Vascular Chapter 23 - Multiple Choice

At about what rate are femoral and popliteal aneurysms associated with abdominal aortic aneurysms?

A. 15%

B. 20%

C. 30%

D. 50%

15%

In which of the following patients would an abdominal aortic aneurysm most likely be found?

A. A 69 y/o male

B. A 75 y/o female

C. A 37 y/o male

D. A 28 y/o female

A. A 69 y/o male

What causes the indication to evaluate the aortoiliac segments known as blue toe syndrome?

A. Vasospasm

B. Small vessel occlusive disease

C. Cold sensitivity

D. Embolic Events

D. Embolic Events

Which of the following patient preparation steps should be taken to reduce overlying bowel gas before an aortoiliac duplex evaluation?

A. Take medication for gas reduction

B. Fast overnight

C. No specific preparation is necessary

D. Chew gum

B. Fast overnight

What position can the sonographer assume to help relieve strain on the arm and/or elbow when applying pressure to view the aorta and iliac arteries?

A. Position shoulder over the transducer to allow body weight to help push

B. Abduct arm to reach across the patient

C. Bend at waist and extend arm to better visualize iliac vessels

D. Position flexed wrist over transducer and push from the shoulder

A. Position shoulder over the transducer to allow body weight to help push

To visualize the deep vessels of the abdomen, what transducer is most frequency is most commonly used?

A. 7 to 10 MHz

B. 1 to 5 MHz

C. 5 to 8 MHz

D. 1 to 2 MHz

B. 1 to 5 MHz

What is the most common location for abdominal aortic aneurysms?

A. Suprarenal

B. At the level of the SMA

C. Infrarenal

D. Proximal aorta just as it passes through the diaphragm

C. Infrarenal

Which of the following is NOT associated with normal findings in the abdominal aorta?

A. Smooth margins

B. Tapering distally

C. Tortuosity near the bifurcation

D. No focal dilatation

C. Tortuosity near the bifurcation

At what diameter is the abdominal aorta considered aneurysmal?

A. 1 cm

B. 2 cm

C. 3 cm

D. 3mm

C. 3 cm

What shape are most aortic aneurysms?

A. Fusiform

B. Saccular

C. Mycotic

D. Dissecting

A. Fusiform

As an abdominal aortic aneurysm enlarges, what does it also tend to do?

A. elongate

B. foreshorten

C. straighten

D. constrict

A. elongate

To get the most accurate diameter measurement of the abdominal aorta, how should the technologist align the transducer to the vessel?

A. Parallel

B. Oblique

C. Perpendicular

D. Sagittal

C. Perpendicular

When viewing the abdominal aorta in transverse, which dimension provides the most accurate diameter measurement?

A. Anterior to posterior

B. Right to left lateral

C. Superior to inferior

D. All are equally accurate

A. Anterior to posterior

During an aortoiliac duplex examination, the distal aorta measures 2.5 cm in diameter. What are these findings consistent with?

A. Normal aortic dimension

B. Aortic ectasia

C. Aortic aneurysm

D. Aortic dissection

B. Aortic ectasia

When an abdominal aortic aneurysm is found, which of the following additional parameters should be included?

A. length of aneurysm

B. proximity of aneurysm to renal arteries

C. presence and extent of any intraluminal thrombus

D. all the above

D. All of the above

What landmark is used to determine the end of the common iliac artery and beginning of the external iliac artery?

A. Inguinal Ligament

B. Origin of internal iliac artery

C. Umbilicus

D. Iliac crest

B. Origin of internal iliac artery

All of the following system settings can be used to optimize the grayscale image to identify a dissection EXCEPT:

A. Decreasing dynamic range

B. Using a chroma map

C. Increasing overall gain

D. Decreasing the number of focal zones

D. Decreasing the number of focal zones

When evaluating a stent within the aortoiliac system, which of the following is FALSE?

A. Stent alignment should be visualized

B. Full deployment of stent should be documented

C. Relationship of the stent to the vessel wall is needed

D. Evaluation of the vessel distal to the stent is not needed

D. Evaluation of the vessel distal to the stent is not needed

A 65-year-old male presents to the vascular lab for evaluation of the abdomen after involvement in a car accident. During the duplex examination, an asymmetric outpouching is identified in the mid to distal aorta. What do these findings represent?

A. Fusiform aneurysm

B. Saccular aneurysm

C. Aortic dissection

D. Aortic stenosis

B. Saccular aneurysm

Upon duplex evaluation of a known abdominal aortic aneurysm, homogeneous echoes with smooth borders are visualized with the aneurysm sac. What do these findings suggest?

A. calcifications

B. atherosclerotic plaque

C. thrombus formation

D. vessel dissection

C. thrombus formation

A 72-year-old male presents to the vascular lab for follow-up after common iliac stenting. Upon examination, the stent in the mid common iliac artery is elliptical in shape. What does the this appearance likely indicate?

A. Partial stent compression

B. Normally deployed stent

C. A kink within the stent

D. Vessel dissection in the area of

A. Partial stent compression

During Doppler evaluation of the abdominal aorta, two flow channels are noted. What do these findings suggest?

A. Fusiform aneurysm

B. Saccular aneurysm

C. Aortic dissection

D. Aortic stenosis

C. Aortic dissection

A 76-year-old female patient presents to the vascular lab with left hip and buttock claudication. During the duplex evaluation, velocities in the distal common iliac artery are 72 cm/s whereas velocities in the proximal external iliac artery are 302 cm/s. Which of the following has occurred?

A. More than 50% stenosis in the proximal external iliac artery

B. Less than 50% stenosis in the proximal external iliac artery

C. More than 50% in the distal common iliac artery

D. External iliac disec

A. More than 50% stenosis in the proximal external iliac artery

Which of the following is NOT a benefit of endovascular stent graft repair of AAA?

A. Lower perioperative mortality

B. Decreased survival rates over open surgical repair

C. Shorter recovery time

D. Lack of abdominal incision

B. Decreased survival rates over open surgical repair

What is the goal of EVAR?

A. Reduce the size of the aortic lumen

B. Occlude the aorta to avoid aortic rupture

C. Exclude the aneurysm sac from the general circulation

D. Increase the size of the aorta to treat stenosis

C. Exclude the aneurysm sac from the general circulation

Which of the following can color Doppler ultrasound monitoring of EVAR demonstrate?

A. Residual sac size

B. Graft limb dysfunction and kinking

C. Hemodynamics within the graft site

D. All of the above

D. All of the above

Which of the following is most frequently deployed stent graft device?

A. Bifurcated

B. Straight tube

C. Uni-iliac graft

D. Fenestrated grafts

A. Bifurcated

During the evaluation of an aortic stent graft, the vascular technologist notes a hyperechoic signal along the anterior and posterior walls of the aortic lumen just below the level of the renal arteries. What does this finding suggest?

A. Kinking of the stent graft

B. Normal findings of the proximal attachment site

C. Endoleak at the proximal graft

D. Graft bifurcation at the distal attachment site

B. Normal findings of the proximal attachment site

Which of the following is NOT an indication of aneurysm sac instability after EVAR?

A. Increase in sac size

B. Pulsatility of the sac

C. Decrease in size of aneurysm sac

D. Areas of echo-lucency within the sac

C. Decrease in size of aneurysm sac

An 80 y/o male presents for follow-up after endovascular treatment of his AAA. During the evaluation, the stent graft is identified and appears to be in a correct position by B-Mode: however, the aortic diameter is 5.5 cm compared to 4.9 cm on previous examination. Doppler evaluation is then performed and flow is identified along the posterior aorta outside the stent graft material. What is the likely cause of these findings?

A. Kinking of the stent graft material

B. Stent graft endoleak

B. Stent graft endoleak