Week 4

Question 2

What is the definition of arteriosclerosis?

Answer 2

Hardening and thickening of arterial walls due to calcium

Arteriosclerosis is characterized by calcium deposits and loss of elasticity in arterial walls.

Question 3

What is the definition of atherosclerosis?

Answer 3

Fatty deposits (plaques) build up on arterial walls

Atherosclerosis involves the accumulation of fatty material, cholesterol, and plaque formation.

Question 4

What are the primary pathological features of arteriosclerosis?

Answer 4

Calcium deposits, loss of elasticity

This condition leads to a generalized hardening of all arteries.

Question 5

What are the primary pathological features of atherosclerosis?

Answer 5

Fatty material, cholesterol, plaque formation

Atherosclerosis primarily causes localized narrowing and blockage of arteries.

Question 6

What is a common example of arteriosclerosis if coronary vessels are affected?

Answer 6

Coronary artery disease

This condition can lead to reduced blood flow to the heart muscle.

Question 7

What can result from carotid plaque?

Answer 7

Stroke, embolism, or thrombosis

These conditions arise from the narrowing and blockage of carotid arteries.

Question 8

What are the components of atherosclerotic plaques?

Answer 8

Lipids, necrotic cells, cholesterol crystals

These components contribute to the risk of stroke and thrombosis.

Question 9

What are common sites for atherosclerosis?

Answer 9

Branches, bifurcations, and vessel origins

Atherosclerosis typically occurs in areas of turbulence in blood flow.

Question 10

What is amaurosis fugax?

Answer 10

Transient vision loss

It is often a symptom of carotid atherosclerotic disease.

Question 11

What does TIA stand for?

Answer 11

Transient Ischemic Attack

Symptoms last less than 24 hours and indicate potential stroke risk.

Question 12

What is the mechanism of stroke related to atherosclerosis?

Answer 12

Artery blockage

This blockage can lead to ischemic strokes.

Question 13

What is an embolic stroke?

Answer 13

Embolism from heart

It occurs when a blood clot travels to the brain.

Question 14

What causes cerebral hemorrhage?

Answer 14

Ruptured vessel due to hypertension or aneurysm

This type of stroke involves bleeding in the brain.

Question 15

What are the views used in imaging of plaque?

Answer 15

Short axis and Long axis

These views help evaluate plaque characteristics.

Question 16

What characteristics are evaluated in plaque imaging?

Answer 16

Size and surface morphology, echogenicity, mobility

These factors help assess the risk of embolism.

Question 17

What plaque characteristic is most associated with a higher risk of embolism?

Answer 17

Mobile or ‘flapping’ plaque

Mobility indicates instability and higher embolism risk.

Question 18

What are the types of plaque morphology?

Answer 18

Soft Plaque, Hard (Fibrous) Plaque, Heterogeneous Plaque, Ulcerative Plaque, Hypoechoic (Echolucent)

Each type has distinct characteristics and associated risks.

Question 19

What is a characteristic of soft plaque?

Answer 19

Homogeneous, low echo, smooth surface

Soft plaque is considered stable.

Question 20

What is a characteristic of hard (fibrous) plaque?

Answer 20

Calcified, shadowing, drop-out areas

This type of plaque is stable but obstructive.

Question 21

What describes heterogeneous plaque?

Answer 21

Mixed echogenicity, irregular surface

It is unstable and associated with TIA risk.

Question 22

What is the risk associated with ulcerative plaque?

Answer 22

High stroke risk

Ulcerative plaque has significant instability.

Question 23

Why are hypoechoic plaques difficult to evaluate on B-mode ultrasound?

Answer 23

Their low echogenicity makes it hard to distinguish plaque borders from the lumen

This complicates assessment and detection.

Question 24

What key parameters are measured in Doppler & flow measurement?

Answer 24

PSV (Peak Systolic Velocity) & EDV (End-Diastolic Velocity)

These parameters help assess blood flow in carotid arteries.

Question 25

What is the preferred Doppler angle for measurements?

Answer 25

≤60° ## Footnote This angle ensures accurate flow measurements.

Question 26

What is the flow type in the ICA?

Answer 26

Continuous diastolic flow ## Footnote ICA has low resistance flow characteristics.

Question 27

What is the flow type in the ECA?

Answer 27

High-resistance waveform ## Footnote ECA flow can be positively influenced by a temporal tap.

Question 28

What is the flow type in the CCA?

Answer 28

Mix of ICA & ECA flow ## Footnote CCA flow is pulsatile in nature.

Question 29

What characteristic supports ICA occlusion in Doppler findings?

Answer 29

High-resistance waveform in the ipsilateral CCA ## Footnote This finding indicates a lack of blood flow in the ICA.

Question 30

What are sonographic clues for severe ICA stenosis?

Answer 30

PSV > 230 cm/s, visible plaque >70%, color aliasing, post-stenotic turbulence, spectrum broadening, EDV > 100 cm/s, color bruit ## Footnote These indicators suggest significant narrowing of the artery.

Question 31

What does 'tardus parvus' indicate?

Answer 31

Seen downstream of a stenosis, slow systolic rise, low amplitude ## Footnote It reflects the impact of stenosis on blood flow characteristics.

Question 32

What distinguishes occlusion from very severe stenosis?

Answer 32

Occlusion has no emboli release, very severe stenosis has embolic risk ## Footnote Occlusions are typically not surgically corrected, while severe stenosis may require urgent surgery.

Question 33

What happens during CCA occlusion and collateralization?

Answer 33

ECA → retrograde flow → ICA ## Footnote Color Doppler confirms this flow pattern.

Question 34

What causes subclavian steal syndrome?

Answer 34

Proximal subclavian/innominate artery stenosis ## Footnote This condition leads to reversed flow in the vertebral artery.

Question 35

What is the description of the pre-steal stage in subclavian steal?

Answer 35

Bunny waveform (transient systolic reversal) ## Footnote This waveform indicates early signs of steal.

Question 36

What does 'thud flow' indicate?

Answer 36

Damped systolic flow with reversed flow in early diastole at the point of occlusion ## Footnote This pattern reflects significant arterial blockage.

Question 37

What is the purpose of angioplasty and stenting?

Answer 37

To open the narrowed artery and maintain blood flow ## Footnote This procedure is commonly used in carotid artery disease.

Question 38

What is a carotid body tumor?

Answer 38

Paraganglioma at carotid bifurcation (between ICA & ECA) ## Footnote These tumors are highly vascular and can cause significant symptoms.

Question 39

What are symptoms of a carotid body tumor?

Answer 39

Neck pain, hoarseness, dizziness, syncope ## Footnote These symptoms indicate potential vascular issues.

Question 40

What is fibromuscular dysplasia (FMD)?

Answer 40

Non-atherosclerotic condition affecting carotid & renal arteries ## Footnote It is characterized by a 'string of beads' appearance on angiography.

Question 41

What causes arterial stenosis in FMD?

Answer 41

Overgrowth of collagen in the media wall layer ## Footnote This abnormal growth leads to narrowing of the arteries.

Question 42

What is carotid dissection?

Answer 42

Blood enters between intima and media ## Footnote It can occur spontaneously or due to trauma.

Question 43

What are symptoms of carotid dissection?

Answer 43

Neck pain, headache ## Footnote These symptoms may arise due to disruption of blood flow.

Question 44

What sono sign indicates carotid dissection?

Answer 44

Echogenic flap ## Footnote This sign reflects the presence of a dissection in the arterial wall.

Question 45

What defines a carotid aneurysm?

Answer 45

Involves all 3 wall layers ## Footnote Aneurysms can be congenital, trauma-related, or due to atherosclerosis.

Question 46

How is carotid aneurysm best visualized?

Answer 46

Best seen on ultrasound, confirmed with further imaging ## Footnote Ultrasound is often the first step in diagnosis.