Vascular 1

1.

1 point

which of the following are not normal findings of the ophthalmic artery?

it is visualized between 40 and 60 mm using a transorbital approach

if providing collateral flow from the ECA to the brain, flow is directed from the eye orbit toward the brain

it normally displays from the brain toward the orbit of the eye

it normally displays high velocity diastolic flow

2.

1 point

from a transtemporal window, which statement concerning the PCA is correct?

the direction of flow in the ipsilateral P1 segment and proximal P2 segments is toward the transducer

the direction of flow in the ipsilateral P1 segment is away and toward in the proximal P2 segment

the direction of flow in the ipsilateral P1 segment is toward and away in the proximal P2 segment

The direction of flow in both the right and left P1 segments is toward the transducer

3.

1 point

which two vessels complete the circle of willis by connecting the right and left components of the circle

the right and left cerebellar arteries

the anterior and posterior communicating arteries

the right and left vertebral arteries

the superior and inferior cerebellar arteries

4.

1 point

how will the color pattern within a carotid pseudoaneurysm appear?

red color filling during systole with no color during diastole

constant antegrade color flow

high velocity color aliasing throughout the cardiac cycle

red and blue color filling within different portions of the sac

5.

1 point

which is usually the development of the first stage of a potential ischemic event?

embolism

atherosclerosis

aneurysm

thrombosis

6.

1 point

what are two major branches of the ECA

supraorbital and frontal arteries

supraorbital and middle cerebral arteries

internal maxillary and opthalmic arteries

superficial temporal and facial arteries

7.

1 point

this vessel normally can display flow toward, away or bidirectional depending on the orientation of the vessel to the transducer..

the BA

the internal carotid artery at the carotid siphon

the retromandibular ICA

the PCA

8.

1 point

elevated velocities seen in carotid stents may be due to

reduced arterial compliance

increased arterial capacitance

length of the original stenosis

length of the carotid stent used

9.

1 point

what are the three terminal branches of the OA?

basilar, anterior communicating and posterior arteries

nasal, frontal and facial arteries

superficial, facial and frontal arteries

nasal, frontal and supraorbital arteries

10.

1 point

which is not commonly used to analyze transcranial spectral waveforms?

peak systolic velocity

pulsatility index

time average peak velocity

waveform morphology

11.

1 point

in a dissection with only one tear and a blind end, how will flow in the false lumen present?

no flow signal

a high resistance pattern

a low resistance pattern

normal antegrade flow

12.

1 point

the arterial pulsations often felt in front of the ear and just above the zygomatic arch are from which artery?

superficial temporal

maxiallary

facial

transverse facial

13.

1 point

doppler waveform features proximal to a severe stenosis with limited collaterals will display what type of pattern?

a low resistance patter with high velocity diastolic flow

a tardus-parvus pattern

a high velocity flow pattern in both systole and diastole

a high resistance pattern with low or absent diastolic flow

14.

1 point

the most common pitfall associated with carotid stent ultrasound is

the stent placement is usually high in the neck and difficult to access with ultrasound

the metal of some stents reflects all the ultrasound signals

acoustic shadowing from vessel wall calcification will limit views

the stent is hard to distinguish in most patients when compated to the vessel wall

15.

1 point

what does a high resistance flow pattern in the internal carotid artery indicate?

diverse network of patent collateral arteries distally

middle cerebral and anterior cerebral arteries are totally occluded

innominate or common carotid artery severe stenois

a severe stenosis or occlusion distal to the segment being insonated

16.

1 point

what is considered a normal pulsatility index for the majority of the intracranial arteries?

0.6-1.1

2.5-4.0

1.0-2.5

>4.0

17.

1 point

assuming volume flow remains the same, if the area of a blood vessel decreases then what must happen?

the mean velocity is unchanged

the velocity must increase

the velocity must decrease

the resistance must decrease

18.

1 point

which of the following is considered a vertebrobasilar symptom

diplopia

unilateral paresis

aphasia

amaurosis fugax

19.

1 point

prior to performing a carotid exam, a complete physical should be performed. Which would not normally be included in the physical exam?

auscultate for bruits

palpate carotid pulses

heart rate

bilateral brachial pressures

20.

1 point

which is not considered a non-athersclerotic cause of an ischemic event?

fibromuscular dysplasia

pseudoaneurysm

carotid body tumor

dissection

21.

1 point

a remnant of plaque in the proximal or distal edges of an endarterectomy can be referred to as

a dissection

an intimal flap

a shelf lesion

an intimal tear

22.

1 point

which best classifies a transient ischemic attack (TIA)?

resolves after 24 hours

resolves in 72 hours

resolves within 24 hours

does not resolve in 24 hours

23.

1 point

the depth of the VA confluence is approximately:

45-80mm

50mm

80mm

60mm

24.

1 point

which of the following will a TIA of teh right anterior hemisphere of the brain likely affect?

the right side of the body

the entire body

the left side of the body

the right side of the face

25.

1 point

which technique should not be utilized to differentiate string sign flow from complete vessel occlusion?

high wall filters

high color gain

power doppler

low color scale

26.

1 point

severe vasospasm is associated with MCA mean velocities of

>125 cm/s

>150 cm/s

>100 cm/s

>200 cm/s

27.

1 point

which doppler finding is most import ant for indicating a greater that 70% stenosis?

mean velocity

end diastolic velocity

percent window reduction

peak systolic velocity

28.

1 point

which of the following does not typically cause diminished flow in the vertebral artery?

bilateral hypoplastic VA's

distal VA or basilar a occlusion

bow hunters syndrome

poor cardiac output

29.

1 point

what are carotid aneurysms that result from infection called?

pseudoaneruysms

enteric aneurysms

saccular aneurysms

mycotic aneurysms

30.

1 point

in general, which statement describes flow velocities in the transcranial vessels?

MCA>ACA>PCA-BA-VA

MCA>ACA-PCA-BA-VA

MCA>ACA>PCA>BA-VA

31.

1 point

what doppler findings indicate a proximal vertebral artery severe stenosis?

antegrade, dampened doppler flow within the VA at mid and distal neck

antegrade, high resistance doppler flow within the vertebral artery at mid and distal neck

antegrade, hesitant doppler flow within the VA, a latent subclavian steal

retrograde doppler flow within the VA, a completed subclavian steal

32.

1 point

which best describes a RIND (reversible ischemic neurologic deficit)?

a neurologic symptom which lasts less than one hour

a neurologic symptom which lasts between 1 and 24 hours

a neurologic symptom which lasts between 3 and 7 days

a neurologic symptom which lasts between 24 and 72 hours

33.

1 point

which one of the following statements represents findings that are likely associated with fibromuscular dysplasia?

sudden turbulence and high velocities in the distal ICA

tardus-parvus waveforms within the proximal ICA

increased resistance within the distal ICA waveform

turbulence and high velocities in the proximal ICA

34.

1 point

the PSV threshold for a 50% stenosis in a carotid stent varies somewhat between published reports but is generally a minimum of :

110 cm/s

150 cm/s

175 cm/s

125 cm/s

35.

1 point

the circle of willis receives its blood supply from which combination of arteries?

Carotid and VA

PCA & BA

ICA & ECA

Subclavian and VA

36.

1 point

which statement is not true concerning the NASCET trial results in regard to carotid endarterectomy?

it addressed the stroke rate in surgery versus non-surgery symptomatic patients

it proved a decreased risk of stroke exists in asymptomatic male patients

it was a study performed to determine the benefit of carotid endarectomies at various degrees of stenosis

it proved to benefit patients with a >70% stenosis diameter reducing ICA stenosis

37.

1 point

what flow volume is demonstrated in patients that exhibit nonlocalized cerebrovascular symptoms suggestive of posterior circulation ischemia (vertebrobasilar system flow)?

greater than 200 mL/min

less than 500 mL/min

greater than 100 mL/min

less than 200mL/min

38.

1 point

what generally occurs when plaque develops and starts to fill the carotid bulb?

arterial waveform contours will be highly irregular

doppler waveforms will demonstrate flow reversal

flow separation disappears

the vessel will be less uniform in diameter

39.

1 point

which of the following flow profiles will not be displayed within the true lumen and the false lumen of a vessel with a dissection?

normal flow patterns in both lumens

antegrade flow in the true lumen and retrograde flow in the false lumen

antegrade flow in both lumens

antegrade flow in the true lumen and "to and fro" in the false lumen

40.

1 point

what is approximate highest reported rate of variations in the circle of willis?

10%

33%

50%

25%

41.

1 point

which intracranial artery is most likely to infarct and cause a stroke?

Vertebrobasilar artery

ACA

MCA

PCA

42.

1 point

the cavernous portion of the ICA is referred to as the..

carotid bulb

terminal ICA

cerebral portion

carotid siphon

43.

1 point

which of the following diseases can be associated with a carotid dissection?

marfan syndrome

congestive heart failure

radiation injury

takayasu's arteritis

44.

1 point

which of the following is considered an anterior circulation symptom?

amnesia

unilateral paresis

syncope

bilateral visual blurring

45.

1 point

what is the normal number of branches off the ECA?

6

9

10

8