphasic pattern has two components of diastolic flow. Retrograde
flow occurs immediately after systole ends followed by a small amount of antegrade flow. When the
arterial occlusion. Remember the 6 "P" of acute arterial occlusion: pain, pulselessness, pallor, polar,
paresthesia, and paralysis.
D-dimer levels are most accurate for predicting:
A. the absence of DVT
B. the risk of pulmonary embolism
C. the presence of DVT
D. the risk of clot formation - A. the absence of DVT
When evaluating a pregnant patient for DVT, the patient should be placed in the ___ position.
A. supine
B. right oblique or decubitus
C. trendelenburg
D. left oblique or decubitus - D. left oblique or decubitus
The uterus can compress the IVC causing flow changes that lead to false results in the extremities.
Placing the patient in the left oblique or decubitus position will reduce uterine pressure on the IVC.
A patient presents for a dedicated TCD exam to rule out an AVF. What should you do first?
A. send the patient to MRI department instead
B. start with the MCA on the opposite side from the suspected abnormality
C. consult the radiologist regarding the inability to visualize the abnormality on TCD
D. start with the MCA on the affected side - C. consult the radiologist regarding the inability to
visualize the abnormality on TCD
TCD does not provide image, only doppler waveforms. This makes diagnosis of an AVF very difficult if not
impossible. Anytime the procedure cannot evaluate the suspected disorder, you should clarify the order
with the radiologist or referring physician before proceeding.
, A 58yo male presents with an order for a Lower extremity arterial doppler exam and the reason for the
order is "follow-up". The patient states that he had another exam done last week at a local facility. He
suffered from severe right leg pain with pallor and numbness/weakness of the lower leg. The doctor put
him on streptokinase and he feels so much better today. You attempt to get the report from the prior
study, but are unsuccessful. These findings are most suggestive of:
A. presence of newly formed collateral arterial pathways
B. evidence of resolving arteritis due to buerger disease
C. recanalization of an acute arterial occlusion
D. recanalization of an acute DVT - C. recanalization of an acute arterial occlusion
Streptokinase is a lytic agent used to treat an acute arterial occlusion and significant, extensive acute
DVT. The exam was most likely ordered as an arterial exam to evaluate the recanalization of an acute
D-dimer levels are most accurate for predicting the absence of DVT. D-dimer levels can be elevated for
many reasons including DVT, cancer and other diseases. If DVT is suspected but the D-dimer levels are
low, DVT is most likely not present.
When preparing for a patient with suspected thoracic outlet syndrome, what other information should
you review for pertinent information?
A. lab results for hematocrit levels
B. aortogram
C. chest x-ray
D. CT of he brain - C. chest X-ray
A chest X-ray could demonstrate the cervical rib that is a common cause for TOS.
When evaluating a suspected stenosis in the lower extremity arterial system, the peak systolic velocity is
documented on the waveform obtained. What other two factors should be reported to determine the
severity of the stenosis?
A. resistive index and velocity ratio
B. resistive index and diastolic flow direction
C. velocity ratio and diastolic flow direction
D. pulsatility index and velocity ratio - C. velocity ratio and diastolic flow direction
The velocity ratio is used to compare the PSV proximal to the stenosis to the PSV at the stenosis. A ratio
greater than 2 indicates stenosis. A triphasic pattern has two components of diastolic flow. Retrograde
flow occurs immediately after systole ends followed by a small amount of antegrade flow. When the
