Landmarks for renal artery and vein? - ANS ✓Left renal vein crosses the aorta
anteriorly and is superior to renal artery.
Right renal artery crosses posteriorly to IVC.
Two main categories for alternative diagnostic tests related to venous
disease are? - ANS ✓1. Evaluation for possible venous thrombosis or venous
reflux.
2. Evaluation of a pulmonary embolism (PE).
What is a D-dimer test? - ANS ✓D-dimer is a protein fragment produced when a
blood clot dissolves in the body and is normally undetectable, but it is
measurable when a clot is breaking down. With an increase of product
breakdown, the level of D-dimer in blood rises.
-high level of D-dimer suggests presence of thrombus.
Capabilities of D-dimer test? - ANS ✓-measurable product of thrombolysis
detected on a quantitative blood assay.
- can rule out thromboembolism if negative. If positive, has little specificity but
points out need for additional testing to diagnose cause of hypercoagulability.
Limitations of D-dimer? - ANS ✓-there are many different methods/products to
detect D-dimer in blood, causing wide variation in results obtained.
-D-dimer may be elevated with pregnancy, liver disease, renal disease, cancer, or
any thrombotic process, including recent surgery.
-lacks specificity and positive predictive value.
RVT ARDMS
, 2
RVT
Two types of contrast venography (phlebography) are? - ANS ✓1. Ascending
2. Descending
Ascending venography is? - ANS ✓Image the veins from distal to proximal and
detects venous abnormalities including DVT.
Descending venography is? - ANS ✓Image the veins from proximal to distal and
assess valve function and venous reflux.
Capabilities of venography? - ANS ✓-helps evaluation of acute DVT.
-evaluates congenital venous disease and/or anomalies.
-assists in evaluation of chronic venous changes.
-can detect and quantify reversed flow.
Limitations of venography? - ANS ✓-highly technical in technique and
interpretation.
-expensive
-may be uncomfortable for patients
-can have allergic reactions in patients with severe allergies to iodine,
troublesome in patients with severe peripheral vascular occlusive disease
-exposes patients to radiation
How is ascending venography preformed? - ANS ✓Requires contrast agent to
be injected into a distal superficial vein and directed into the deep system.
-lower extremity study, a vein on dorsum of foot is used.
-upper extremity study, the basilic or cephalic may be used.
-Serial x-rays are taken as contrast material passes through some of the deep
veins.
How is descending venography performed? - ANS ✓-evaluates lower
extremity only.
RVT ARDMS
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