Module 5.1 : Indirect Testing

Question 1

what is an ankle brachial index ABI

Answer 1

• non invasive pathological test that compares systolic blood pressure at the ankle to the systolic pressure of the brachial artery
• CW analog doppler waveforms are recorded to support the pressure information

Question 2

what does a lumen narrowing to a critical level do to the blood pressure

Answer 2

• distal arterial flow and blood pressure with significantly decrease

Question 3

how do we calculate the ABI

Answer 3

pedal pressure / highest brachial pressure

Question 4

what is the average ABI in supine resting patient

Answer 4

1.2

Question 5

what is the normal ABI

Answer 5

> 0.9

Question 6

in what patients will ABIs be falsely high

Answer 6

• medial calcification

Question 7

what should be done with > 1.3

Answer 7

• toe pressures

Question 8

what is the normal TBI

Answer 8

> 0.75

Question 9

what does an ABI of > 0.1

Answer 9

normal

Question 10

what does and ABI or 0.9 - 1.0 mean

Answer 10

• minimal disease

- asymptomatic

Question 11

what does an ABI of 0.9-0.9 means

Answer 11

• claudication

- single level disease

Question 12

what does and ABI of < 0.5 means

Answer 12

• rest pain
• severe
• multilevel disease

Question 13

what does and ABI of < 0.3

Answer 13

• Beverly ischemic leading to gangrene

Question 14

what is the level of pressure measurement determined by

Answer 14

• cuff postion

- not by doppler interrogation

Question 15

what are 6 limitations to ABI

Answer 15

• falsely increased pressures from calcified vessels
• significant lesions with developed collateral circulation will result in normal distal pressures and waveforms at rest
• acute DVT in lower extremities should not have pressure cuffs inflated over thrombus
• extensive bandaging
• trauma surgery, ulceration graft no cuffs over
• pressures not permitted on ipsilateral side of mastectomy or AVG/ AVF

Question 16

what does exercise stress testing determine

Answer 16

• determines functional significance of disease by evaluating the arterial hemodynamics of lower extremities

Question 17

what is a normal result of exercise testing

Answer 17

• little to no drop in ankle BP after 5 minutes of exercise
• decreased in post exercise BP should be < 20% of the resting pressure and should return to baseline within 3 minutes of exercise

Question 18

if recovery time after exercise test < 3 minutes mean

Answer 18

• normal

Question 19

if recovery time after exercise test 2-6 minutes mean

Answer 19

• single level disease

Question 20

if recovery time after exercise test 6-12 minutes mean

Answer 20

• multilevel disease

Question 21

if recovery time after exercise test > 15 minutes mean

Answer 21

• severe occlusive disease

Question 22

what is an abnormal result fo exercise testing

Answer 22

• immediate decrease from baseline in post exercise ankle BP indicates significant arterial obstruction
• severity of the disease is also related to the distance a patient can walk and the absolute pressure drop