RVT Study 1

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RVT Study 1
2014-07-02 18:40:13

study for RVT
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  1. Which artery does not arise from the subclavian artery? 
    b) superior thyroid
    c)internal thoracic 
    d) thyrocervical trunk
    b, superior thyroid
  2. Infraoribital artery is a terminal branch of the:
    a. maxillary artery
    b. facial artery
    c. inferior alveolar artery
    d. transverse facial artery
    • A, Maxillary artery. 
    • This artery creates a possible anastamoses with the orbital branch to create a possible collateral pathway.
  3. The three terminal branches of the opthalamic artery:
    a. Superficial, facial, frontal
    b. Nasal, Frontal, Supraorbital
    c. Basilar, ACA, PCA
    d. Nasal, Frontal, Facial
    • B, Nasal, Frontal, Supraorbital
    • These arteries are involved with ECA collateral pathways.
  4. Intracranial collateral pathways of clinical significance include all except: 
    a. ACA
    b. PCA
    c. Superficial Temporal
    d. Leptomesengeal
    e. Rete Mirable
    A, Superficial Temporal (not intracranial)
  5. What is the equation for Poiseuilles?
    • R= 8nL/ (pie)r4
    • This explains that resistance increases with greater length, smaller diameter and higher viscosity
  6. This vessel courses along the medial aspect of the psoas muscle:
    a. Femoral artery
    b. Internal iliac
    c. External iliac
    C, External iliac
  7. What is a useful landmark for locating the origin of the renal arteries?
    Superior Mesenteric Artery
  8. Which artery is the left branch of the celiac trunk?
    Splenic artery
  9. What are the smallest vessels in the body?
  10. The layer of arterial/venous wall composed entirely of endothelial cells:
    Tunica Intima
  11. Regarding capillaries, which is false? 
    a. They only have intima/adventita
    b. They measure roughly 8 microns in diameter
    c. Transit time is roughly one to three seconds
    • A, they only have intima/adventita
    • - They really only have intima (endothelial cells)
  12. A left arm pressure 40 mmHg lower can be all except:
    a. TOS
    b. Subclavian Steal
    c. Coarctation of the arch
    d. Innominate Artery occlusion
    D, Innominate artery occlusion (this is located on the right side of the body)
  13. After carotid bifurcation disease, the next most common source of stroke symptoms: 
    a. cardiac-source embolization
    b. DVT via PFO
    c. Spinal stenosis
    d. Aortic dissection
    A, Cardiac-source embolization (MI/ A-fib is the most common cause of mural thrombus)
  14. Which statement is false regarding subclavian steal?
    a. most common on the left side
    b. usually asymptomatic
    c. results from severe stenosis/occlusion in the proximal vertebral artery
    d. lower BP is seen in the affected arm
    c, Results from severe stenosis/occlusion in the proximal vertebral artery
  15. A 24 y/o with a h/o recent MVA arrives to the ICU with sx of R-sided weakness and aphasia. The likely etiology is: 
    a. carotid dissection
    b. cerebral aneurysm rupture
    c. severe ICA stenosis
    d. embolic activity from the heart
    A, Carotid dissection
  16. The term hemiparesis means: 
    a. paralysis of one side
    b. weakness on one side
    c. numbness/tingling one side
    d. dizziness
    B, weakness on one side
  17. NASCET classifies ICA disease using:
    Diameter of the percentage stenosis calculated by dividing minimal diameter by the diameter of the unstenosed distal ICA
  18. The patient relates a 10 minute loss of vision. He closed each eye and the reduction in 1/2 of this visual filed was present bilaterally. He is describing amaurosis fugax. True or False?
    False! Patient is describing homonymous hemianopia.
  19. A symptom of vertebrobasilar insufficiency is: 
    a. unilateral paresis
    b. aphasia
    c. amaurosis fugax
    d. diplopia
    D, diplopia (presents bilaterally)
  20. New strokes per year: 
    a. 150,000
    b. 250,000
    c. 700,000
    d. 1,000,000
    c, 700,000
  21. Simultaneous bilateral ocular symptoms in the patient wtih suspected cerebrovascular disease generally originate from: 
    a. vertebrobasilar arteries
    b. opthalmic arteries
    c. both CCA's 
    d. both ICA's
    A, vertebrobasilar arteries. Bilateral sx usually stem from posterior circulation, and the visual cortex is in the occipital lobe. Specific ocular sx usually stem from the MCA.
  22. Amaurosis fugax can be interpreted as: 
    a. stroke of the eye
    b. TIA
    c. stroke of visual cortex
    d. TIA of frontal cortex
    B, TIA
  23. Paresthesia refers to: 
    a. dizziness
    b. speech disturbance
    c. loss of limb function
    d. weakness
    e. tingling
    E, Tingling
  24. A patient describes a 30- minute episode of garbled speech called: 
    a. Dysphasia
    b. Aphasia
    c. Dysphagia
    d. Syncope
    A, Dysphasa (Phasia= Speech)
  25. A right handed patient experiences 30-minute episode of dysphasia. Which area of circulation is suspected? 
    a. right hemisphere
    b. left hemisphere
    c. vert/basilar
    b, left hemisphere (speech area is in the temporal lobe of the dominate hemisphere)
  26. A hemispheric stroke usually affects:
    a. MCA distribution and contralat side of the body
    b. MCA distribution and ipsilat side of the body
    c. the ACA distribution and ipsilat side
    A, MCA and contralat side of body
  27. Stenosis of the following presents highest risk for TIA:
    a. CCA
    b. ICA
    c. ECA
    d. MCA
    b, ICA
  28. A decreased pulse at mid neck is suggestive of:
    a. CCA stenosis if contralat pulse is normal
    b. CCA stenosis if contralat pulse is decreased
    a, CCA stenosis if contralat pulse is normal
  29. A stronger pulse is palpated in the right neck than the left. This could be from all except:
    a. Tortuous CCA
    b. Carotid aneurysm
    c. L carotid obstruction
    d. Innominate obstruction
    d, innominate obstruction (this is located on the right side, so it would decrease the pulse on the right)
  30. In duplex imaging, the best arterial wall image quality is obtained with the beam is at the following angle to the artery walls:
    a. 90 b. 60 c. 0 d. oblique
    a, 90 (more echoes return to the transducer)
  31. Amaurosis fugax related to an ICA lesion will cause: 
    a. temporary blindness/shading ipsilat eye
    b. temporary blindness/shading contralat eye
    c. temporary blindness/shading both eyes
    a, temporary blindness/shading the ipsilat eye
  32. Dysphagia is a:
    a. L hemisphere symptom (for R handed pt)
    b. R hemisphere symptom (for L handed pt)
    c. Sx of vertebrobasilar insufficiency
    • c, sx of vertebrobasilar insufficiency 
    • (Phagia= swallowing)
  33. Phasia is to _____, as Phagia is to______
    Phasia= Speech, Phagia= Swallow
  34. Performing TCD you insonate the L anterior cerebral artery. Flow is towards the beam, suggesting: 
    a. ipsilat carotid obstruction, w/ R to L collat
    b. contralat carotid obstruction, w/ L to R collat
    c. Ipsilat carotid obstruction, w/ Posterior to anterior collat
    a, ipsilat carotid obstruction with right to left collateralization (this suggests flow coming across from the other hemisphere via the anterior communicating artery)
  35. Which of the following is/are true regarding axial resolution in carotid scanning?
    a. Differentiates soft plaque from blood
    b. resolves two targets positioned one in front of another along axis of beam propogation
    c. Improves observers ability to estimate wall thickness
    d. B and C
    B and C
  36. All of the following are consistent with total occlusion except: 
    a. absence of flow in ICA lumen
    b. Decreased velocity proximal to occulsion 
    c. retrograde flow in the distal ICA
    d. increased flow through collaterals
    C, retrograde flow in the distal ICA (flow wouldnt be completely retrograde).
  37. ____ % cross-sectional area reduction correlates to a ____ % diameter reduction.
    75% to 50%
  38. An arterial stenosis that is 80% by diameter reduction corresponds to a cross-sectional area reduction of: 
    a. 96% b. 88% c. 70% d. 60% e. 45%
    A, 96% cross section reduction corresponds to an 80% diameter reduction
  39. Acoustic windows for TCD include all except:
    a. Temporal bone
    b. Medial part of frontal bone
    c. orbit of eye
    d. suboccipital window
    e. submandibular area
    b, medial part of frontal bone
  40. Major complications of cerebrovascular angio include all of the following except: 
    a. death b. stroke c. inadvertent venous puncture d. arterial occlusion e. renal failure
    c, inadvertent venous puncture.
  41. What information cannot be determined by cerebrovascular angiography? 
    a. degree narrowing of ICA by diameter
    b. presence of ulceration
    c. degree narrowing by cross sectional area
    d. total ICA occlusion
    e. crossover collateralization from contralat hemisphere.
    c, degree narrowing by crossectional area
  42. NASCET trial indicated the best treatment for carotid stenosis in symptomatic patient is:
    a. carotid endart for stenosis greater than 70% diameter
    b. carotid endart for stenosis less than 70% diameter
    A, carotid endart for stenosis greater than 70% diameter reduction
  43. The greatest pressure of venous HTN in secondary varicose veins occurs: 
    a. at rest
    b. muscle contraction
    c. muscle relaxation
    d. while standing quietly
    b, during muscle contraction
  44. What percentage of PE originate from lower extremity DVT?
    a. greater than 90%
    b. 75%
    c. Roughly 50%
    a, greater than 90%
  45. A condition that presents as a severely swollen blue, cool lower extremity is called:
    a. phlegasia alba dolens
    b. phlegmasia cerulea dolens
    b, phlegmasia cerulea dolens (blue leg!)
  46. Clinical exam for DVT is: 
    a. specific & sensistive
    b. not specific but sensitive
    c. specific but not sensitive
    d. not specific nor sensitive
    D, neither specific nor sensitive
  47. An elderly patient presenting with localized pain at mid calf has an u/s revealing non-occlusive thrombus of the femoral vein. Pain significantly increases after heparin administration. Second u/s shows: 
    a. progression of DVT into pop and calf
    b. non occlusive thrombus at femoral vein
    c. popliteal aneurysm
    d. hypoechoic mass shaped like an egg at mid calf thought to be a hematoma
    d, hematoma like mass
  48. Which type of ulcers are non-painful and cephalad to the foot?
    Venous ulcers
  49. All may be present in clinical presentation of PE except: 
    a. chest pain
    b. dyspnea
    c. pleural effusion
    d. positive LEV u/s
    e. tachypnea
    d, positive LEV u/s (this isnt a clinical presentation)
  50. In CW Doppler reflux testing, a normal result is:
    cessation of flow with proximal compression, resuming on release
  51. The test for venous incompetence that uses tourniquets and alternations of patient positioning:
    The Trendelenburg test
  52. Of the following, which would be the least effective in detecting significant DVT?
    a. PPG
    b. Duplex U.S
    c. impedence plethyso
    d. pneumo plethysmo
    e. strain-gauge plethysmo
    A, PPG (good for chronic venous insuff. but not DVT)
  53. What affect to venous flow does the valsalva maneuver have?
    Slows or stops flow everywhere in the body
  54. Desending venography is used to diagnose:
    Valvular insufficiency
  55. Venous puncture for DVT R/O venography is done at:
    Dorsal vein on the foot
  56. Patient position for venography is:
    On exam table tilted 60 degrees upright
  57. The drug heparin can cause:
    Thrombocytopenia (doesn't affect prothrombin time)
  58. Agent of choice in the initial management of PE is:
    a. Heparin
    b. Streptokinase
    c. Urokinase
    d. Coumadin
    e. TPA
    Heparin, as age of DVT is unknown
  59. More than 90% of infrarenal abdominal aneurysms:
    a. traumatic origin
    b. degenerative origin
    c. anastomotic origin
    d. infectious origin
    e. syphilitic
    Degenerative origin
  60. Most common source of lower/upper extremity peripheral arterial embolus is: 
    a. ulcerated plaque
    b. the heart
    c. aneurysmal dissections and athrosclerosis
    d. aneurysms 
    e. small vessel diseae
    the heart (80-90 % from the heart)
  61. The chance of a patient dying from a rupture of a AAA averages:
    a. 25%
    b. 35%
    c. 45%
    d. 55%
    e. 80%
    E, 80% (30-40% pts die before reaching the hospital)
  62. Which of the following about AAA is false?
    a. AAA usually infrarenal
    b. CT and MRI commonly used for diagnosis of AAA
    c. U/S most frequently used for diagnosis
    d. most prerupture AAA discovered fro Abdominal Sx and distal emboli
    D, AAA discovered from abdominal sx and distal emboli (usually found with routine physical exam)
  63. What vascular disease commonly presents as back, abdominal and flank pain?
  64. Arterial ischemic ulcers are:
    Very painful and commonly located distally over dorsum of foot
  65. Pulsatility index is defined as:
    Peak systolic and end diastolic divided by mean velocity
  66. What change occurs in peripheral blood flow of limbs with obstructive arterial disease in response to laboratory-induced ischemia (reactive hyperemia procedures) or exercise?
    Hyperemia is prolonged in obstructed limbs in comparison to limbs with no obstruction.
  67. Key terminology in arterial pneumoplethysmography is:
    a. two pairs of electrode bands monitoring impedence
    b. two photocells monitoring subcutaneous color changes
    c. pressure transducer monitoring cuff pressure over a limb
    d. large air cuff enclosing entire calf
    Pressure transducer monitoring cuff pressure over the limb
  68. assessement of palmar arch patency is useful when?
    Before placement of AVF and to evaluate flow into digital arteries.
  69. Protocols for cardiac treadmill testing and claudication treadmill testing differ, the major difference being:
    Speed is varied during cardiac testing
  70. The correct setting for arterial volume recording is:
    a. AC coupled output
    b. DC coupled output
    c. 35 Hz filter setting
    d. "mean" filter setting
    A, AC coupled output
  71. The most widely used interpretive technique for analog Doppler waveforms:
    a. quantitative approach evaluating diagnostic features of waveform
    b. qualitative approach or pattern recognition
    c. spectral analysis of velocity profiles within waveform
    B, qualitative approach or pattern recognition
  72. The amplitude of arterial volume recording waveforms:
    Is only marginally meaningful diagnostically
  73. Usual cuff pressure used in arterial volume recording is:
    a. 65 mmhgc      b. 10 mhg
    c. suprasystolic  d. 100 mmhg
    65 mmhg
  74. Little or no increase of blood flow velocity in response to post occlusive reactive hyperemia using an inflated thigh cuff, would most likely indicate:
    a. well developed collateral bed
    b. significant obstructive disease
    c. normal arterial segment
    b, significant obstructive disease (normally major velocity increases over 100%)
  75. To minimize error during the measurement of systolic pressure using a manometer having 2 mmHg marks, the deflation rate should be: 
    a. ~5 mmhg/sec
    b. <1 mmhg/sec
    c. ~2 mmhg/heart beat
    d. depends on cuff size
    c, ~ 2 mmHg/ heart beat (too fast or slow can be inaccurate)
  76. Velocities inside a reversed saphenous vein bypass graft are usually:
    Higher proximally and lower distally
  77. Normal values in TCPO2 assessment:
    a. 60-80 mmhg
    b. ~ 760 mmhg
    c. 0-20 mmhg
    a, 60-80 mmHg
  78. A normal ankle pressure response to reactive hyperemia:
    transient decrease of aprox 20%
  79. A clenched fist will change the following parameter in the brachial artery waveform:
    a. increase PI 
    b. decrease PI
    c. increase diastolic flow
    d. decrease systolic flow
    a, increase PI
  80. Which is a significant problem w/ digital subtraction angio?
    patient cooperation
  81. What isn't true about peripheral arterial angio?
    a. used prior to elective LEA operation
    b. issues w/ vessel overlap
    c. arteriography used for routine f/u
    d. contrast reactions are less of an issue
    c, used for routine f/u (not true, too many risks/exposures)
  82. The 5 yr risk of rupture for a AAA of 4 cm is aprox:
    a, >50%
    b. 40%
    c. 30%
    d. 20% 
    e. <10%
  83. Which is not common feature of renal allograft rejection?
    a. increased allograft size
    b. increased cortical echogenicity
    c. decresed flow resistance in parynchma 
    d. increased prominence of renal pyramids
    Decreased flow resistance (it would INCREASE)
  84. demonstration of vein wall coaptation of the subclavian vein is best performed with:
    Taking a quick, deep breath (sniff)
  85. Which is a normal finding in a patient with TIPS?
    a. hepatofugal flow in MPV
    b. hepatopetal flow in MPV
    c. hepatofugal flow in splenic V
    d. absence of flow in portal v.
    B, hepatopetal flow in MPV   (splenic and portal should be hep petal. Petal= towards the liver)
  86. Incidence of PSAN is:
    a. increasing
    b. decreasing
    c. staying same
    d. stabilizing
    a, increasing (more transmural procedures)
  87. Regarding impotence, penile pressures can ______ after treadmill testing
  88. What is normal PBI at rest?
    > 0.75
  89. What type of DAF is the brescia-cimino
    Radial artery and cephalic vein
  90. A congenital AVF involves:
    Multitude of AV channels
  91. In liver transplants, the native common hepatic artery is anastomosed to the donor hepatic artery:
    a. in posterior aspect of R lobe liber
    b. in medial segment of L lobe liver
    c. Several centimeters proximal to hepatic hilum
    d. at portahepatis where hepatic artery enters liver
    c, sever cm prox to hepatic hilum
  92. Probability that a positive test reveals actual disease (compared to GS) is called:
    a. accuracy
    b. sensitivity
    c. positive PV
    d. negative PV
    positive predictive value
  93. if we increase the PSV needed to call a carotid test positive:
    The positive predictive value will increase, the negative predictive value will decrease, accuracy may increase or decrease
  94. How must accuracy compare to sensitivity/specificity and PPV/NPV?
    It must fall in between them
  95. The calculation that has as its denominator the total number of non invasive tests:
    a. PPV
    b. sensitivity
    c. overall accuracy
    d. specificity
    e. NPV
    e, negative predictive value (true negatives / (true negatives + false negatives)
  96. A correlation of a non-invasive test to its "gold standard" yields a postive predictive value of 86%. This means that:
    a. of all non-invasive tests performed, 86% correctly classified the disease
    b. of all gold standard results that were abnormal, the noninvasive test correctly classified 86% 
    c. of all positive non invasive tests, 86% correctly predicted that the gold standard would be abnormal
    d. of all noninvasive tests performed, 86% were positive
    C, of all positive non invasive tests, 86% correctly predicted that the gold standard would be abnormal
  97. A correlation of a non-invasive test to its gold standard yields a sensitivity of 93%. Which of the following statements regarding specificity is correct?
    a. must be greater than sensitivity
    b. must be within 10-15% of sensitivity
    c. must be a value from 0-100%
    c, must be value from 0-100%
  98. In Kappa statistics, if there is no relationship between the two variables being compared, the Kappa value is
    a. zero
    b. 1.00
    c. -1.00
    d. >1.00
    e. <1.00
    a, zero
  99. At any moment how much of the bodys blood volume is found in the veins?
    a. 10-20%
    b. 25-40%
    c. 40-50% 
    d. 60-75%
    e. 85-95%
    d, 60-75%