Vascular Ultrasound Question with Correct Answers
Carotid duplex scan, 82 y/o female demonstrates disease in the right
internal carotid artery with a peak systolic velocity of 494 cm/sec, a end
diastolic velocity of 187, and post stenotic turbulence. What symptoms
would be most likely seemed in this patient? Correct Answer-Left
hemiparesis
We categorized the severity of carotid stenosis using the Doppler shifted
Frequency and resultant velocity calculations and have proven highly
reliable. What factor should NOT potentially result in UNDER
ESTIMATION of disease? Correct Answer-Stenosis caused by a short
focal plaque
A patient present with two episodes of left arm hemiparesis. You find a
normal right CCA with a PSV of 72 cm/sec and a stenosis in the right
ICA with a PSV of 227 cm/sec. Would this patient be likely to benefit
from intervention? Correct Answer-No. We would be looking for a
ICA:CCA ration of greater than 4. In this case it is 3.2 (data suggests
this patient would not benefit from intervention)
Post carotid endarterectomy, the most common cause of restenosis is
Correct Answer-Intimal hyperplasia
The standard TCD examination protocol includes assessment of the
bilateral Correct Answer-Distal extracranial ICA, ACA (Anterior
Cerebral arteries) MCA, PCA, vertebral, basilar arteries and ophthalmic
arteries
,According to the NASCET criteria, the best criteria for diagnosing a
greater than 70% stenosis of the internal carotid artery is Correct
Answer-ICA/CCA ratio of greater than 4.0
In a transverse image, correct image orientation for carotid duplex
evaluation places the patient's right side Correct Answer-To the left of
the screen
The best method to differentiate the intimal carotid artery from the
external carotid artery is Correct Answer-The ICA has lower resistance
flow compared to the ECA which is more high resistance
Your duplex examination of the left renal reveals a peak systolic
velocity of 238 cm/sec, a renal aortic ratio of 3.7 and systolic
acceleration time of 102 milliseconds in the distal renal artery at the
renal hilum. Your best conclusion would be Correct Answer->60% renal
artery stenosis (Peak systolic > 180 cm/sec, renal aortic ratio 3.5,
acceleration time > 100 milliseconds)
Following endovascular repair of an abdominal aortic aneurysm AAA, a
Type V Endoleak would be defined as Correct Answer-Endotension -
enlarging aneurysmal sac with no detectable leak
A stenosis of the celiac artery that resolves with deep inspiration best
describes Correct Answer-Arcuate ligament compression syndrome
(AKA celiac axis compression occurs from the median arcuate ligament
of the diaphragm during expiration)
, A peripheral artery aneurysm is defined by a dilatation of Correct
Answer-greater than 1.5 times adjacent artery
When imaging the aorta in a transverse plane, a prominent landmark for
identifying the renal arteries is Correct Answer-The left renal vein
Which of the following terms best describes normal flow in the distal
inferior vena cava? Correct Answer-Phasic
A greater than 60% renal artery stenosis can be categorized by a renal
aortic ration of Correct Answer-Greater than 3.5
When describing the portal vein, all the following are correct (EXCEPT)
Correct Answer-Hepato-petal flow
Blood into the liver
Formed by the confluence of the SMV and splenic veins
The portal vein carries blood from the stomach and intestine INTO the
liver for filtration. The hepatic veins carry blood back to the IVC
(EXCEPT: Carries blood out of the liver)
When evaluating pressures obtained from the lower extremities, a drop
of Correct Answer-20-30mmHg or more between levels is considered
significant
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