Prep And Reporting

Question 1

A patient presents for a venous insufficiency exam. The exam demonstrates normal bilateral saphenous veins that extend up to the mid-thigh, but do not appear to connect to the deep system. What should you review in the patient chart to explain these findings?

a. medical history for Paget Schroetter syndrome
b. medical history for Klippel Trenaunay Webber syndrome
c. treatment history for RF ablation of the bilateral GSVs
d. surgical history for venous ligation of the bilateral GSVs

Answer 1

d. surgical history for venous ligation of the bilateral GSVs

Question 2

A patient presents for a carotid ultrasound due to the presence of bilateral bruits in the proximal neck. What should be the next step in evaluating this patient?

a. evaluate the cardiac history section of the patient chart to look for a hx of CHF.
b. evaluate the medical history section of the patient chart to look for a hx of polycythemia vera
c. evaluate the vascular history section of the patient chart to look for a hx of a
subclavian steal
d. evaluate the cardiac history section of the patient chart to look for a hx of aortic valve stenosis.

Answer 2

d. evaluate the cardiac history section of the patient chart to look for a hx of aortic valve stenosis.

Question 3

According to the findings on this arteriogram,
which abnormal findings will be identified on a carotid Duplex exam?
a. flow reversal in the left vertebral and left
subclavian arteries
b. absence of flow in the left subclavian
artery and left vertebral arteries
c. left subclavian steal

Answer 3

b. absence of flow in the left subclavian
artery and left vertebral arteries

Question 4

A patient presents for a TCD exam due to an abnormal report from a CT of the brain.
The report states that there is an acute infarct in the right frontal lobe. A significant
stenosis in which of the following arteries would be the most likely cause for these
findings?
a. right ACA or right MCA
b. left ACA or left MCA
c. left PCA or left vertebral
d. bilateral ACA

Answer 4

a. right ACA or right MCA

Question 5

A 65yr old female presents with mild left leg pain and mild to moderate left leg swelling
for over three years. There is no brown discoloration present in the distal calf and ankle area. Which of the following patient history questions would provide an explanation of the symptoms?
a. do you have pain in the legs at night when in bed?
b. if you elevate the leg, does the pain increase?
c. does your pain increase with quick dorsiflexion of the left foot?
d. have you had coronary artery bypass surgery?

Answer 5

d. have you had coronary artery bypass surgery?

Question 6

You perform a carotid Doppler exam that demonstrates minimal atheroma formation bilaterally. You record waveforms that demonstrate laminar flow with the following velocities:
Right Proximal CCA PSV 135cm/s, EDV 35cm/s
Right Proximal ICA PSV 175cm/s, EDV 50cm/s
Left Proximal CCA PSV 140cm/s, EDV 38cm/s
Left Proximal ICA PSV 166cm/s, EDV 40cm/s
What will you report on your worksheet?

a. flow velocities are increased bilaterally, which is most likely related to increased cardiac output
b. flow velocities are increased bilaterally, which is most likely related to soft plaque formation not visible on 2D and color evaluation
c. flow velocities are increased bilaterally, which is most likely related to stenosis at the aortic valve

Answer 6

a. flow velocities are increased bilaterally, which is most likely related to increased
cardiac output

Question 7

D-dimer levels are most accurate for predicting:
a. the presence of DVT
b. the risk of clot formation
c. the absence of DVT.

Answer 7

c. the absence of DVT.

Question 8

Air in a patch used during a carotid endarterectomy can degrade the evaluation of the treated area in the immediate post-op setting. What is the recommended approach for evaluating these patients?

a. patients with a recent endarterectomy should not be evaluated with ultrasound within the first 14 days after the procedure
b. use the most posterior approach possible
c. use the most anterior approach possible

Answer 8

b. use the most posterior approach possible

Question 9

If the velocities in both carotid arteries are increased since last year’s exam with no visible change in plaque formation, what should you review in the patient chart as a possible explanation?
a. lab values for decreased hematocrit levels
b. medical history for polycythemia vera
c. medical history for controlled HTN

Answer 9

a. lab values for decreased hematocrit levels

Question 10

Venography is usually performed with the patient in what position?
a. supine with table at 60-degree Trendelenburg
b. supine with table horizontal
c. supine with table at 60-degree reverse Trendelenburg

Answer 10

c. supine with table at 60-degree reverse Trendelenburg

Question 11

A patient presents for a venous insufficiency exam. The exam demonstrates normal bilateral great and short saphenous veins. The deep system is not identified well in either leg. Both calves have multiple varicose veins. How do you explain these findings?

a. medical history for Klippel Trenaunay Webber syndrome
b. treatment history for RF ablation of the bilateral GSVs
c. medical history for Paget Schroetter syndrome
d. surgical history for venous ligation of the bilateral GSVs

Answer 11

a. medical history for Klippel Trenaunay Webber syndrome

Question 12

A patient presents for a TCD exam due to an abnormal CT scan of the brain. The report states there is a recent cerebellar infarct. What vessel(s) should you pay special attention to during the TCD exam?

a. vertebral and basilar arteries
b. MCA and PCA
c. ACA and MCA

Answer 12

a. vertebral and basilar arteries

Question 13

A patient presents for a carotid ultrasound. The exam demonstrates significant atheroma formation and string flow in the proximal right ICA. Which of the following signs or symptoms listed in the patient chart would be related to the findings?

a. left arm and leg paresthesia
b. left eye visual disturbances
c. right sided bruit

Answer 13

a. left arm and leg paresthesia

Question 14

A recent CT scan demonstrates an acute infarct in the parietal lobe and a new blockage in the proximal left MCA. Which of the following is the most likely source for the embolism?

a. plaque broke away from the sclerotic aortic valve
b. plaque broke away from the wall of the proximal ECA
c. plaque broke away from the wall of the ACA

Answer 14

a. plaque broke away from the sclerotic aortic valve

Question 15

A patient is referred for a Doppler ultrasound of the IVC and hepatic veins due to an abnormal echocardiogram. The report states that the hepatic veins appear to empty directly into the right atrium with limited visualization of the upper IVC. What are you looking for in the abdomen?

a. azygous or hemiazygos IVC
b. situs inversus
c. duplicated IVC

Answer 15

a. azygous or hemiazygos IVC

Question 16

A patient presents with dysphagia and hoarseness. The referring physician suspects Ortner syndrome. What type of exam will you be performing?
a. transcranial Doppler exam
b. bilateral carotid duplex exam
c. upper extremity arterial duplex exam

Answer 16

c. upper extremity arterial duplex exam