Vascular technology mcq questions

1000 mcq questions on vascular technology

containing 37 chapters

Chapter: 1

1. The aortic arch has several branching vessels. Among them the brachiocephalic artery is the first branch off of the aortic arch. Where does it arise?a) on the left onlyb) on the right onlyc) either on the right side or on the left sided) on the both sides

[Ans. b]

2. The left subclavian artery is the branch of the aortic arch. Which one is correct for the Left subclavian artery?a) It divides in to right common carotid and subclavian arteriesb) It terminates at the carotid bifurcationc) It divides in to left common carotid and subclavian arteriesd) It terminates at the thoracic outlet

[Ans. d]

3. The aortic arch has several branching vessels. What are the correct orders of the branches of the aortic arch?a) The left subclavian artery, the innominate artery, the left common carotid

arteryb) The left common carotid artery, the brachiocephalic artery, the left subclavian

arteryc) The innominate artery, the left common carotid artery, the left subclavian

artery.d) The brachiocephalic artery, the left subclavian artery, the left common carotid

artery

[Ans. c]

4. Which of the following information is true for the left common carotid artery?a) It is the third branch of the aortic archb) It terminates at the carotid bifurcationc) It is the first branch of the aortic archd) It terminates at the thoracic outlet

[Ans. b]

5. What is the name of the artery that travels along the shoulder to the upper arms and becomes the axiliary?a) The left common carotid artery

b) The brachiocephalic arteryc) The subclavian artery.d) Thoracic artery.

[Ans. c]

6. The axillary artery becomes the brachial after giving off seven branches. Which one is not among the seven branches?a) Superior arteryb) Radial arteryc) Subscapular arteryd) Thoracodorsal artery

[Ans. b]

7. The brachial artery courses down to upper arm, ending about 1 cm beyond the bend of the elbow where it divides into-a) Anterior and posterior arteriesb) Thoracic and lateral thoracic arteriesc) Radial and ulnar arteriesd) Superior and subscapular arteries

[Ans. c]

8. The antecubital fossa, located anterior to and below the elbow. What is it?a) A triangular regionb) A circular regionc) A rectangular regiond) A square region

[Ans. a]

9. Which artery originates from the brachial artery and travels down the lateral side of the fore arm in to the hand?a) The ulnar arteryb) The superior arteryc) Thoracic arteryd) The radial artery

[Ans. d]

10.The ulnar artery originates from the brachial artery and-a) travels down the lateral side of the fore arm in to the hand

b) gives off a deep a palmer branch and then terminates in the superficial palmar arch

c) Gives off a branch in the hand to from the superficial palmar arch.d) Terminates in the deep palmar arch of the hand by joining the deep branch of

the ulnar artery

[Ans. b]

11.Which information is correct for superficial palmar arch which continues into the hand and a branch of radial artery?a) consists of the deep palmar branch of the ulnar arteryb) consists of the distal portion of the radial arteryc) originates from the brachial arteryd) consists of the distal portion of the ulnar artery

[Ans. d]

12.The deep palmar arch which consists of the deep palmar branch of the ulnar artery and the deep palmer arch also-a) Consists of the distal portion of the ulnar arteryb) Consists of the distal portion of the radial arteryc) It continues in to the hand and a branch of the radial artery.d) Originates from the brachial artery

[Ans. b]

13.What are the name of the arteries which divide in to lateral and medial branches and are extending in to fingers/toes?a) The radial arteriesb) The ulnar arteriesc) The brachial arteriesd) The digital arteries

[Ans. d]

14.Which of the following information is not correct for the digital arteries?a) Arise from the palmar arches.b) Divide in to lateral and medial branchesc) Arises from the brachial arteryd) Extend in to finger/toes

[Ans. c]

15.The ascending aorta has two branches, the right coronary artery and left coronary artery. From where the ascending aorta arise?a) Left ventricleb) Palmar archesc) Brachial arteryd) Ulnar artery

[Ans. a]

16.The ascending aorta arises from the left ventricle and it has two branches. What are the branches of ascending aorta?a) Radial and ulnar arteriesb) The digital arteriesc) Thoracic and left thoracic arteriesd) Right and left coronary arteries

[Ans. d]

17.The ascending aorta arises from the left ventricle. The ascending aorta has two branches and it forms-a) The palmar archb) The aortic archc) The digital arteriesd) Coronary arteries

[Ans. b]

18.Which one is not one of the major visceral branches of the abdominal aorta feeds the stomach, liver, pancreas, duodenum etc?a) The celiac arteryb) The renal arteryc) The superior mesentic arteryd) Coronary artery

[Ans. d]

19.The celiac artery one of the visceral branches of the abdominal aorta, which feeds the stomach, liver, pancreas, duodenum and-a) Spleenb) Intestinec) Cecumd) Ascending colon

[Ans. a]

20.The superior mesentic artery is commonly abbreviated as “SMA”. The superior mesentic artery is located approximately 1 cm distal to the-a) Common hepatic arteryb) The ulnar arteryc) The celiac arteryd) The radial artery

[Ans. c]

21.Multiple renal arteries are not uncommon bilaterally. The renal artery which supplies blood to kidney, suprarenal glands and-a) Spleenb) Intestinec) Duodenumd) Ureters

[Ans. d]

22.At what distance above aortic bifurcation, the inferior mesenteric artery arises from the abdominal aorta and act as a collateral connection?a) 3-4 cmb) Approximately 3-4 cmc) 2-3 cmd) Approximately 2-3 cm

[Ans. b]

23.There are four major visceral branches of abdominal aorta and three major parietal branches of abdominal aorta. Which one is the major parietal branch of the abdominal aorta?a) the inferior mesenteric arteryb) the inferior phrenic arteryc) The superior mesenticd) The renal artery

[Ans. b]

24.The terminal branches of the abdominal aorta are right and left common iliac arteries where do the distal branches of the aorta carrying blood?a) Pelvis, abdominal wall and lower limbsb) Kidney, suprarenal glands and spleenc) Liver, duodenum and ureters

d) Pelvis, kidney and lower limbs

[Ans. a]

25. The common iliac arteries are divide into the internal and external iliac arteries at the level of the lumbosacral junction-a) About 3 cm from their originb) About 3 cm from the inguinal ligament on the lateral sidec) About 5 cm from their origind) About 5 cm from the inguinal ligament on the lateral side

[Ans. c]

26.Which arteries have the branches that provide arterial inflow to regions like pelvic wall, gluteal muscle, pelvic viscera, thigh and perineum?a) The common iliac arteriesb) The common femoral arteriesc) The internal iliac arteriesd) The external iliac arteries

[Ans. c) The internal iliac arteries]

27.The external iliac artery when passes underneath the inguinal ligament, what is it become?a) The common femoral arteryb) The common iliac arteryc) The internal iliac arteryd) Popliteal artery

[Ans. a) The common femoral artery]28.The popliteal artery is a discontinuation of the-

a) The common femoral arteryb) The common iliac arteryc) The celiac arteryd) The superficial femoral artery

[Ans. d]

29.What is the name of the artery that transverse the dorsum of the foot toward the base of the first toe?a) The distal popliteal arteryb) The anterior tibial arteryc) The common femoral artery

d) The common iliac artery

[Ans. b]

30.The tibioperoneal trunk is the second branch of the distal popliteal artery. It-a) Passes superficial to the interosseous membraneb) Becomes the dorsalis pedis arteryc) Penetrates in to the sole of footd) Quickly gives rise to the posterior tibial and peroneal arteries

[Ans. d ]

31.To supply the sole of foot the posterior tibial artery below the medial malleous divides into-a) Anterior and posterior tibial arteries b) Internal and external tibial arteriesc) Medial and lateral tibial arteriesd) Internal and lateral tibial arteries

[Ans. c]

32.The peroneal artery at the distal end of the tibioperonal trunk, arises supply structures in the calcaneal region of the foot and-a) Lateral side of the legb) Medial side of the legc) Anterior side of the legd) Posterior side of the leg

[Ans. a]

33.The planter arch consists of the deep planter artery and lateral planter artery and-a) The medial planter arteryb) The peroneal arteryc) The dorsal metatarsal arteriesd) The digital arteries

[Ans. c]

34.All of the following information is correct for capillaries. Which of the information is not correct?a) They are more than a micrometer longb) They are vessels of the microcirculationc) Flow quality is steady

d) They are 8-10 microns in diameter

[Ans. a]

35.What are considered to be resistance vessels help to regulate blood flow by contracting and releasing?a) Capillariesb) Capillary bedsc) Arteriolesd) Aorta

[Ans. c]

36.The tunica intima consists of a surface layer of smooth endothelium over a base membrane and connective tissue, is the-a) Outermost layer of the arterial wallb) Innermost layer of the arterial wallc) Intermediate layer of the arterial walld) Intermediate layer of the capillary beds

[Ans. b]

37.The tunica media is composed of smooth muscle and connective tissue and these components usually arranged in aa) Triangular patternb) Square patternc) Rectangular patternd) Circular pattern

[Ans. d]

38.Which layer usually consists the vasa vasorum, tiny vessels that carry blood to the walls of the larger arteries?a) The tunica externab) The tunica mediac) The tunica intimad) the capillary beds

[Ans. a]

Ch-2

1. With every beat of heart, each one of the arterial tree oscillates what amount oof blood in aorta?a. 50 mlb. 60 mlc. 70 mld. 80mlans-c

2. In case of stroke volume, at the begining of cardiac contraction, the pressure in the left ventricles rises rapidly, quickly exceeding that in the aorta so that the aortic valve opens,a. blood is entered, blood pressure risesb. blood is ejected, blood pressure lowersc. blood is ejected, blood pressure risesd. blood is entered, blood pressure lowersans-c

3. The arterial system is-a. a singlebranched elastic conduit that carries blood away from the heart and outward to the most distant tissuesb. a multibranched elastic conduit that carries blood to the heart and outward to the most distant tissuesc. a singlebranched elastic conduit that carries blood to the heart and outward to the most distant tissuesd. a multibranched elastic conduit that carries blood away from the heart and outward to the most distant tissuesans-d

4. As the arterial pressure wave moves distally-away from the heart and out toward the periphery, the propagation speed-the pulse wave velocity increases with growing stiffnessof the arterial walls.What factors of the pressure wave change as the wave move through the arterial system?a. the propagation speed and strengthb. the propagation shape and strengthc. the propagation speed, shape and strengthd. the propagation speed and shapeans-c

5. What delivers an increased blood volume that supplies more nutrients?a. increased heart rateb. decreased heart ratec. normal heart rated. normal and incresed heart rateans-a

6. When the pressure waves move from the larger arteries through the high resistant vessels,capilliaries and then into the venous side, how does the mean pressure reacts?a. the mean pressure gradually increasesb. the mean pressure gradually declinesc. the mean pressure remains normald. the mean pressure increases fastans-b

7. What do the arterial pressure and total peripheral resistance do?a. determine the volume of plasma that enters it

b. determine the volume of blood that enters itc. determine the volume of plasma that leaves itd. determine the volume of blood that leaves itans-d

8. Where is the greatest blood pressure?a. at the leverb. at the kidneyc. at the stomachd. at the heartans-d

9. What does the requirement(s) of any fluid medium between any two points?a. a route along with the fluid can flowb. a difference in energy levels between the two pointsc. a route along with the fluid can flow and a difference in energy levels between the two pointsd. a difference in pressure levels between the two pointsans-c

10. Which one is the correct relationship?a. lower resistance=lower flow rateb. higher resistance= lower flow ratec. higher flow rate=higher resistanced. higher resistance=lower resistanceans-b

11. What is the main form of energy present in flowing blood?a. kinetic energyb. gravitational energyc. pressure energyd. chemical energyans-c

12. Potential energy has several components. The dominant source is the pumping action of the heart muscle. The other one isa. peer pressureb. blood pressurec. parental pressured. hydrostatic pressureans-d

13. Kinetic energy is the ability of flowing blood to do work as a result of its velocity. It isa. proportional to the density of bloodb. not completely compared to the pressure energyc. proportional to the density of blood and proportional to the square of the velocityd. proportional to the square of the velocityans-c

14. How is the gravitional energy expressed?a. millimiteres of hydrogenb. millimiteres of mercuryc. millimiteres of oxygend. millimiteres of carbon dioxideans-b

15. What introduce the gravitional energy of the fluid column?a. changes in the widthb. changes in the height

c. changes in the squared. changes in the densityans-b

16. Gravitional energy is also known as hydrostatic pressure. In the ciculatory system,hydrostatic pressure is equivalent toa. weight of the column of blood extending from heartb. height of the column of blood extending from heartc. density of the column of blood extending from heartd. square of the column of blood extending from heartans-a

17. For example, in a supine, medium sized patient in whom the arteries and veins are approximately the same levelas the heart. What is the difference in hydrostatc pressure effect on the arteries and veins?a. vastb. much more c. lessd. negligibleans-d

18. An energy gradient is necessary for blood to move from one point to another. When will the movement occur?a. low pressure state to low pressure stateb. high pressure state to high pressure statec. low pressure state to high pressure stated. high pressure state to low pressure stateans-d

19. At the time of the acceleration phase of pulse, how is the pressure?a. evenly accumulatedb. oddly distributedc. evenly distributedd. oddly accumulatedans-c

20. What happens at the deceleration phase of the pulse (early systole to peak systole)?a. cardiac output increases to the point at which outflow through the high resistance peripheral vessels exceeds the volume ejected from heartb. cardiac output decreases to the point at which outflow through the low resistance peripheral vessels exceeds the volume ejected from heartc. cardiac output increases to the point at which outflowt hrough the low resistance peripheral vessels exceeds the volume ejected from heartd. cardiac output decreases to the point at which outflowt hrough the high resistance peripheral vessels exceeds the volume ejected from heartans-d

21. Laminar flow is the type of flow thought to exist in many vessels. In this case, each very thin layer flows at a velolocity of,a. fastest at the vessel wall and slowest at the center of the vesselb. both fast at the vessel wall and at the center of the vesselc. both slow at the center of the vessel and at the vessel walld. fastest at the center of the velssel and slowest at the vessel wallans-d

22. In case if Laminar flow, what happens to the friction and energy losses?a. decrease to the extent that laminar flow is distributedb. remain the same to the extent that laminar flow is distributed

c. increase to the extent that laminar flow is distributedd. laminar flow has no relation with friction and energy lossans-c

23. There are two forms of laminar flow. Parabolic flow and Plug flow.How is the velocity in Parabolic flow?a. gradually decreasing at the center of lumenb. same at the center of lumen and vessel wallc. gradually increasing at the vessel walld. highest at the center of the lumenans-d

24. The movement of blood through artery depends ona. the physical properties of the fluidb. the interaction between the conduit and fluidc. both the physical properties of the fluid and the interaction between the conduit and fluidd. neither the physical properties of the fluid nor the interaction between the conduit and fluidans-c

25. What is the relationship between the conduit, fluid and pressurea. the longer the conduit the shorter the fluid is in contract and higher pressure requiredb. the longer the conduit the longer the fluid is in contract and higher pressure requiredc. the longer the conduit the longer the fluid is in contract and lower pressure requiredd. the longer the conduit the shorter the fluid is in contract and lower pressure requiredans-b

26. Viscosity can be described as a chracter of fluid. The true relationship between the viscosity and velocity isa. increased viscosity=increased velocityb. decreased viscosity=decreased velocityc. increased viscosity=no change in velocityd. decreased viscosity=increased velocityans-d

27. In the circulation system, energy is lost in the form of heat as the layers of the red blood cells rub against each other, creating friction. Friction is generated-a. by the viscous properties of the fluidb. automaticallyc. by the force of bloodd. by the solids on the fluidans-a

28. Energy loss during blood flow occurs because of friction. In part, what determine the amount of friction and energy loss?a. the height of the vesselsb. the width of the vesselsc. the length of the vesselsd. the dimensions of the vesselsans-d

29. In the micro circulation, the blood flow layers are relatively close to the vessel walls resulting in a -a. blockage to the flowb. assistance to the flowc. resistance to the flow

d. smoothness to the flowans-c

30. Due to the high viscosity in the circulatory system, what can be seen?a. high hematocritb. more red blood cellsc. more volume of plasmad. lower anemiaans-b

31. In the following equation, which symbol reflects the right abbreviation?R-8ηL/πr4 a. r=the overall flow resistanceb. L=vessel widthc. η=the viscosity of the fluidd. R=the radius of the vessel lumenans-c

32. Energy loss in a fluid system can also be inertial in nature.Inertial losses are caused by-a. changes in derection and velocity and increase with deviations in laminar flowb. changes in derection and/or velocity and increase with deviations in laminar flowc. changes in derection or velocity and increase with deviations in laminar flowd. changes in derection and/or velocity and decrease with deviations in laminar flowans-b

33. Whose law defines the relationship between pressure, volume flow and resistance and helps to answer the question of how much fluid is moving through a vessel?a. Priestleyb. Priestlyc. Prusinerd. Poiseuilleans-d

34. Which characteristics of a vessel affects resistance more dramatically than either viscosity or vessel length?a. lengthb. widthc. heightd. diameterans-d

35. which one is directly proportional to the to the volume flow and small changes may cause large change to the flow?a. lengthb. heightc. radiusd. widthans-c

36. According to the basic laws of fluid dynamics most notably law of conservation of mass, the relationship among velocity, volume flow and cross sectional area of the vessel is-a. V=A/Qb. A=Q/vc. Q=V/Ad. V=QAans-b

37. In the cardiovascular system, why the changes in blood flow occurs?a. because of red blood cells

b. because of the changes in the radius of a vesselc. because of the changes in the radius of a vessel and the pressure energy gradientd. because of the pressure energy gradientans-c

38. What is the Poiseuille’s equation exactly?a. Q=[(P1-P2) 8ηL]/ πr4

b. Q=[(P2-P1)πr4]/8ηLc. Q=[(P1-P2) ηr4]/8πLd. Q=[(P1-P2)πr4]/8ηLans-d

39. What is the abbreviated pressure-volume flow relationship?a. Q=R/Pb. Q=P/Rc. P=Q/Rd. Q=PRans-b

40. What is the Ohm’s law related to the flow of electricity?a. I=R/Eb. I=ERc. E=I/Rd. I=V/Rans-d

41. After the initial acceleration in systole, blood movement continues and develops into distinct streamline formations. What happens when the flow pattern becomes unstable?a. streamline accumulates and form big circular currentsb. streamlines accumulatec. streamlines break up and form small circular currentsd. streamlines form big circular currentsans-c

42. Who sought to determine how visvcosity, vessel radius and the pressure/volume relationship influence the stability of flow through a vessela. Osborne Reynoldsb. Hugh Watkinsc. David Alterd. Martin Appleans-a

43. The elements that affect the development of turbulentflow are expressed by a dimensionless number. The number is called=a. Watkins numberb. Alter’s numberc. Martin’s numberd. Reynold’s numberans-d

44. The factors that affect the development of turbulance are expressed by Reynold’s number. What is the equation?a. Re-(Vq2η)/rb. Re-(V η2r)/qc. Re-(Vq2r)/ ηd. Re- η/(Vq2r)ans-c

45. Because the density and viscosity of the blood are fairly constant, the development of turbulence depends mainly on the size of the vessels and the velocity of flow. When the laminar flow tends to become distributed?a. When the Reynold’s number exceeds 500b. When the Reynold’s number exceeds 1000c. When the Reynold’s number exceeds 2000d. When the Reynold’s number exceeds 3000ans-c

46. Turbulent flow may cause vessel walls to vibrate, the harmonics of this vibration produce-a. vascular bleedingb. Aneurismal bruitsc. arterial bruitsd. vascular bruitsans-d

47. In case of pressure /velocity relationship, if gravitional energy remains constant, but kinetic energy increases, then what will happen to the potential energy?a. potential energy may decreaseb. potential energy must decreasec. potential energy must increased. potential energy will have no effectans-b

48. Whose equation shows that the velocity and pressure are inversely related like where there is high velocity, there is low pressure, where there is low velocity, there is high pressure?a. Reynold’s equationb. Boussineq’s equationc. Bernouli equationd. Navier-Stokes equationans-c

49. In the region proximal to the stenosis, how is the pressure energy and kinetic energy?a. the pressure energy is higher and the kinetic energy is lowerb. the pressure energy is lower and the kinetic energy is higherc. both the pressure energy and the kinetic energy are higherd. both the pressure energy and the kinetic energy are lowerans-a

50. Distal to the stenosis(poststenosis), the kinetic energy decreases and the pressure energy increases. At this point, the total energy sum is-a. highestb. lowestc. normald. fluctuatedans-b

51. Pressure gradients varies between two points in a vessel. Flow separation within a vessel may be caused by-a. changes in the geometry of the flowb. changes in the direction of the flowc. changes in the geometry of the vesseld. changes in the density of red blood cellsans-c

52. What kind of regions are left behind at the time of flow separation?a. regions of red blood cellb. regions of velocityc. regions of pressured. regions of stagnantans-d

53. In case of systole, because flow moves from higher to lower pressure, the direction of flow in the refgion of flow separation changes with respect to the transducer and causes-a. no color changeb. non visible color changec. visible color changed. the color into redans-c

54. In case of diastole, when the flow at the vessel wall is stagnant, there is no movement of blood and causesa. visible color changeb. non visible color changec. the color into redd. no color changeans-d

55. Steady flow is the result of a steady driving pressure. If there is no decreases in the pressure downstram then what will ahappen?a. there will be more flow away from the driving pressureb. there will be no flow away from the driving pressurec. the flow will remain the same as befored. the flow will increase suddenlyans-b

56. Where there is steady flow in a rigid tube, energy losses are mainly viscous. Which equation can describe this?a. Reynold’’s equationb. Boussineq’s equationc. Bernouli’s equationd. Poiseuille’s equation ans-d

57. What flow reflect changes in both the driving pressure conditions and the response of the vascular system?a. Pulsatileb. Steadyc. Diastolicd. Reverseans-a

58. During the systole, which flow remains throughout the periphery?a. backwardb. forwardc. no flowd. normal flowans-b

59. At the end of the systole, the aortic valve closes and what happens next?a. minimum ventricular contraction is obtainedb. maximum ventricular contraction is fofeitedc. maximum ventricular contraction is forfeited

d. maximum ventricular contraction is obtained ans-d

60. In which stage, the flow moves forward again as the reflective wave hits the proximal resistance of the next wave and reverses direction again?a. diastoleb. early diastolec. systoled. early systoleans-b

61. How does the vessels recoil, convert potential energy into kinetic energy and maintain flow more distally?a. as the pressure wave moves slowlyb. as the pressure wave moves very quicklyc. as the pressure wave moves quicklyd. as the pressure wave moves forwardans-c

62. If you drop a golf ball and there is no floor, it keeps moving downward and if you drop a golf ball onto a cement floor, it reverses direction. Whicj of the following statement goes with this example?a. flow always moves along the path of least assistanceb. flow always moves along the path of most resistancec. flow always moves along the path of resistanced. flow always moves along the path of least resistanceans-d

63. Diastolic flow reversal is a hallmark of vessels that supply-a. low resistance peripheral vascular bedsb. high resistance vascular bedsc. high resistance peripheral vascular bedsd. high resistance peripheral bedsans-c

64. Vasodilation is produced by body heating, exercise and stenosis.When vasodilation occurs, what happens to the flow reversal?a. increasesb. is presentc. decreases or is absentd. is always absentans-c

65. The flow of a continuous nature throughout systole and diastole feeding a dilatedvascular bed is known as-a. low-resistance flowb. high-resistance flowc. high-assistance flowd. low-assistance flowans-a

66. The internal carotid, vertebral, renal, celiac, splenic and hepatic arteries are characterized by-a. low-resistance flowb. high-resistance flowc. high-assistance flowd. low-assistance flowans-a

67. The external carotid, subclavian, aorta, iliac, externity arteries and fasting superior mesenteric arteries are characterized by-a. low-resistance flowb. high-resistance flowc. high-assistance flowd. low-assistance flowans-b

68. What are the reasons for the characteristic reversal of flow in a biphasic or triphasic high resistance disappears distal to a stenosis?a. decreased peripheral assistance as a result of relative ischemiab. increased peripheral resistance as a result of relative ischemiac. decreased peripheral resistance as a result of relative ischemiad. increased peripheral assistance as a result of relative ischemiaans-c

69. How is the pulsatility flow in response to vosoconstriction ?a. in medium and small size arteries of the limbs increasesb. in minute arteries, arterioles and capillaries increasesc. in medium, minute arteries and arterioles increasesd. in small, medium and minute arteries increasesans-a

70. How is the pulsatility flow in response to vosodilation ?a. in medium and small size arteries of the limbs decreasesb. in minute arteries, arterioles and capillaries decreasesc. in medium, minute arteries and arterioles decreasesd. in small, medium and minute arteries decreasesans-a

71. Compensatory responses of the microcirculation tend to maintain pressure and flow. When it is important to obtain information about pressure and flow patterns?a. at restb. after the exercisec. at rest but not after exercised. both at rest and after exerciseans-d

72. In an extremity at rest and in the presence of severestenosis or complete occlusion of the main artery, how is the blood flow?a. partial blood flow may be fairly normalb. partial blood flow may be abnormalc. total blood flow may be fairly normald. total blood flow may be abnormalans-c

73. What can an arterial obstruction do?a. decrease the volume flowb. forward the flow directionc. decrease velocityd. alter flow in nearbyans-d

74. Exercise should induce peripheral vasodilation in the microcirculation. As a result we can get-a. both distal peripheral resistance and blood flow markedly increasesb. distal peripheral resistance decreases and blood flow markedly increasesc. distal peripheral resistance increases and blood flow markedly decreases

d. nearby peripheral resistance decreases and blood flow markedly increasesans-b

75. Vasoconstriction and vasodilation of the blood vessels within skeletal muscles are also influenced by sympathetic innervation fibers. The job is-a. to regulate body controlb. to regulate body resistancec. to regulate body temperatured. to maintain antibodyans-c

76. Autoregulation controls vasoconstriction and vasodilation which is accounted for the ability of most vascular beds-a. to maintain an increased level of blood flowb. to maintain a decreased level of blood flowc. to maintain a constant level of blood flowd. to maintain an increased level of plasma flowans-c

77. A low resistance, monophasic Doppler flow signal may be present normally in an extremity artery after vigorous exercise because the exercise causes peripheral dilatation and reduced flow resistance. What decision can we adopt from this example?a. By increasing resistance in the working muscle, exercise normally decreases reflection of the Doppler flow signal in the exercising externityb. By decreasing resistance in the working muscle, exercise normally increases reflection of the Doppler flow signal in the exercising externityc. By decreasing resistance in the working muscle, exercise normally decreases reflection of the Doppler flow signal in the exercising externityd. By decreasing resistance in the working muscle, exercise normally shows constant reflection of the Doppler flow signal in the exercising externityans-c

78. When a high resistance signal may occur?a. at increased vasoconstriction at the arteriolar levelb. at normal vasoconstriction at the arteriolar level or from distal arterial obstructionc. at decreased vasoconstriction at the arteriolar leveld. at normal vasoconstriction at the arteriolar level or from nearby arterial obstruction ans-b

79. What does the proper characterization of velocity waveforms require?a. an understanding of the normal flow characteristics of a particular arteryb. an understanding of the psychologic status of the circulationc. an understanding of the normal flow characteristics of a particular artery but not the psychologic status of the circulation supplied by vesseld. an understanding of both the normal flow characteristics of a particular artery and the psychologic status of the circulation supplied by vesselans-d

80. How one can examine the externity cooled or warmed?a. Flow to a cool, vasodilated externity will have pulsatile signalsb. Flow to a cool, vasoconstricted externity will have pulsatile signalsc. Flow to a warm, vasodilated externity will have pulsatile signalsd. Flow to a warm, vasoconstricted externity will have steady signalsans-b

81. If good collateralization is present, proximal or distal Doppler velocity waveform qualities-a. may be alteredb. may not be altered

c. must be alteredd. must not be alteredans-b

82. How is the distribution of frequencies of Laminar flow?a. even distribution of frequencies at diastoleb. odd distribution of frequencies at systolec. even distribution of frequencies at systoled. odd distribution of frequencies at diastoleans-c

83. A critical, hemodynamically significant stenosis causes a major reduction in volume flow and pressure. What is the percentage of cross-sectional area of the arterial lumen reduction and a diameter reduction?a. 75% and 50% respectivelyb. 50% and 75% respectivelyc. 75% and 25% respectivelyd. 25% and 75% respectivelyans-a

84. Diameter reduction is a-a. one-dimensional measurementb. two-dimensional measurementc. three-dimensional measurementd. four-dimensional measurementans-a

85. Area reduction is a-a. one-dimensional measurementb. two-dimensional measurementc. three-dimensional measurementd. four-dimensional measurementans-a

86. What happens in the critical stenosis?a. only pressure decreaseb. only flow volume increasec. only pressure increased. both pressure and flow volume decreaseans-d

87. The occurrence and degree of hemodynamic abnormality produced by a stenosis depend on many factors. One of thm is-a. smoothness of surfaceb. depth of narrowingc. arteriovenous pressure gradientd. arterial resistance nearby to the stenosisans-c

88. Critical arterial stenosis produces certain identifiable hemodynamic phenomena that are described in the literature as -a. arterial profileb. stenosis profilec. collateral profiled. peripheral profileans-b

89. The flow enters, passes through and/or exists the stenosis. As a result there is a/ana. decrease in Doppler shift frequencies but increase in velocities

b. increase in Doppler shift frequencies but increase in velocitiesc. increase in Doppler shift frequencies and in velocitiesd. decrease in Doppler shift frequencies and in velocitiesans-c

90. When the poststenotic arterial lumen widens rather quickly, large flow separation patterns are observed at the walls as a result of velocity gradients. Who described this?a. Reynold’b. Boussineq’c. Bernoullid. Navierans-c

91. Why the energy is expected largely in the form of heata. eddy currents work for and vortices work against the viscosity of bloodb. vortices work for and eddy currents work against the viscosity of bloodc. eddy currents and vortices work for the viscosity of bloodd. eddy currents and vortices work against the viscosity of bloodans-d

92. Reduction in the diameter of a vessel increase the velocity of flow. The size of the vessel is inversely proportional to the velocity of blood flow. So we can form the equation like-a. V=A/Qb. A=Q/Vc. Q=V/Ad. V=QAans-b

Chap 3

1. Due to what disease the patient notes muscle fatigue with work and the discomfort is usually predictable ,occurring with the same amount of work and disappearing within minutes of activities cessation-a) Chronic occlusiveb) Claudicationc) Acute arterial occlusiond) Ischemic rest pain

[Ans. b]

2. If the patient complains of pain in a specific part of the leg after walking two city blocks. What note may include in the history of the patient?a) Block claudicationb) Thigh claudicationc) Calf claudicationd) 2 block claudication

[Ans. d]

3. Buttock claudication, which strongly suggests artoiliac disease. What can be suggested if the symptoms are unilateral?a) Distal iliac diseaseb) Common femoral diseasec) Iliofemoral diseased) Popliteal disease

[Ans. c]

4. If a patient feels pain at rest when the limb is not in a dependent position and the patient blood pressure is decreased, which one of the following is responsible for this situation?a) Buttock claudicationb) Ischemic rest painc) Acute arterial occlusiond) Block claudication

[Ans. b]

5. Necrosis (tissue death), usually due to a deficient or absent blood supply. Necrosis is the most severe symptom of –a) Arterial insufficiencyb) Acute arterial occlusion

c) Ischemic rest paind) Tissue loss

[Ans. a]

6. Symptoms include the five Ps: pain, pallor, pulselessness, paresthesia, paralysis. Some include a sixth “P” for “polar”. Some even include a seventh “P” for “purplish”. Which one is represented by seventh “P”?a) Arterial insufficiencyb) Ischemic rest painc) Acute arterial occlusiond) Block claudication

[Ans. c]

7. What may result from thrombus, embolism or trauma & is an emergency situation since the abrupt onset does not provide for the development of collateral channels?a) Arterial insufficiencyb) Ischemic rest painc) Acute arterial occlusiond) Block claudication

[Ans. c]

8. For cold sensitivity symptoms include changes in skin color such as pallor (paleness), cyanosis (bluish discoloration) or rubor (dark red coloration) and the patient often experiences-a) Paresthesia and painb) Paralysis and painc) Paresthesia and paralysisd) Paralysis and pulselessness

[Ans. a]

9. In what condition symptoms of intermittent ischemia of the fingers or toes occur in response to cold exposure?a) Mesenteric ischemiab) Renovascular hypertensionc) Arterial insufficiencyd) Raynaud’s phenomenon

[Ans. d]

10.Raynaud’s phenomenon is a condition that exists when symptoms of intermittent ischemia of the fingers or toes occur in response to cold exposure as well as-a) Physical stressb) emotional stressc) Physical paind) Physical & mental stress

[Ans. b]

11.What is more common form among diabetics and normally occurs at a younger age in human?a) Diabetics mellitusb) Medial calcificationc) Atherosclerosisd) Diabetes

[Ans. c]

12.What is the disease of the distal popliteal artery and tibial vessels that diabetics have a higher incidence?a) Occlusiveb) Occlusionc) Claudicationd) Arterial insufficiency

[Ans. a]

13.There is a higher incidence of gangrenous changes and ultimately, amputations, poor sensation as a result of neuropathy leads to increases likelihood of-a) Hypertensionb) Emotional stressc) Physical stressd) Trauma

[Ans. d) trauma]

14. It remains unclear whether high blood pressure is a causative factor or enhances and complicates the development of the atherosclerotic process in case of-a) Traumab) Hypertensionc) Arterial insufficiencyd) Occlusion

[Ans. b) Hypertension]

15.What is associated with a greater incidence of coronary atherosclerosis and also increases an individual’s susceptibility to peripheral and cerebrovascular involvement?a) Traumab) Renovascular Hypertensionc) Systemic Hypertensiond) Hyperlipidemia

[Ans. c) systemic Hypertension]

16.Although increased lipids may result from metabolic problems associated with heredity, a diet high in certain types of fat is associated with hyperlipidemia. As they are insoluble in water, elevated plasma lipids are closely associated with the development of-a) Occlusionb) Atherosclerosisc) Medial calcificationd) Mesenteric ischemia

[Ans. b]

17.Studies have demonstrated that the chemicals in cigarettes irritate the endothelial lining of the arteries in addition to causing-a) Vasoconstrictionb) Atherosclerosisc) Medial calcificationd) Hyperlipidemia

[Ans. a]

18.The term “atherosclerosis” is applied to a number of pathological conditions in which there is thickening, hardening and loss of elasticity of the -a) Media layers of vesselb) Intimac) Visceral vesseld) Walls of the arteries

[Ans. d]

19.There are so many risk factors that cause atherosclerosis such as hypertension, hyperlipidemia, family history, diabetes mellitus, sedentary lifestyle and smoking. What are the major factors among them?a) Hypertension, hyperlipidemia, family history

b) Smoking, hyperlipidemia, family historyc) hyperlipidemia, family history, diabetes mellitusd) smoking, diabetes mellitus, sedentary lifestyle

[Ans. b]

20.Atherosclerosis most often occurs at the carotid bifurcation, origins of brachiocephalic vessel, origins of the visceral vessels, the infrarenal aortoiliac system, superficial femoral artery at the abductor canal, the popliteal trifurcation and-a) The subclavian arteryb) The common femoral arteryc) The common femoral bifurcationd) The common femoral trifurcation

[Ans. c]

21.Leriche syndrome, caused by obstruction of the terminal aorta. It usually occurs in males and is characterized by fatigue in the hips, thighs or claves on exercising, often coldness of the lower limbs and absence of pulsation. Where does the absence of pulsation occur?a) Femoral arteriesb) subclavian arteriesc) Popliteal arteriesd) brachial arteries

[Ans. a]

22.Obstruction of a blood vessel by a foreign substances or blood clot, may be solid, liquid or gaseous and may arise from body or may enter from without is called –a) Aneurysmb) Embolic) Pseudo aneurysmd) Atherosclerosis

[Ans. b]

23.Emboli move distally and become stuck in the vessels of the smallest caliber. Toe ischemia results, which often improves mainly as the result of blood flow from smaller –a) Digital arteriesb) Femoral arteriesc) brachial arteries

d) Collateral arterial branches

[Ans. d]

24.A true aneurysm is different from false aneurysm which does not contain all arterial wall layers. What is a true aneurysm?a) a dilatation of all Four layers of the arterial wallb) a dilatation of all Five layers of the arterial wallc) a dilatation of all Three layers of the arterial walld) a dilatation of all Two layers of the arterial wall

[Ans. c]

25.Arterial aneurysms can occur in nearly any artery of the body. What is the most common location for arterial aneurysms?a) Infrarenal aortab) aortic archc) carotid arteryd) Thoracic aorta

[Ans. a]

26.Patients with one aneurysm have a higher chance of having second aneurysm. Which of the following is not included as other location for second aneurysm?a) Carotid arteryb) Renal arteryc) Subclavian arteryd) Splenic arteries

[Ans. c]

27.The cause of aneurysm is unknown but may include poor arterial nutrition, congential defects, infection or trauma, iatrogenic injury and –a) Occlusiveb) atherosclerosisc) Medial calcificationd) Hypertension

[Ans. b]

28.Some terms that relate to aneurysm shape include focal aneurysm, fusiform aneurysm, saccular aneurysm and concentric aneurysm. What is a Fusiform aneurysm?a) Localized out-pouching of an artery

b) Localized out-pouching of a vesselc) Diffuse, circumferential dilatation of an arteryd) Diffuse, circumferential dilatation of an arterial segment

[Ans. d]

29.Any aneurismal formation has the propensity to form thrombotic material at the walls. The main complications of aneurysm include distal embolization of peripheral aneurysm and –a) Rupture of aortic aneurysmb) circumferential dilatation of an arterial segmentc) Localized out-pouching of an arteryd) Embolization of pseudo aneurysm

[Ans. a]

30.Some terms that relate to aneurysm shape include focal aneurysm, fusiform aneurysm, saccular aneurysm and concentric aneurysm. What is a Saccular aneurysm?a) Localized out-pouching of a vesselb) Diffuse, circumferential dilatation of an arterial segmentc) Localized out-pouching of an arteryd) Rupture of aortic aneurysm

[Ans. c]

31.What occurs when a small tear of the intima allows blood to form a cavity between two wall layers and a new lumen, the false lumen is formed?a) Pseudo aneurysmb) Dissecting aneurysmc) Aortic aneurysmd) Peripheral aneurysm

[Ans. b]

32.Two conditions must usually be met for dissecting aneurysm to form. Among the two the second condition is: development of an intimal tear through which blood leaks to media and first one is – a) Strengthening of the media of the vesselb) Thickening of the media of the vesselc) Weakening of the media of the vesseld) Scratching of the media of the vessel

[Ans. c]

33. In case of a dissecting aneurysm atherosclerosis is not generally considered to be a causative factor. Where does a dissection most often occur?a) Thoracic aortab) Infrarenal aortac) Subclavian arteryd) Thoracic artery

[Ans. a]

34.A pseudo aneurysm is essentially a pulsating hematoma. A hole in the arterial wall permits blood to escape under pressure, in to a contained area in the –a) Media of the vesselb) Adjacent tissuec) Artery walld) Thoracic aorta

[Ans. b]

35.A hematoma forms in the tissue and if confined by the surrounding structures and if there is continuous blood flowing from the artery to the –a) Pulsatile structure in the tissueb) Adjacent tissuec) Media of the vesseld) Nonthrombotic region of the hematoma

[Ans. d]

36.A pseudo aneurysm is essentially a pulsating hematoma. To be considered a pseudo aneurysm, there must be a communication (channel) from the main artery to the –a) Nonthrombotic region of the hematomab) Media of the vesselc) Pulsatile structure in the tissued) Adjacent tissue

[Ans. c]

37.Arteritis – inflammation of the arterial wall – often results in thrombosis of the vessel and can affect tibial and peroneal arteries as well as the smaller and more distal arterioles and –a) Media of the vesselb) Thoracic aortac) Nutrient vessel

d) Nonthrombotic region of the hematoma

[Ans. c]

38.Arteritis – inflammation of the arterial wall – often results in thrombosis of the vessel and can affect tibial and peroneal arteries. There are several types of arteritis. Which of the following is not one of them?a) Takayasu’s diseaseb) Occlusive diseasec) Polyarteritis diseased) Buergr’s disease

[Ans. b]

39.Arteritis – inflammation of the arterial wall. There are several types of arteritis. What is the most common form of arteritis among them?a) Thromboangiitis obliteransb) Polyarteritis diseasec) Takayasu’s diseased) Occlusive disease

[Ans. a]

40.Arteritis – inflammation of the arterial wall – often results in thrombosis of the vessel and can affect tibial and peroneal arteries. They have some characteristics. Which of the following is not one of the characteristics?a. Associated with heavy cigarette smokingb. Patients present with occlusions of the distal arteriesc. Superficial thrombophlebitis is a primary resultd. Most often associated with collagen vascular syndromesans- ce) Arteritis – inflammation of the arterial wall – often results in thrombosis of the

vessel. At early stage of the disease may occur rest pain and -a. Atherosclerotic Occlusiveb. Ischemic ulcerationc. Superficial thrombophlebitisd. gangreneans- b

41.Arteritis is associated with heavy cigarette smoking and occurs primarily in men younger than 40 years of age. Patients present with occlusions of the-a. Digital arteriesb. Carotid arteriesc. Femoral arteries

d. Distal arteriesans- d

42.One of the several congenital anomalies of the arterial system, coarctation of the aorta is congenital narrowing or structure of the thoracic aorta, what may as well affect by this?a. Infrarenal aortab. distal arteriesc. abdominal aortad. digital arteriesans- c

43.One of the several congenital anomalies of the arterial system, coarctation of the aorta is congenital narrowing or structure of the thoracic aorta. Clinical findings may include hypertension due to decreased kidney perfusion or manifestations of lower extremity ischemia. Which is not the example of these criteria?a. paralysis and traumab. decreased pulsesc. decreased segmental Doppler pressuresd. decreased pulses and decreased segmental Doppler pressuresans- a

44. In dissection the media is weakened, the intima develops a tear through which blood leaks in to the -a. true lumenb. arterial lumenc. false lumend. main lumenans- c

45. In dissection the media is weakened, the intima develops a tear through which blood leaks in to the false lumen that has developed between the intima and media. Flow velocities differ in each lumen. Dissection can affect the aorta and -a. distal arteriesb. peripheral arteriesc. digital arteriesd. Carotid arteriesans- b

46.What is divided in to two compartments by a thin membrane that plays the distinguishing feature of ultrasonographic? a. true lumenb. false lumenc. main lumend. arterial lumenans- d

47.Dissection can affect the aorta. Aortic dissections. Which can also extend to the iliac arteries, may occur as a consequences of hypertension or –a. severe chest traumab. emotional stressc. physical stressd. hyperlipidemia ans- a

48.The complication is when the dissection enlarges, there is a risk of significant stenosis and/or occlusion of the -a. brachial arteriesb. digital arteriesc. main arteryd. carotid arteryans- c

49.Which one has the symptoms that include changes in skin color such as pallor (paleness), cyanosis (bluish discoloration), or rubor (dark red coloration) and the patient often suffers from paresthesia and pain?a. spastic Raynaud’s syndromeb. vasopastic disorders c. obstructive Raynaud’s syndromed. ischemic ulcerationans- b

50.Raynaud’s phenomenon is a condition that exits when in response to cold as well as emotional stress fingers and toes shows symptom of -a. spastic Raynaud’s syndromeb. intermittent ischemiac. vasopastic disordersd. ischemic ulcerationans- b

51.Primary Raynaud’s disease may be heredity and very common in young women. Which is not the alternative name of Primary Raynaud’s phenomenon?a. idiopathic Raynaud’s phenomenonb. spastic Raynaud’s syndromec. intermittent ischemiad. obstructive Raynaud’s syndromeans- d

52.Secondary Raynaud’s, also known as secondary Raynaud’s phenomenon. What may be the first manifestation of Secondary Raynaud’s? a. intermittent ischemia, anatomic abnormalityb. anatomic abnormality, vasospastic disorderc. collagen disease, buerger’s disease, anatomic abnormality

d. collagen disease, intermittent ischemia, anatomic abnormalityans- c

53.Entrapment of the popliteal artery is the most written about entrapment syndrome. It is thought to be caused by compression of the popliteal artery by the medial head of the -a. gastrocnemius muscleb. fibrous musclec. gastrocnemius muscle and fibrous bandsd. gastrocnemius muscle or fibrous muscleans- a

54.Pallor means paleness. Pallor term is used when skin becomes pale. Which of the following is mainly the result of-Pallor or paleness of skin? a. reactive hyperemiab. deoxygenated hemoglobinc. arterial obstructiond. deficient blood supplyans- d

55.Rubor suggests damaged, dilated vessels or vessels dilated as a result of reactive hyperemia or infection. What is the meaning of rubor?a. palenessb. a dark reddish discolorationc. bluish discolorationd. purple patchesans- b

56.Cyanosis, a bluish discoloration of the skin and mucous membranes. What does the Cyanosis generally occur?a. concentration of deoxygenated hemoglobinb. deficient blood supplyc. reactive hyperemia or infectiond. dilated capillary and venue fillingans- a

57.When there are purple patches (similar to bruising) on the skin of the dorsum of the foot, usually the result of dilated capillary and venue filling is calleda. pallorb. cyanosisc. livedo reticularisd. ruborans- c

58. It is essential to touch patient’s skin and feel the patient’s skin to determine the temperature of the skin. The patient’s skin should be -a. normal

b. warmc. coldd. warm or coldans- b

59.What are the results of arterial insufficiency those are usually deep and regular in shape, often located over the tibial area?a. ulcerationsb. lesionsc. cyanosisd. venous ulcerationsans- a

60. It is important to elicit from the patient the length of time the ulceration has been present and also to examine and record observations of the -a. foot and fingersb. fingers and toesc. foot and toesd. foot and handans- c

61.Gangrene is usually caused by deficient or absent of blood supply. What is the Gangrene?a. arterial insufficiencyb. reactive hyperemia or infectionc. deficient blood supplyd. death of tissueans- d

62.Loss of hair on the extremity may reflect a poor nutritional state caused by decreased circulation, although hair loss alone is poor indication of –a. peripheral occlusive diseaseb. peripheral vascular occlusive diseasec. vascular occlusive disease d. popliteal occlusive disease ans- b

63.The healthy flesh color branches in appearance as superficial vessels are constructed by manual pressure, normal skin color should return immediately upon the release of the pressure. When does Arterial perfusion decrease?a. capillary refill time decreaseb. capillary refill time remain constantc. capillary refill time increased. capillary refill time reach at highans- c

64.Elevating the extremity with impaired circulation produces a cadaveric pallor because of very poor arterial perfusion. With the extremity elevated only minimal arterial blood flow can make its way distally. Returning the extremity to a dependent position causes a slow return to normality followed by the -a. bluish discoloration called cyanosisb. red discoloration called dependent ruborc. bluish discoloration called dependent cyanosisd. red discoloration called ruborans- b

65. Returning the extremity to a dependent position causes a slow return to normality followed by the red discoloration. The ruborous coloration caused by the large amount of blood flowing in to small vasodilated -a. superficial arteriesb. carotid arteriesc. digital arteriesd. thoracic arteriesans- a

66.The rhythmic throbbing caused by the regular contraction and alternate expansion of an artery on time with the heartbeat usually signifies -a. arterial insufficiencyb. arterial sufficiencyc. inadequate circulatory statusd. adequate circulatory statusans- d

67.Grading pulses on scale of 0 to 4= is fairly standard. Always pulses palpated are compared on one side to the pulse at the same site on the other side. Which of the following grading is correct?a. 1+= weak, 4+=strongb. 2+=strong, 4+= standardc.3+= strong, 4+= bounding d. 3+= good, 4+=strongans- c

68.What are easily palpated and their pulses quite bounding in response to the pressure of palpation if present?a. aneurysmsb. embolismc. atherosclerosisd. arteritisans- a

69.Palpable pulses include the aorta, dorsal pedis, posterior tibial arteries etc. What is the name of the artery that cannot be palpated?

a. femoral arteryb. peroneal arteryc. popliteal arteryd. thoracic aortaans- b

70.Normal flow patterns evident when listening through a stethoscope are often described as a lub-dub sound that corresponds with the closure of the -a. pulmonary valvesb. aortic valvesc. ventricular valvesd. artiventricular valvesans- d

71.What is abnormal low frequency sounds heard on auscultation, they can be caused by significant stenosis that sets up a vibratory response in the tissue distal to the stenosis?a. bruitsb. elevationc. auscultationd. palpationans- a.

72.Because bruits are low frequency, and depending on the examiner's hearing

range, they may or may not always be heard. Bruits may be graded on the

basis of their strength and duration. What are the grades of bruits?

a. 1+=mild, 2+=good, 3+= strong

b. . 1+=poor, 2+=strong, 3+= bounding

c. 1+=mild, 2+=moderate, 3+= severe

d. 1+=mild, 2+=strong, 3+= severe

ans- c

73.The rhythmic throbbing caused by the regular contraction and alternate expansion of an artery on time with the heartbeat usually signifies arterial insufficiency. Which of the following may not indicate a - palpable "vibration" or "thrill" over a pulse site?a. fistulab. aneurysmsc. poststenotic turbulenced. patent dialysis graft.ans- b

Ch-4

1. During the psychologic studies,what kind of environment is essential to be maintained for the patient?a. normalb. coolc. warmd. changeableans-b

2. What is it given to the patient whenever direct, indirect Doppler or imaging information is to be obtained?a. acoustic coupling gelb. a kind of antibiotic liquidc. special creamd. mixture of water and gelans-a

3. Which one is not the capability among the following?a. helps to confirm the diagnosis of arterial occlusive diseaseb. integrate the severity of the occlusive processc. indicates the approximate location of the obstructiond. provides follow-up informationans-b

4. Which one is not the limitation among the following?a. Uncompensated congestive heart failure may resultb. can not precisely localize the obstructionc. the test is technologist-dependentd. waveforms may not be affected by the waveformsans-d

5. How the patient is positioned with the extremities at the same level as the heart?a. prone positionb. supine positionc. right side positiond. left side positionans-b

6. At the time of evaluating extremities, the patient’s head can be slightly elevated.What is the position of the arms?a. on the bellyb. on the chestc. at the sidesd. at the sides wide apartans-c

7. When a wave is reflected from a moving target, the frequency of the wave receives differ from that of the transmitted wave.What is the name of this difference?a. Doppler shiftb. Doppler effectc. Doppler equationd. Doppler signans-a

8. Whenever there is a relative motion between the source and the receiver of the sound, then what is it called?

a. Doppler shiftb. Doppler effectc. Doppler equationd. Doppler signans-b

9. Suppose an ambulace is running.The changing pitch of the ambulance siren,which is higher as the ambulance approaches and lower as the ambulance moves away.Which theory can be related with this example?a. Doppler shiftb. Doppler effectc. Doppler equationd. Doppler signans-a

10. A continuous wave Doppler is used when the blood is moving target and the transducer is the stationary source.How many crystal(s) are there in a CW Doppler?a. one b. twoc. threed. fourans-b

11. The Doppler probe (transducer) must be probed on which axisof the vessel?a. shortb. longc. left d. rightans-b

12. Which angle of insonation is appropriate to the skin surface?a. 35-50 degreesb. 65-80 degreesc. 55-70 degreesd. 45-60 degreesans-d

13. What kind of signal can mean that the probe angle is very acute to the vessel angle or it can indicate a significant arterial obstruction?a. a lower-pitched signalb. a higher-pitched signalc. a continuous signald. a discrete signalans-b

14. What kind of frequency meter is employed by Analog method to display the signals graphically on a strip-chart recorder?a. a zero-crossing frequency meterb. a single crossing frequency meterc. a double-crossing frequency meterd. a triple-crossing frequency meterans-a

15. The circuitry counts every time the input signal crosses the baseline within a specific time span.Which one of the following is the right baseline?a. threeb. twoc. one

d. zeroans-d

16. The machine used to estimate the frequency of the reflected signal and displays it.What do the horizontal and vertical axis represent?a. the horizontal axis represents the amplitude of Doppler-shifted frequenciesb. the vertical axis represents the timec. the vertical axis represents the amplitude of Doppler-shifted frequenciesd. the vertical axis represents direct frequenciesans-c

17. What is the method that displays frequency on the vertical axis,time on the horizontal axis and the amplitude of backscattered signals at any given frequency and time?a. Auditory methodb. Analog method c. Sinclair methodd. Spectral analysisans-d

18. What is applied to the site to be evaluated in Spectral analysis?a. acoustic gelb. a kind of antibiotic liquidc. special creamd. mixture of water and gelans-a

19. What Doppler probe is utilized in the Spectral analysis?a. 4-6 MHzb. 6-8 MHzc. 8-10 MHzd. 10-12 MHzans-c

20. In case of Spectral analysis,For the upper extremities,which Doppler velocity waveform is not recorded from the following arteries bilaterally?a. Axillaryb. Brachialc. Radiald. Poplitealans-d

21. In case of Spectral analysis,For the lower extremities,which Doppler velocity waveform is not recorded from the following arteries bilaterally?a. Common femoralb. Posterior tibialc. Dorsalis pedisd. Ulnarans-d

22. Suppose an examiner is using a headset.Auditory signals are obtained.Which one of the following is the right signal?a. left earphone provides retrograde flow signalsb. right earphone provides retrograde flow signalsc. both the earphone provides retrograde signalsd. both the earphone provides antegrade signalsans-a

23. Suppose an examiner is using a headset.Auditory signals are obtained.Which one of the following is the right signal?a. right earphone provides antegrade flow signalsb. leftt earphone provides antegrade flow signalsc. both earphone provides antegrade flow signalsd. both earphone provides retrograde flow signalsans-a

24. Which one is not the potential sources of technical error when performing Doppler arterial survey?a. Improper probe positionb. Excessive pressure on probe tipc. Adequate amount of geld. Incorrect incident angleans-c

25. In case of interpretation in qualitative way, normal signals have some characteristics except-a. triphasic with a rapid upstrokeb. rapid downstrokec. a long peak below the baselined. resumption of forward flowans-c

26. In case of interpretation in qualitative way, abnormal signals have some characteristics except-a. monophasicb. pulsatilec. biphasic signalsd. deterioration of the Doppler signalans-b

27. What kind of effect is seen on the pulsatility of the arterial signal, causing it to assume the quality of low-resistance vessels by the vasodilation of the distal vessels ?a. it can increase the pulsatility of the arterial signalb. it can reduce the pulsatility of the arterial signalc. it helps to keep the pulsatility of the arterial signal remain samed. it has no effect on the pulsatility of the arterial signalans-b

28. Post exercise waveforms normally maintain or augment preexercise waveforms with all of the waveform components usually depicted above the baseline.Abnormally the following changes can occur except one.Which one is it?a. slow upstroke with more rounded peak b. slow downstrikec. fast downstriked. no reverse componentans-c

29. What is produced for blood flow to the muscles,which does cause an element of arterial vasodilation?a. supplyb. demandc. normal flow

d. vacancyans-b

30. The inability to elict the Doppler signals may suggest occlusion,but the sensitivity to slow flow by the CW Doppler-which can not detect velocities of less than-a. 6 cm/secb. 7 cm/secc. 8 cm/secd. 9 cm/secans-a

31. “”The arteriovenous shunts in the skin of the fingertips cause the flow patterns in the hand to vary tremendously”-Hemodynamics for Surgeons.Who is/are the author(s) of it?a. Swetnam and Subrab. Scott and Staalc. Strandness and Sumnerd. Steere and Starzlans-c

32. Regarding to the upper extremities,it is not uncommon to see continuous low-resistance Doppler signals in some arteries except one of a patient who is relaxed and warm.Which one is it?a. brachialb. fimoralc. radiald. ulnarans-b

33. Suppose the recorder stylus is not recording any waveforms.Then you must check to make certain the proper test and probe have been selected.Which one is the right probe?a. 6 MHzb. 7 MHzc. 8 MHzd. 9 MHzans-c

34. Suppose bands of noise are displayed on the tracing.Which one of the following is not a way to get rid of it?a. increasing the gainb. increasing the filterc. turning the system off and then ond. plugging the system into another outletans-a

35. Suppose no auditory signal is obtained,but there are recordable signals on the tracing.What should you do?a. Adjust the volume controlb. plug out the headset connectionc. increase the filterd. increase the gainans-a

36. Suppose there is an auditory Doppler signal but no tracing.Which of the following may not happen?a. the recorder is offb. the recorder is in pause modec. the recorder is in freeze mode

d. the recorder is onans-d

37. Pulsatility index provides a quantitative data, although it is independentent of the beam-to-vessel angle when using handheld Doppler equipment.How is it determined?a. (Peak-to-Peak Frequency+Mean Frequency)/2b. (Peak-to-Peak Frequency-Mean Frequency)/2c. (Peak-to-Peak Frequency/Mean Frequency)d. (Peak-to-Peak Frequency x Mean Frequency)ans-c

38. In case of Pulsatility index,which value is normal for the common femoral artery?a. greater than 5.5b. less than 5.5c. greater than 6.5d. less than 6.5ans-a

39. In case of Pulsatility index,which value is normal for the popliteal artery?a. approximately 7.0b. approximately 7.5c. approximately 8.0d. approximately 8.5ans-c

40. In case of Pulsatility index,which value is normal for the artery in presence of the proximal occlusive disease?a. greater than 5.0b. greater than 8.0c. less than 8.0d. less than 5.0ans-d

41. In case of inverse damping factor,the ratio of the distal pulsatility index to the proximal pulsatility index of an arterial segment is counted.Which is the normal value for inverse damping factor?a. 0.8-1.0b. 0.9-1.1c. 1.0-1.2d. 1.1-1.3ans-b

42. By using acceleration time, how one can suggest the presence of significant iliac disease?a. acceleration time ≥ 145b. acceleration time ≤ 143c. acceleration time ≥ 133d. acceleration time ≤ 123ans-c

43. Systole should be simultaneously evident at a specific site bilaterally.A delay on one side may indicate a more proximal occlusive process.This description relates to-a. Transit timeb. Acceleration timec. Frequency timed. Pulsatility timeans-a

Ch5

1. Doppler segmental pressure provides objective baseline to follow the progression of the disease process or postoperative course. Which one of the followings presence and severity is being identified?a. chronic occlusiveb. arterial insufficiencyc. arterial occlusive diseased. occlusion diseaseans- c

2. Limitations of Doppler segmental pressure are it cannot precisely localize the area of obstruction, although it can identify a general location. What cannot be discriminated by Doppler segmental?a. stenosis and occlusionb. common femoral disease and occlusion diseasec. external iliac disease and stenosisd. stenosis and common femoral diseaseans- a

3. Limitations of Doppler segmental pressure are it cannot precisely localize the area of obstruction, although it can identify a general location and difficult to discriminate between -a. common femoral disease and external iliac diseaseb. common femoral disease and occlusion diseasec. stenosis and common femoral diseased. external iliac disease and occlusionans- a

4. Limitations of Doppler segmental pressure are it cannot precisely localize the area of obstruction, although it can identify a general location and may show falsely elevated Doppler pressure in those patients with renal disease and -a. paralysisb. intermittent ischemiac. paresthesiad. diabeticsans- d

5. It is essential that the patient has rested at least 20 minutes prior to the Doppler segmental pressure test. When does it become essential?a. if the patient has diabeticsb. if the patient has vascular diseasec. if the patient has renal diseased. if the patient has chronic occlusiveans- b

6. It is essential that the patient has rested at least 20 minutes prior to the Doppler segmental pressure test. Just walking in to the test can reduce the amount of blood flow to the extremities if in fact the patient does have -a. claudicationb. block claudicationc. vascular claudicationd. 2 block claudicationans- c

7. The patient is positioned supine with extremities at the same level as the heart so that hydrostatic pressure cannot falsely elevate the blood pressure measurement. What is hydrostatic pressure?a. which would affect standing patientb. which would affect sitting patientc. which would affect patient having diabeticsd. which would affect patient having vascular diseaseans- b

8. The patient is positioned supine with extremities at the same level as the heart so that hydrostatic pressure cannot falsely elevate the blood pressure measurement. Which of the following is not appropriate position to facilitate the lower extremity evaluation?a. the patient head of the bed can be elevated slightly and patient’s head can rest on a pillowb. the patient hip is externally rotated with the knee slightly bent c. right or left lateral decubitusd. prone for access to the popliteal spaceans- a

9. When a wave is reflected from a moving target the frequency of the wave received differs from that of the transmitted wave. What is the name of this difference?a. Doppler effectb. Doppler velocity waveform analysisc. Volume pulse waveformsd. Doppler shiftans- d

10.When a wave is reflected from a moving target the frequency of the wave received differs from that of the transmitted wave. Whenever there is relive motion between the source and the receiver of the sound, there is -a. Doppler effectb. Doppler velocity waveform analysisc. Volume pulse waveforms

d. Doppler shiftans- a

11.Blood is the moving target and the transducer the stationary source. Depending on direction of flow relative to the Doppler beam, the reflected frequency is higher or lower than the-a. Doppler velocity waveformb. Doppler shiftc. continuous wave Dopplerd. Volume pulse waveformsans- b

12.The Doppler probe must be positioned on the long axis of the vessel. There is appropriate angle of insonation to the skin surface; this angle tends to work fairly well. What is the angle?a. 45-90 degreesb.60-90 degreesc. 45-60 degreesd. 90-120degreesans- c

13.Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. When the blood pressure does artifactually lower and artifactually higher respectively?a. cuff is too large, cuff is too narrowb. cuff is too narrow, cuff is too largec. cuff is large, cuff is narrowd. cuff is narrow, cuff is largeans- a

14.Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. Bilateral brachial are obtained using blood pressure cuffs-a. 12X14cm bladdersb. 12X24cm bladdersc. 12X40 cm bladdersd. 12X40 mm bladdersans- c

15.Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. Bilateral brachial are obtained using blood pressure cuffs 12X40 cm bladders. What is being utilized?a. 10-12 MHz Dopplerb. 8-10 MHz Dopplerc. 6-8 MHz Doppler

d. 10-12 Hz Dopplerans- b

16.Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. Appropriate sized blood pressure cuffs are utilized as four cuff techniques. What is not included in four cuff techniques?a. high thigh b. below kneec. low thighd. at the toeans- d

17.All cuffs should be placed straight on the extremity site and fit snugly so that bladder inflation quickly transmits the pressure in to the -a. vesselb. musclec. tissued. bloodans- c

18.All cuffs should be placed straight on the extremity site and fit snugly so that bladder inflation quickly transmits the pressure in to the tissue. Where does a loose cuff create additional space?a. between skin and tissueb. between skin and bladder c. between skin and vesseld. between skin and veinsans- b

19.At what times the width of the pneumatic cuff should be at least greater than the diameter of the limb so that the artery under evaluation can be compressed when the bladder is inflated?a. 1.2b. 2.2c. 2d. 2.2ans- a

20.At what percent the width of the pneumatic cuff should be at least greater than the diameter of the limb so that the artery under evaluation can be compressed when the bladder is inflated?a. 20b. 22c. 12

d. 10ans- a

21.The width of the pneumatic cuff should be at least 20% greater than the diameter of the limb so that the artery under evaluation can be compressed when the bladder is inflated. What must be compressed to avoid the falsely elevated pressure?a. bony structureb. bladderc. tissued. arteryans- c

22. If the cuff bladder is too wide for the extremity segment being evaluated, what will be the blood pressure measurement?a. falsely highb. falsely elevatedc. highd. falsely lowans- d

23. If the cuff bladder is too narrow for the extremity segment being evaluated, what will be the blood pressure measurement?a. falsely highb. falsely elevatedc. lowd. falsely lowans- b

24.The relationship between the size of the extremity and the size of the cuff bladder encircling the extremity is critical for measuring -a. falsely elevated pressureb. normal blood pressurec. falsely low pressured. accurate blood pressureans- d

25.What blood pressure is expected when the narrow cuffs are purposely used on the thigh in order to obtain two separate blood pressure readings?a. falsely elevated blood pressureb. accurate blood pressurec. normal blood pressured. falsely low pressureans- a

26.Falsely elevated blood pressure is expected when the narrow cuffs are purposely used on the thigh in order to obtain two separate blood pressure readings. What

will a narrow cuff secondary to body habitus produce?a. falsely low pressureb. falsely low pressurec. falsely elevated blood pressured. falsely high blood pressureans- c

27.The use of two thigh cuff is advantageous in that provides proximal and distal thigh pressure measurement. The disadvantage is that artifactually elevated pressures are obtained. What does it mean?a. the pressure at the low thigh level is normally 30 mmHg or higher than the highest brachial pressureb. the pressure at the high thigh level is normally 30 mmHg or higher than the highest brachial pressurec. the pressure at the high thigh level is normally 30 mHg or higher than the highest brachial pressured. the pressure at the low thigh level is normally 30 mHg or higher than the highest brachial pressureans- b

28.The bladder of the cuff should be placed over the artery. This is especially important when the bladder does not encircle the -a. arteryb. limbc. tissued. vesselans- b

29. Ideally, the bladder of the cuff should encircle the limb’s circumference. Where should be the bladder of the cuff placed when the bladder does not encircle the limb as it is important? a. over arteryb. over limbc. over vesseld. over thighans- a

30.The use of two thigh cuff is advantageous in that provides proximal and distal thigh pressure measurement. The disadvantage is that artifactually elevated pressures are obtained. Why the disadvantages occur?a. thigh cuff width is too much large for the usually large girth of the thighb. thigh cuff width is too much narrow for the usually narrow girth of the thighc. thigh cuff width is too much large for the usually narrow girth of the thighd. thigh cuff width is too much narrow for the usually large girth of the thighans- d

31.What is the technique that involves the use of one large cuff placed as high as possible on the thigh and satisfies the recommended width-girth relationship, it is so wide that one can fit on the thigh?a. the two cuff techniqueb. the three cuff techniquec. the two thigh cuff techniqued. one cuff techniqueans- b

32.The three cuff technique involves the use of one large cuff placed as high as possible on the thigh and satisfies the recommended width-girth relationship, it is so wide that one can fit on the thigh. What is the advantage?a. falsely elevated pressure is identifiedb. provides proximal and distal thigh pressure measurementc. more accurate thigh pressure is obtainedd. artifactually elevated pressures are obtainedans- c

33.The three cuff technique involves the use of one large cuff placed as high as possible on the thigh and satisfies the recommended width-girth relationship. Where do the remaining two cuffs in the three cuff technique applied?a. calf and toeb. calf and anklec. knee and ankled. calf and kneeans- b

34.Doppler signal are obtained and evaluated for the posterior tibial artery, dorsalis pedis artery. For which artery Doppler signal is obtained and evaluated if needed?a. peroneal arteryb. popliteal arteryc. renal arteryd. femoral arteryans- a

35.A 45-60 degree angle of insonation to the vessel is optimal and necessary to obtain the clearest and best possible signal. What will be the angle of insonation behind the knee in relation to the skin surface because of vessel angle?a. 60 degreesb. 45 degreesc. 90 degreesd. 180 degreesans- c

36.What pressures are obtained bilaterally by using a handheld sphygmomanometer with manual inflation or a computerized system with automatic inflation and digital display?a. falsely elevated pressuresb. accurate blood pressurec. two pedal Doppler pressuresd. Segmental Doppler pressuresans- d

37.Usually the higher of the two pedal Doppler pressures is used to obtain the remainder of the certain pressure in the leg beginning with the calf level. What is that certain pressure?a. Segmental Doppler pressuresb. falsely elevated pressuresc. two pedal Doppler pressuresd. falsely low pressureans- a

38.To determine the measurements of pressures in calf or below knee the examiner use the higher of the posterior tibial artery pressures and-a. popliteal artery pressuresb. peroneal artery pressuresc. dorsalis pedis artery pressuresd. bladder calf pressuresans- c

39. It is important to start at the ankle level and then to move proximally at a time to eliminate the possibility of underestimating the measurement of -a. segmental Doppler pressuresb. systolic pressurec. the posterior tibial artery pressuresd. dorsalis pedis artery pressuresans- b

40.The high-thigh cuff is inflated to above systole and then slowly deflated to determine the blood pressure. If the cuff is quickly deflated, immediately followed by inflation of the next cuff, there is not enough time for arterial blood to completely normalize in the leg. What would be the blood pressure like, obtained this way?a. falsely elevated pressure c. falsely lower than it should bed. falsely higherans- c

41.When a full extremity study is not required, the posterior tibial artery and dorsalis pedis artery are used for determining what?

a. ankle pressureb. ankle/brachial pressurec. brachial pressured. ankle and brachial pressureans- a

42.Complete cessation of blood flow should be accomplished by inflating the cuff beyond the audible Doppler arterial signal and the cuff should be inflated -a. 10-20 mmHgb. 20-40 mmHgc. 20-30 mmHgd. 20-40 mHgans- c

43. In order to determine how high to take the inflation pressure, note the higher brachial systolic pressure and then increase inflation pressure-a. 20-40 mmHg higher than it isb. 20-40 mHg higher than it isc. 20-30 mmHg higher than it isd. 20-30 mHg higher than it isans- c

44.The higher brachial pressure is used because if there is a subclavian stenosis present unilaterally, with the affected side being lower there would be a systolic pressure difference. What would be the difference?a. 20-30 mmHg or greaterb. 15-20 mHg or greaterc. 20-30 mHg or greaterd. 15-20 mmHg or greaterans- d

45. If pressure measurements need t O be repeated, the cuff should be fully deflated for about a minute prior to repeat so arterial flow stabilizes, what will happen otherwise?a. brachial blood pressure can be underestimatedb. segmental pressure can be underestimatedc. brachial blood pressure can be overestimatedd. segmental pressure can be overestimatedans- b

45.Which pressure is recorded as the pressure at which the first audible Doppler arterial signal returns, similar to listening first audible sound when taking a brachial blood pressure with a stethoscope?

a. segmental Doppler pressuresb. brachial pressurec. the systolic pressured. arterial pressureans- c

46.To avoid unreliable results blood pressure and comments regarding difficulty with the study should be documented. What is the meaning of this line?a. to clearly discriminate a poor arterial signal from Doppler arterial signalb. to clearly discriminate a poor arterial signal from a venous signalc. to clearly discriminate a popliteal from proximal tibial diseased. f to clearly discriminate a falsely elevated pressure and falsely low pressureans- b

47.The ankle/brachial index (ABI) is calculated by dividing the ankle pressure by the higher of the two brachial pressures. Which one is not included as additional terms for this index which utilize the same formula?a. ankle/leg index (ALI)b. ankle/arm pressure index (API)c. ankle/arm index (AAI)d. ankle/arm pressure index (API) or ankle/arm index (AAI)ans- a

48. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is considered to be the result of incompressible vessels, as are not reproducible?a. An ABI < 1.3-1.5b. An ABI > 1.4-1.5c. An ABI > 1.3-1.5d. An ABI < 1.4-1.5ans- C

49. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is indicated by ankle/brachial index (ABI) > 1.0?a. asymptomatic obstructive diseaseb. normalc. minimal arterial diseased. claudicationans- b

50. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is the finding if the ankle/brachial index (ABI) is 0.5-0.9?a. claudicationb. normalc. minimal arterial disease

d. asymptomatic obstructive diseaseans- a

51. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is the finding if the ankle/brachial index (ABI) > 0.9-1.0?a. claudicationb. asymptomatic obstructive diseasec. occlusive diseased. normalans- b

52. Incompressible vessels have falsely elevated and therefore inaccurate pressures. An ABI of > 1.3-1.5 is considered to be the result of incompressible vessels, as are not reproducible (112 mmHg when repeated). What is the measurement of pressure of one time?a. 168 mmHgb. 148 mmHgc. 158 mmHgd. 1118 mmHgans- c

53.From which highest pressure normally the ankle systolic pressure is the same as or greater than that pressure?a. falsely elevated pressuresb. brachial blood pressurec. segmental Doppler pressuresd. ankle/brachial pressureans- b

54.The Doppler segmental pressure study usually not combined with -a. Doppler velocity waveforms b. plethysmographic waveformsc. volume pulse waveformsd. Doppler volume waveformsans- d

55.What is the range of ankle/brachial index (ABI) if the patient usually suffers from rest pain?a. 0.5-0.75b. 0.25-0.5c. 0.25-0.55d. 0.5- 0.55ans- b

56. It is better at predicting symptoms at rest if there are those who feel that an absolute ankle pressure which is less than 50 mmHg approximately rather than the ABI -

a. 0.5b. 0.25c. o.35-0.5d. 0.05ans- a

57.What is the value of ankle/brachial index that represents single segment involvement and that lesser values are more indicative of multiple lesions?a. ABI > 0.5b. ABI ≥ 0.25c. ABI ≥ 0.5d. ABI > 0.25ans- c

58.What would be suggested if a decrease pressure of > 30 mmHg between two consecutive levels?a. obstruction diseaseb. significant obstructionc. insignificant pressured. insignificant obstructionans- b

59.When do you can suggest that patient has obstructive disease at or above the level in the leg with lower pressure?a. A horizontal difference of 20-40 mmHg or moreb. A vertical segmental pressure difference of 20-30 mmHg or morec. A horizontal difference of 20-30 mmHg or mored. A vertical segmental pressure differences of 20-40 mmHg or moreans- c

60.Horizontal pressures are less important when compared to vertical segmental pressure differences. When do horizontal pressure differences no longer valid?a. once obstructive disease has been detectedb. once proximal disease has been detectedc. once peroneal disease has been detectedd. once popliteal disease has been detectedans- b

61.As limb girth increases from the ankle to the thigh, pressure measurement also increases. What is normally the high-thigh pressure in the average-size limb?a. at least 30 mmHg greater than the highest brachial pressure.b. at least 30 mmHg greater than the brachial systolic pressure.c. at least 40 mmHg greater than the highest brachial pressure.d. at least 40 mmHg greater than the brachial systolic pressure.ans- a

62.As limb girth increases from the ankle to the thigh, pressure measurement also increases. The above knee and below knee systolic pressure should be the same as or -a. greater than the highest brachial pressure.b. at least 30 mmHg greater than the brachial systolic pressure.c. greater than the brachial systolic pressured. at least 30 mmHg greater than the highest brachial pressureans- c

63.With the three cuff technique the large, single cuff segmental pressure is normally similar to the highest brachial pressure. Why does it happen?a. because it does not allow differentiation of proximal and distal thigh pressureb. because the cuff has wide girthc. because the single cuff has a smaller bladderd. because the single cuff has a longer bladderans- d

64.Although wide-girth cuff usually yields a more accurate pressure, it does not allow differentiation of -a. highest brachial pressure and systolic pressureb. proximal and distal thigh pressurec. systolic pressure and brachial systolic pressured. proximal and systolic thigh pressureans- b

65.What is the pressure level for foot ulcer healing when foot and toe ulcer fail to heal?a. 30 mmHgb. 20 mmHgc.30 mHg d. 20 mHgans- a

66.For which of the following reasons resting value are compares to those after exercise (if no limitations pr contradictions exist) or after hyperemia ( an alternate means of stressing the peripheral circulatory system)?a. to determine the presence and absence of true claudication and pseudoclaudicatonb. to determine the presence and absence collateralsc. to help differentiate between true claudication and collaterald. to help differentiate between pseudoclaudication and collateralans- b

67.Which is the preferable test because it produces physiologic stress that reproduces a patient’s ischemic symptoms?a. reactive hyperemia testing

b. Doppler segmental pressure lower extremities testingc. treadmill testingd. ischemic testingans- c

68.Which of the followings are not contradictions and limitations of exercise testing?a. renal problemsb. shortness of breathc. hypertensiond. cardiac problemsans- a

69.How long the patient walks on a constant-treadmill at ≤12% elevation and 1.5 MPH, after resting values are obtained in exercise testing?a. maximum 7 minutesb. minimum 5 minutesc. minimum 7 minutesd. maximum 5 minutesans- d

70.Some patients who complain of claudication have to stop walking because of conditions other than leg pain. What is not included as other condition?a. shortness of breathb. . hypertensionc. thoracic problemd. cardiac problemsans- c

71.Postexcercise Doppler pressures are obtained from the higher brachial blood pressure. In exercise testing to capture the maximum pressure drop, where the pressure is first measured?a. contralateral ankleb. lower extremity anklec. armd. higher extremity ankleans- b

72.How long a process can take to obtain postexcercise ABI immediately and then every two minutes until preexcercise pressures are once again attained? a. 10-12 minutesb. 10 minutesc. 20-25 minutesd. 20 minutesans- d

73.What can be suggested if ankle pressure that drop too low or unrecordable levels immediately after exercise and then increase to resulting levels in 2 to 6

minutes?a. obstruction at a single levelb. significant obstructionc. multiple obstructiond. . obstruction at a lower extremity levelans- a

74.What can be suggested if ankle pressure that drop too low or unrecordable levels immediately after exercise and remain reduced or unrecordable for up to 12 minutes or more?a. obstruction at a single levelb. obstruction at a lower extremity levelc. multiple obstructiond. significant obstructionans- c

75.What the name of the alternate method is for stressing the peripheral circulation that may indicate when the patient cannot walk long enough, uses a cane or walker, has pulmonary problems, has poor cardiac status or other situations?a. treadmill testingb. exercise testingc. reactive hyperemia testingd. Doppler segmental pressure lower extremities testingans- c

76. If the patient has known severe arterial disease in one extremity and moderate arterial disease in the other. With walking, the extremity with the severe disease will force the patient to stop sooner, making it impossible to determine what the actual response would be in the other extremity. What test would be essential to perform to test both extremities for a truer comparison?a. exercise testingb. reactive hyperemia testingc. treadmill testingd. Doppler segmental pressure lower extremities testingans- b

77.After treadmill exercise, ankle systolic pressures in normal limbs do not decrease. But what is the range of transient pressure decrease occurs at the ankles of normal limbs after reactive hyperemia?a. 17%-24%b. 7%-14%c. 27%-34%d. 17%-34%ans- d

78.Which testing is considered by many to be preferable test because it produces a physiological stress that produces a patient’s ischemic symptoms?a. treadmill testingb. reactive hyperemia testingc. Doppler segmental pressure lower extremities testingd. ischemic testingans- a

Chap-6

1. Which one of the following is not the capability of Doppler segment pressures-upper extremities?a. Identifies the presence and severity of arterial occlusive disease.b. provides an objective baselinec. objectively evaluates the treatment pland. results are usually differntiatedans-d

2. Which one of the following is not the limitation of Doppler segment pressures-upper extremities?a. may show falsely elevated Doppler pressures in patientsb. patients with casts or extensive bandages that can’t be removedc. this test can discriminate stenosis from occlusiond. waveforms may be affected by the ambient temperatureans-c

3. Which one of the following is not included in the patient positioning of Doppler segment pressures-upper extremities?a. the arms should be at the patient’s sidesb. the patient’s head can be slightly elevatedc. the patient’s leg should be foldedd. the cuffs should be applied snugly over the muscular portion of the armans-c

4. When a wave is reflected from a moving target, the frequency of the wave receives differ from that of the transmitted wave.What is the name of this difference?a. Doppler shiftb. Doppler effectc. Doppler equationd. Doppler signans-a

5. Whenever there is a relative motion between the source and the receiver of the sound, then what is it called?a. Doppler shiftb. Doppler effectc. Doppler equationd. Doppler signans-b

6. Suppose an ambulace is running.The changing pitch of the ambulance siren,which is higher as the ambulance approaches and lower as the ambulance moves away.Which theory can be related with this example?a. Doppler shiftb. Doppler effectc. Doppler equationd. Doppler signans-a

7. A continuous wave Doppler is used when the blood is moving target and the transducer is the stationary source.How many crystal(s) are there in a CW Doppler?a. one b. twoc. three

d. fourans-b

8. The Doppler probe (transducer) must be probed on which axisof the vessel?a. shortb. longc. left d. rightans-b

9. In case of the techniques of Doppler segment pressures-upper extremities,which size of cuff is placed snugly on the upper arm biliterally?a. 10x40 cm bladderb. 8x40 cm bladderc. 14x40 cm bladderd. 12x40 cm bladderans-d

10. In case of the techniques of Doppler segment pressures-upper extremities,which size of cuff is placed snugly on the forearm biliterally?a. 8x40 cm bladderb. 10x40 cm bladder c. 12x40 cm bladderd. 14x40 cm bladderans-b

11. A loose cuff creates space between the skin and the bladder, necessitating additional inflation and possibly, falsely elevated pressures.So in case of technique of Doppler segment pressures-upper extremities, how all the cuffs should be placed?a. bentb. horizontalc. verticald. straightans-d

12. In case of technique of Doppler segment pressures-upper extremities,what should be the width of pneumatic cuffs related to the diameter of the limb?a. at least 30% greaterb. at least 40% smallerc. at least 20% greaterd. at least 30% smallerans-b

13. In case of technique of Doppler segment pressures-upper extremities,from where the upper arm pressure is obtained?a. bronchiole arteryb. brachial arteryc. radial arteryd. ulnar arteryans-b

14. For the upper extremities, Doppler velocity waveforms are recorded from the following arteries bilaterally except one.Which one?a. Brachialb. Radialc. Claviand. Ulnarans-c

15. Suppose there is a 15-20 mmHg difference from one brachial pressure to the other.What would be the suggestion of the lower side to the subclavian artery and/or the vessel under the cuff?a. a greater than 30% diameter reductionb. a greater than 40% diameter reductionc. a greater than 50% diameter reductiond. a greater than 60% diameter reductionans-c

16. What is the limit of reduction in blood pressure normally between the upper arm and the forearm ?a. 15-20 mmHgb. 20-25 mmHgc. 25-30 mmHgd. 35-40 mmHgans-a

17. What should be the radial and ulnar artery pressures of each other?a. within 20-25 mmHgb. within 15-20 mmHgc. within 10-15 mmHgd. within 5-10 mmHgans-d

18. Radial and ulnar artery pressures should be within 5-10 mmHg of each other.The vessel with the lower pressure may be obstructed if there is a difference of-a. ≥ 10 mmHgb. ≥ 20 mmHgc. ≥ 30 mmHgd. ≥ 40 mmHgans-b

19. In case of Allen test, which of the following is not the capability of this process?a. determines hand viability if the radial artery is to be removed for useb. Evaluates patency of the wrist arteriesc. Evaluates patency of the palmar archd. the skin over the palm can be stretchedans-d

20. In case of Allen test, which of the following is not the limitation of this process?a. may compress the radial or ulnar arteriesb. may cause compression of the small vesselsc. relative pollar can occur d. may determine hand viabilityans-d

21. While the technologists continues to manually compress the artery in Standard Allen Test, the patient is asked to clench the hand into a tight fist for about what time?a. 30 secondsb. 45 seconds c. 1 minuted. 2 minutesans-c

22. Waveforms can be obtained both prior to and during the radial artery compression maneuver when a photoplethysmographic (PPG) sensor is affixed to-a. 1-2 fingersb. 2-3 fingersc. 3-4 fingersd. 4-5 fingersans-b

23. Which one of the following is not true about the photoplethysmographic (PPG) sensor?a. a photoplethysmographic (PPG) sensor is affixed to 3-4 fingersb. PPG waveforms are obtained as the Digital Pressures and Plethysmography

c. PPG sensor is affixed to the digit using double stick taped. the equipment is set to PPF function(AC mode)ans-a

24. At what speed the strip-chart analog recoeder of photoplethysmographic (PPG) sensor is set if only monitoring is required?a. 2 mm/secb. 3 mm/secc. 4 mm/secd. 5 mm/secans-d

25. At what speed the strip-chart analog recorder of photoplethysmographic (PPG) sensor is set if waveform quality assessment is required?a. 20 mm/secb. 25 mm/secc. 30 mm/secd. 35 mm/secans-b

26. In standard Allen Test,what is indicated by the reappearence of the normal skin color when the hand is relaxed?a. the palmar arch is not patientb. the radial artery continues to be automatically compressedc. the ulnar artery is providing inflowd. the ulnar artery is providing outflowans-c

27. In standard Allen Test, if the hand does not return to its normal color during relaxation,what does it mean except one?a. an obstruction of distal ulnar arteryb. making the hand ischemicc. an obstruction of distal palmar archd. the palmar arch receives adequate blood supplyans-d

28. It is possible to use a continuous-wave Doppler probe instead of a photoplethysmographic (PPG) sensor to obtain waveforms.But what is the difficulty?a. ability to hold the probe steadyb. the size of the digital artery is bigc. ability to hold the probe steady on the very small digital arteryd. inability to hold the probe steadyans-d

Ch 7

1. Which test is helps to determine healing potential of a wound or ulcer by amputation level?a. laser Dopplerb. reactive hyperemia testingc. treadmill testingd. exercise testingans- a

2. Laser Doppler helps to determine healing potential of a wound or ulcer. Which of the followings make the laser Doppler testing difficult?a. skin must be ulceratedb. patient is supine with head in a pillowc. inability of the patient to rest quitelyd. patient positioned comfortablyans- c

3. What is routinely used for the transcutaneous measurement of the movement or flow of blood? a. Doppler shiftb. laser Dopplerc. exercise testingd. Doppler principleans- d

4. The laser Doppler is used to assess the characteristics of the microvascular blood volume in the -a. superficial layers of the tissueb. capillary beds of the skinc. deep arteriesd. veinsans- b

5. What is the name of the system that can be used to measure blood flow velocities in deep arteries and veins?a. optical systemb. light wave lengthc. ultrasound-based systemd. longer wavelengths system

ans- c

6. What are immediately scattered in random directions by both cell types (moving red blood cells are Doppler-shifted in frequency but stationary cells are not)?a. photons

b. protonsc. ultrasound wavelengthsd. optical wavesans- a

7. A portion of the scattered laser light is collected by a receiving optical fiber and returned to a photo detector. The photo detector converts this optical signal to determine microvascular blood volume into - a. energyb. ultrasound wavelengthc. electronic signal d. short wavelengthans- c

8. In laser Doppler testing skin perfusion pressure (SSP) mode is activated. What is the measurement of the pressure to inflate the cuff?a. 40 mmHgb. 100 mmHgc. 65 mmHgd. 20 mmHgans- b

9. In laser Doppler test the pressure is held for 10 seconds, waiting for the volume indicator drop below 0.1%. If it does not, the transducer is inflated another -a. 40 mmHgb. 100 mmHgc. 65 mmHgd. 20 mmHgans- d

10.What angle the patient’s leg is elevated and holding it there until the volume drops below 0.1?a. 60 degrees above horizontallyb. 60 degrees below horizontallyc. 60 degrees above verticallyd. 60 degrees below verticallyans- a

11.When the patient’s skin perfusion pressure (SSP) is obtained?a. once the volume is >0.1b. once the volume is <0.1c. once the volume is >0.01d. once the volume is<0.01ans- b

12. In laser Doppler testing the examiner sees a steady baseline, which is followed by a doubling or more of the graph’s pressure scale. What is indicated by this?

a. patient’s falsely elevated pressureb. Patient’s falsely low pressurec. patient’s actual pressured. patient’s falsely higher pressureans- c

13.What can be indicated by skin perfusion pressure (SSP) >30 mmHg in case of laser Doppler testing?a. less likely to healb. likely to healc. unlikely to heald. no ulcerans- b

14.What can be indicated by skin perfusion pressure (SSP) <30 mmHg in case of laser Doppler testing?a. less likely to healb. likely to healc. unlikely to heald. no ulcerans- a

Chap8

1. What are the limitations of Penile Pressures and Waveforms except one ?a. hihjly anxious or antagonistic patients are difficult to studyb. only duplex and color flow imaging provide datac. may indicate pelvic steal,arterial vasospasm or ipsilateral arterial diseased. patient may be unable to undergo the injection acomponentans-c

2. In case of duplex /color flow imaging evaluation, what Doppler probe can be utilized and Doppler waveforms and pressures are obtained?a. 6-8 MHzb. 8-10 MHzc. 10-12 MHzd. 12-14 MHzans-b

3. What kind of imaging and Doppler spectral analysis with or without color flow imaging are included in duplex scanning?a. A-modeb. B-modec. C-moded. D-modeans-b

4. Appropriately sized blood pressure cuffs are placed on the upper arms, ankles and proximal shaft of the penis.Penile cuff sizes are-a. 2 x 12 cmb. 2.5 x 12.5 cmc. 3 x 13 cmd. 2 x 9 cmans-b

5. Penile pressures are obtained with some end-point detectors. Which of the following is not one of them?a. strain gaugeb. plethysmographyc. continuous waved. pulse volume plethysmographyans-b

6. Penile/brachial index(PBI) is calculated using the higher brachial pressure.What is the normal Penile/brachial index(PBI)?a. 0.75 or greaterb. 0.65 or greaterc. 0.55 or greaterd. 0.45 or greaterans-a

7. Penile/brachial index(PBI) is calculated using the higher brachial pressure.What is the marginal Penile/brachial index(PBI)?a. 0.35-0.44b. 0.45-0.54c. 0.55-0.64d. 0.65-0.74ans-d

8. Penile/brachial index(PBI) is calculated using the higher brachial pressure.What is the abnormal Penile/brachial index(PBI)?a. less than 0.45b. less than 0.55c. less than 0.65d. less than 0.75ans-c

9. The penile/brachial index least expected in a young adult male with normal sexual response would be anything less than-a. 0.55b. 0.65c. 0.70d. 0.75ans-b

10. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is not normal?

a. sharpb. systolic peakc. prominenet dictoric waved. downslope is bowed away ans-d

11. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is not mildly abnormal?a. sharp peakb. absent dictoric wavec. systolic peakd. downslope is bowed away from baselineans-c

12. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is not moderately abnormal?a. sharp peakb. flattened systolic peakc. upslope and downslope time decreasedd. dictoric wave absentans-a

13. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is the sign of severely abnormal?a. sharpb. systolic peakc. prominenet dictoric wave d.pulse wave has low amplitude ans-d

14. According to the penile pressures and waveforms, in most cases informed consent is obtained from the patient. What kind of transducer is selected in this case?a. 6 or 9 MHzb. 7 or 10 MHzc. 6 or 10 MHzd. 8 or 11 MHzans-b

15. Repeat measurements are obtained postinjection.Protocol varies in the literature regarding how soon the postinjection velocities and cavernous artery dimensions are measured.What is the time that multiple measurements may be obtained at various increments after the injection?a. upto 6 minutesb. upto 5 minutesc. upto 4 minutesd. upto 3 minutesans-a

16. Peak systolic and end diastolic measurements are obtained from the proximal cavernous arteries before full erection is achievedTo obtain the highest velocity recordings how many measurements may be required?a. only oneb. no measurementc. severald. maximum twoans-c

17. At what time the dimensions of the cavernous arteries are measured in an A/P transverse view?a. during diastoleb. during systolec. during erectiond. any timeans-b

18. It is important for the patient to instruct about priapism.He must contact his urologist if a rigid erection is maintained for a period of time after injection.What is the time period?a. 1 hoursb. 2 hoursc. 3 hoursd. 4 hoursans-c

19. Which of the following is the right interpretation about the preinjection and the postinjection?a. preinjection has a low resistance quality b. both of them have the same resistance qualityc. preinjection has a high resistance qualityd. postinjection has a high resistance qualityans-c

20. There are various schools of thought concerning the importance of peak systolic and end diastolic velocities.The general normal measurement is-a. ≥ 10 cm/secb. ≥ 20 cm/secc. ≥ 30 cm/secd. ≥ 40 cm/secans-c

21. There are various schools of thought concerning the importance of peak systolic and end diastolic velocities.The general marginal measurement is-a. 55-59 cm/secb. 45-49 cm/secc. 35-39 cm/sec

d. 25-29 cm/secans-d

22. There are various schools of thought concerning the importance of peak systolic and end diastolic velocities.The general reduced measurement is-a. < 15 cm/secb. < 25 cm/secc. < 35 cm/secd. < 45 cm/secans-b

23. Postinjection,the deep dorsal venous flow velocities should not increase.What is the normal measurement?a. < 1 cm/secb. < 2 cm/secc. < 3 cm/secd. < 4 cm/secans-c

24. Postinjection,the deep dorsal venous flow velocities should not increase.What is the moderately increased measurement?a. 10-20 cm/secb. 20-30 cm/secc. 30-40 cm/secd. 40-50 cm/secans-a

25. Postinjection,the deep dorsal venous flow velocities should not increase.What is the markedly increased measurement?a. > 10 cm/secb. > 20 cm/secc. > 30 cm/secd. > 40 cm/secans-b

26. It has been suggested that an increase in postinjection may indicate a venous leak, which could contribute to the erectile dysfunction. What is the measure?a. > 3 cm/secb. > 4 cm/secc. > 5 cm/secd. > 6 cm/secans-b

27. A varicocele is an enlargement of the veins of the spermatic cord. A condition which occurs most often in a particular age of people. What is the general period?a. very young like boyb. adolescentc. middle aged. old ageans-b

28. A varicocele is an enlargement of the veins of the spermatic cord. A condition which occurs most often in young men and adolescents. In which side it is most common?a. front sideb. back sidec. left sided. right sideans-c

29. A varicocele is an enlargement of the veins of the spermatic cord. What kind of transducer is been used to determine the presence of varicocele?a. 5 MHz transducerb. 10 MHz transducerc. 15 MHz transducerd. 20 MHz transducerans-b

Ch 9

1. Which one of the followings helps to differentiate true arterial claudication from nonvascular sources?a. Doppler segmental pressureb. plethysmography in combination with Doppler segmental pressurec. plethysmography in combination with Doppler shiftd. plethysmographyans- b

2. One of the limitations of plethysmography is- cannot be specific to a single vessel. What is the reason of this limitation?a. because it may be difficult to discriminate between major arteries and collateral branchesb. because of obesity that makes difficult to perform volume and strain gaugec. because it measures volume changes in a large segment of a limb.d. because it combined with Doppler segmental pressureans- c

3. Which of the followings is not included in the terms that are used to describe volume plethysmography?a. true plethysmographyb. pulse volume recordings plethysmographyc. air plethysmographyd. pneumo plethysmographyans- b

4. Which of the followings is not included in the terms that are used to describe volume plethysmographic waveforms?a. pulse volume recordingsb. volume pulse recordingsc. pulse contour recordingsd. pulse speed recordingsans- d

5. Pneumatic cuffs are placed around specific levels of the extremities or digits. What is the range of pressure of air which is sequentially introduced in to the cuff depending on the site and level of the cuff?a. up to 10-65 mmHgb. up to 10-25 mmHgc. up to 10-55 mmHgd. up to 10-75 mmHgans- a

6. There is momentary increases in the limb segment volume occur during systole, when arterial flow peaks. What are the areas through which arterial flow moves

underneath the cuff?a. arteries, vessels, branches and limbsb. arteries, limb, skin and collateral branchesc. arteries, branches, small vessels and collateral branchesd. arteries, vessels and branchesans- c

7. The pulsatile pressure changes occurring inside the air-filled bladder are converted by pressure transducer into - a. ultrasound waveformb. analog waveformc. optical waveformd. volume plethysmographic waveformsans- b

8. Due to what disease the arterial flow decreases underneath the cuff and because arterial flow decreases the waveform changes in appearance?a. occlusive diseaseb. obstructive diseasec. arterial diseased. vascular diseaseans- b

9. Which one of the followings is not a part of a photoplethysmography?a. thermometerb. transducerc. amplifierd. strip-chart recorderans- a

10.Photoplethysmography is not a true plethysmography, although it is still considered plethysmographic technique. In what name PPG records the rapid changes in blood content of the skin?a. pulse waveformb. volume plethysmographic waveformsc. pulsatile waveformd. analog waveformans- c

11.Photoplethysmography (PPG) sends infrared light directed into the underlying tissue with a light emitting diode, and the adjacent photodetector (photocell) receives the backscattered infrared light and measures the reflection of light. Why is PPG use infrared light?a. because measurements made in the infrared range have a constant but minimal attenuationb. because the tissue and the blood in the cutaneous vessels attenuates a

portion of itc. because measurements made in the infrared range have a constant but minimal reflectiond. because measurements made in the infrared range have a constant but maximum attenuationans- a

12.What is utilizing a mercury-filled silicone-like tube that makes contact with copper electrodes at both end and it is wrapped around the limb part being evaluated with just enough stretch to ensure good contact?a. Photoplethysmographyb. volume plethysmographyc. strain gauge plethysmographyd. displacement plethysmographyans- c

13.The length of the extremity strain gauge is approximately 1-3 cm shorter than the circumference of the extremity. With digits, the gauge is approximately -a. 0.3 cm shorterb. 0.5 cm shorterc. 0.2 cm shorterd. 0.7 cm shorterans- b

14. During volume plethysmography appropriately sized pneumatic cuffs are applied snugly to the thigh, calf and ankle bilaterally. What are the cuff sizes?a. 4cuff versus 3 cuffb. 3 cuff versus 6 cuffc. 4 cuff versus 5 cuffd. 3 cuff versus 4 cuffans- d

15. In case of volume plethysmography if during the recording of the waveforms the stylus pen is not centered rather located at either the top or bottom of chart paper, what should you done to center the stylus pen?a. activate self-calibratesb. activate the re-set controlc. activate central buttond. start the procedure againans- b

16. In volume plethysmography an appropriate amount of air is used to inflate cuff pressure to predetermined levels. From where does the examiner begin with? a. upper part of the extremity and moves distallyb. lower part of the extremity and moves horizontallyc. upper part of the extremity and moves proximally

d. lower part of the extremity and moves distallyans- a

17. In volume plethysmography an appropriate amount of air is used to inflate cuff pressure to predetermined levels. How many pulse cycles are recorded at each level?a. twob. fourc. threed. sixans- c

18.During volume plethysmography, if the cuff is applied too loosely, it will take much more air to inflate the cuff bladder to the predetermined amount. What can happen by doing this?a. can intensify the waveformb. can attenuate the waveformc. can expand the waveform d. can alternate the waveformans- b

19.Appropriately sized strain gauges are applied to various levels of the extremity with careful attention to extremity positioning and gauge application. Which of the followings is not included in these levels? a. high and low thighb. below calfc. ankled. armans- d

20.Photoplethysmography (PPG) is most often applied to the evaluation of -a. digital arterial diseaseb. penile pressurec. obstruction diseased. arterial diseaseans- a

21.There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which of the criteria is not described by anyone?a. qualitative criteria for the waveformsb. quantative criteria for the waveformsc. criteria of a semi quantative natured. criteria that considers both contour and amplitude of the pulse waveformsans- b

22.There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as

normal?a. sharp peak, absent dicrotic reflective waveb. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic wavec. sharp systolic peak with prominent dicrotic waved. absent or low-amplitude pulse wave with equal upslope and downslope time ans- c

23.There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as moderately abnormal?a. wave sharp peak, absent dicrotic reflectiveb. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic wavec. absent or low-amplitude pulse wave with equal upslope and downslope timed. sharp systolic peak with prominent dicrotic waveans- b

24.There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as mildly abnormal?a. sharp systolic peak with prominent dicrotic waveb. absent or low-amplitude pulse wave with equal upslope and downslope timec. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic waved. wave sharp peak, absent dicrotic reflectiveans- d

25.There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as severely abnormal?a. wave sharp peak, absent dicrotic reflectiveb. sharp systolic peak with prominent dicrotic wavec. absent or low-amplitude pulse wave with equal upslope and downslope timed. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic waveans- c

26.How moderately or severely abnormal volume plethysmographic waveforms always reflect the significant disease proximal to the level of the tracing?a. hemodynamicallyb. dynamicallyc. semi-dynamicallyd. non-dynamicallyans- a

27. In case of volume plethysmographic waveforms if amplitude is reduced but there are no changes in the contour of the waveform, what would be the findings?a. insignificant unless it is unilateralb. significant unless it is bilateralc. significant unless it is unilaterald. insignificant unless it is bilateralans- c

28.What is the key reason for combining Doppler pressure with plethysmography technique?a. if amplitude is reduced but there are no changes in the contour of the waveformb. reveal the difference between a normal waveform and a hyperemic waveformc. to obtain a waveform of fair qualityd. to obtain a waveform of fair quality but an abnormal Doppler segmental pressure at the same timeans- d

29.Which of the plethysmographic waveforms reveal the difference between a normal waveform and a hyperemic waveform that is affected collateralization?a. volume plethysmographic waveformsb. comparative plethysmographic waveformsc. strain gauge plethysmographic waveformsd. photoplethysmographic waveformsans- b

30.What would be the problem if the patient’s arterial studies require AC mode and venous studies need the DC mode during plethysmography? a. the machine is not in the correct modeb. too much stylus movementc. recorder stylus cannot be centeredd. there is no tracing at allans- c

31.What would be the action if the recorder stylus is stuck at the bottom or top of the paper (machine is not in the correct mode) during plethysmography?a. activate the reset controlb. reattach the PPG or strain gaugec. confirm that the machine is in the right moded. ascertain that the correct mode has been selectedans- a

32.What would be the action if an acceptable waveform cannot be recorded which means too much stylus movement during plethysmography?a. activate the reset controlb. the machine is not in the correct mode

c. there is no tracing at alld. reattach the PPG or strain gaugeans- d

33.What would be happen if the correct mode has been selected, the correct test name has been entered and the proper paper has been correctly installed during plethysmography?a. ascertain that the correct mode has been selectedb. confirm that the machine is in the right modec. there is no tracing at alld. activate the reset controlans- c

34.Which plethysmography consists of water-filled, watertight container in which the body part is immerses and the water temperature must remain constant?a. volume plethysmographyb. displacement plethysmographyc. strain gauge plethysmographyd. photoplethysmographyans- b

35.Which of the following plethysmography refers to transient changes in limb volume related to pulse-by-pulse activity of the left ventricle, the body part expanding when arterial inflow exceeds venous outflow?a. displacement plethysmographyb. volume plethysmographyc. pulse plethysmographyd. strain gauge plethysmographyans- c

36. If your hand is inside a loose-fitting surgical rubber glove, a certain pressure exerted by surrounding fluid that keeps the glove in close contact with the skin. What is the name of that pressure?a. systolic pressureb. hydrostatic pressurec. increased blood pressured. falsely elevated pressureans- b

Chap10

1. In case of pressures and plethysmography, which one of the following is not the

capabilities ?

a. helps to detect the presence of arterial disease

b. differrentiates temporary arterial obstruction from vasospasm

c. assess effects of treatment

d. helps to determine the presence/absence of sympathetic activity

ans- b

2. Vasoconstriction greatly affects the quality of the results.Before testing the patient, the

examiner should ask some important questions.Which of the following excludes from

these questions?

a. Has the patient just come in from cold weather?

b. Has the patient been smoking?

c. Is the patient nervous?

d. Where does he live?

ans- d

3. Which one of the following is not the limitations of the Vasoconstriction?

a. incorrectly applied photocell to the skin

b. poor positioning of the gauge

c. differentiation of fixed arterial obstruction

d. extensive bandages

ans- c

4. In case of patient’s positioning, for the evaluation of toes, the patient should be

supine.Patient’s head can be elevated-

a. 5-10 degrees

b. 10-15 degrees

c. 10-20 degrees

d. 15-20 degrees

ans- c

5. An appropriately sized cuff, the width of which should be at least 1.2 times that of the

toe, is applied to the base of the toe.What is the measurement of the cuff that is used for

the fingers?

a. 1.5-2.0 cm

b. 2.0-2.5 cm

c. 2.5-3.0 cm

d. 3.0-3.5 cm

ans- b

6. An appropriately sized cuff, the width of which should be at least 1.2 times that of the

toe, is applied to the base of the toe.What is the measurement of the cuff that is used for

the great toe?

a. 1.5-2.0 cm

b. 2.0-2.5 cm

c. 2.5-3.0 cm

d. 3.0-3.5 cm

ans-c

7. There is no specific manual ‘calibration’ done for volume or photoplethysmography prior

to usage, but what is required by strain gauge eqipment?

a. auto calibration by the doctor

b. manual calibration by the doctor

c. auto calibration by the technologist

d. manual calibration by the technologist

ans- d

8. What does the plethysmography measure?

a. all volume changes

b. all flow changes

c. all pressure changes

d. all red blood cell changes

ans- a

9. While the pulsations are being recorded,the examiner inflates the cuff to superstolic

pressure, at which point there should be no pulsations.What is the measurement?

a. 5-10 mmHg higher than ankle pressure

b. 10-20 mmHg higher than ankle pressure

c. 20-30 mmHg higher than ankle pressure

d. 30-35 mmHg higher than ankle pressure

ans- c

10. When a brachial blood pressure is taken while a stethoscope is positioned over the

brachial artery, the arm cuff is normally inflated to about-

a. 100 mmHg

b. 150 mmHg

c. 200 mmHg

d. 250 mmHg

ans- c

11. In case of the technique for fingers, what is the size of the cuff is usually used for the

fingers?

a. 1.5-2.0 cm

b. 2.0-2.5 cm

c. 2.5-3.0 cm

d. 3.0-3.5 cm

ans- b

12. In case of the technique for fingers(without cold stress), what is the width of the cuff is

usually used for the toes?

a. 2.4-3.0 cm

b. 2.0-2.6 cm

c. 3.0-3.6 cm

d. 1.4-2.0 cm

ans- a

13. The fingers are long enough.So how many cuffs can be applied to obtain two levels of

volume plethysmographic waveforms?

a. one

b. two

c. three

d. four

ans- b

14. In case of the technique for fingers(with cold stress),after resting study is performed how

long the feet or hands are immersed in cold water if the patient can tolerate it?

a. two minutes

b. three minutes

c. four minutes

d. five minutes

ans- a

15. In case of normal plethysmographic waveform qualities, which of the following is not

suitable?

a. sharp upstroke during peak systole

b. prolonged downstroke

c. reflected wave approximately half way down

d. amplitude is greater in toe than fingers

ans- d

16. In case of abnormal obstructive waveform qualities, which of the following is not

suitable?

a. waveform is present with functional obstructive disease

b. slow upslope to a rounded peak

c. amplitude is greater in fingers than toe

d. downslope that blows away from baseline

ans- c

17. In case of abnormal peaked waveform qualities, which of the following is not suitable?

a. upslope is slower than normal

b. sharp, anactoric notch is present

c. Dictoric notch located high on the downslope

d. has no characteristics of normal and obstructive waveform

ans- d

18. In case of systolicpressure measurements, what is the measurement of finger/brachial

indices that characterize normal upper extremitydigits?

a. 0.6-0.7

b. 0.7-0.8

c. 0.8-0.9

d. 0.9-1.0

ans- c

19. In case of systolicpressure measurements,what percentage of normal values exceed an

index of 0.79?

a. 60%

b. 70%

c. 80%

d. 90%

ans- d

20. In case of systolicpressure measurements,what index value is exceeded by 90% of

normal values?

a. 0.69

b. 0.79

c. 0.89

d. 0.99

ans- b

21. In case of systolicpressure measurements, the presence of artifactually high ankle

pressures from arterial calcinosis usually negates a toe/ankle pressure index.According

to the literature,normal toe pressures vary from-

a. 30%-40%

b. 50%-70%

c. 60%-80%

d. 70%-90%

ans- c

Ch 11

1. Which technique helps to determine wound healing and amputation level and reflects the tissue oxygen tension that depends on the balance between oxygen supply and consumption?a. laser Dopplerb. transcutaneous oximetry c. Doppler shiftd. plethysmography in combination with Doppler segmental pressureans- b

2. Transcutaneous oximetry (tc PO2) helps to determine wound healing and amputation level. Which of the followings is not a limitation of transcutaneous oximetry (tc PO2)?a. inability to keep the electrode fairly flat on the skin surfaceb. inability of a patient to lie quietly as long as 20 minutesc. reflects tissue oxygen tensiond. electrode cannot be placed on skin that is not intactans- c

3. During Transcutaneous oximetry (tc PO2) patient should be warm and quiet. What should be the ambient room temperature? a. should not exceed 20 degrees Cb. 20 degrees Cc. more or less 20 degrees Cd. should not exceed 20 degrees Cans- d

4. Transcutaneous oximetry (tc PO2) reflects tissue PO2, which depends on a balance between oxygen consumption and oxygen supply. When does PO2 can be measured to within 1-2 % of its true value on the surface of the skin?a. if a patient lie quietly as long as 20 minutesb. if a correctly calibrated electrode is usedc. if electrode fairly flat on the skin surfaced. if the skin is intactans- b

5. During Transcutaneous oximetry (tc PO2) the electrode houses heating element that heats the skin to a temperature of 44-45 degrees C, increasing blood flow and -a. melting a lipid layer in the fatty tissueb. decreases the PO2 near 0 on the surface of the skinc. raises oxygen contentd. moving it to capillariesans- a

6. What is measured by a sensor in the electrode During Transcutaneous oximetry (tc PO2)?a. PO2 on the surface of the skinb. blood flowc. how much oxygen comes through the skind. oxygen contentans- b

7. What is located between a membrane which is attached to the electrode and the skin surface in case of transcutaneous oximetry (tc PO2)?a. sensorb. a self-adhesive molded plastic fixation ringc. electrolyte solutiond. oxygen surfaceans- c

8. The electrode/sensor is gently placed on the skin and turned securely in to the fixation ring. Why is it important that the electrode be as flat as possible against the skin?a. the electrode houses heating element that heats the skinb. so that the electrolyte solution covers the skin inside the fixation ring.c. so that the blood pressure increasesd. decreases the PO2 near 0 on the surface of the skin ans- b

9. After the required manual calibration, within what time PO2 readings are recorded after stabilization, depending on the particular equipment used?a. 15-20 minutesb. 20 minutesc. 20-25 minutesd. 25 minutesans- a

10.The electrode is applied near a wound to determine the probability of healing or at the anticipated level of amputation. Where should not be electrode applied to determine healing potential in toes?a. 5 cm from the toesb. 10 cm below the patellac. 10 cm from the toesd. 10 cm above the patellaans- c

11.Where the sensor of the electrode should not be placed during transcutaneous oximetry (tcPO2)?a. skin close to the boneb. intact skin

c. edematous skind. ulcersans- b

12.What is the PO2 level during transcutaneous oximetry (tc PO2) to perform transcutaneous oximetry with oxygen challenge?a. less than normal onlyb. greater than poorc. greater than normal and poord. less than normal and poorans- d

13.Which of the followings is not one of the steps of transcutaneous oximetry with oxygen challenge?a. electrodes are applied to the chest and to the site of interestb. a few drops of electrolyte solution are put inside the plastic ringc. oxygen per masked is administered to the patientd. PO2 values are obtainedans- b

14.What should be the measurement of increase of oxygen challenge if the PO2 level is normal (60-80mmHg)?a. 10-20 mmHgb. 30-40 mmHgc. 20-30 mmHgd. 10-30 mmHgans- a

15. In case of poor PO2, oxygen challenge would not increase this value to normal; there may be a slight increase or none at all. What is the value of poor PO2?a. 10-20 mmHgb. 30-40 mmHgc. 10-15 mmHgd. 15-20 mmHgans- c

16.What can be suggested if a patient has a poor PO2 reading below the knee but a better one above the knee?a. above-knee amputation are less likely to healb. below-knee amputation are less likely to healc. above-knee amputation are more likely to heald. below-knee amputation are more likely to healans- c

17.What can be suggested if a patient has a poor PO2 reading at the site of a wound or arterial ulceration?a. wound less likely to heal

b. wound will not healc. wound more likely to heald. ulcer less likely to healans- b

18. If a patient’s PO2 falls in between normal and poor, oxygen challenge is the appropriate next step. If a patient’s initial reading is 20 mmHg, what is possible to happen following oxygen challenge?a. it could decrease to 10 mmHgb. it could increase to 30 mmHgc. it could decrease than 20 mmHgd. it could increase to 30 mmHgans- d

19. If a patient’s PO2 falls in between normal and poor, oxygen challenge is the appropriate next step. After oxygen challenge the chest electrode should always -a. remain constantb. increasec. decreased. same as beforeans- b

20.There are many factors that affect the measured tcPO2 value, which of the following two are the most important factors?a. arterial PO2 and capillary temperatureb. skin composition and blood flowc. arterial PO2 and skin blood flowd. . skin composition and capillary temperatureans- c

21. In case of which disease a low tcPO2 can be interpreted as reduced arterial PO2?a. artery diseaseb. cardiac diseasec. pulmonary disease d. cardiopulmonary diseaseans- d

Chap12

1. Which one of the following is not the capabilities of duplex scanning and color flow

imaging of the upper extremities?

a. localize arterial stenosis

b. determine the presence or absence of aneutysm

c. detect arterivenous fistulas

d. IV site imaging is present

ans-d

2. Which oneghi of the following is not the limitation of duplex scanning and color flow

imaging of the upper extremeties?

a. presence of dressings,skin staples,sutures or open wounds

b. evaluation of hemodialysis access graft

c. presence of IV site

d. diagnosis of Raynoud’s syndrome

ans-b

3. Which one of the following is not included in the positioning of the patient of duplex

scanning and color flow imaging of the upper extremeties?

a. patient is supine with small pillow under the head

b. extremity is positioned close to the examiner

c. the arm is positioned at approximately a 80 degree angle from body

d. the patient should be kept in pledge position

ans-c

4. In the technique, the neck vessels are identified,with attention given to the innominate

artery on the right.Which common carotid artery arises from the arotic arch?

a. left

b. right

c. front

d. back

ans-a

5. Duplex scanning (with or without color flow imaging) is performed at an order.Which of

the following is the right order?

a. subclavian> brachial>radial> axillary>ulnar>palmar

b. subclavian>ulnar >axillary>brachial>radial >palmar

c. subclavian>axillary>brachial>radial>ulnar>palmar

d. subclavian>ulnar>axillary>brachial>radial> palmar

ans-c

6. In case of duplex scanning and color flow imaging of the upper extremeties, how the

hemodialysis grafts are evaluated?

a. identify and evaluate outflow artery

b. identify and evaluate inflow artery

c. identify and evaluate arterial anastomosis

d. identify and evaluate body of the graft

ans-a

7. In case of duplex scanning and color flow imaging of the upper extremeties, how the

hemodialysis grafts are evaluated?

a. if color flow imaging is available,observe the image

b. observe the aneurysm

c. identify and evaluate venous anastomosis

d. identify and evaluate inflow vein

ans-d

8. For stenosis, there are no criteria for classifying upper extremity disease as there are for

the lower extremities.Besides peak systolic velocities vary widely with changes in -

a. body temperature

b. skin temperature

c. blood temperature

d. plasma temperature

ans-b

9. Interpretation of duplex and color flow findings is similar to that for other arterial

systems.If there is a hemodynamically significant stenosis present, what happens to the

stenosis profisle?

a. must exist

b. should exist

c. may not exist

d. must not exist

ans-b

10. For the occlusion, it is not uncommon for nerves,tendons, and veins to be mistaken for

an occluded artery.What can be the effect of warming the extremity?

a. can decrease possibility of false-negative information

b. can decrease possibility of positive information

c. can decrease possibility of false-positive information

d. can increase possibility of false-positive information

ans-c

11. In case of hemodialysis access graft findings,which one of the following should not be

identified and documented as to location,extent and type?

a. puncture sites

b. thrombus

c. aneurysmal fixation

d. perigraft fluid

ans-c

12. A low peak systolic velocity associated with poor-quality Doppler signals obtained

throughout the access graft could suggest an-

a. arterial inflow problem

b. arterial outflow problem

c. arterial inflow solution

d. arterial outflow solution

ans-a

13. Occlusion of a fistula or graft obviously prevents successful dialysis.Oftentimes,the

dialysis nurse will have to trouble accessing the fistula or graft.What is it referred for the

patient?

a. to continue

b. to test again

c. duplex evaluation

d. to start over the process

ans-c

14. Volume flow measurement is a method to evaluate dialysis access function.Which of the

following is not true about volume flow measurement?

a. it can be quite variable

b. it gives exact measurement

c. it depends on several factors

d. the evaluation may not be true

ans-b

15. In case of other hemodynamic complications, large blood volumes are shunted from the

artery to the low-resistance venous circulation.What can cause the congestive heart

failure?

a. decreased arterial return

b. increased arterial return

c. decreased venous return

d. increased venous return

ans-d

16. What kind syndrome there can be whereby the distal arterial (high-pressure) blood flow

is reversed into the low resistance (low-pressure) venous circulation?

a. Steal syndrome

b. Sterotonin syndrome

c. Straight back syndrome

d. Barlow syndrome

ans-a

17. In case of other hemodynamic complications, which of the following is not the symptom

of steal syndrome?

a. distal to the shunt

b. pallor

c. coolness of skin

d. increased pulses

ans-d

18. For brachial artery reactivity testing, the patient should be fasting,relaxed and

supine.Reactive hyperemia is induced by inflating a cuff on the forearm(or the upper

arm) to -

a. 150 mmHg

b. 200 mmHg

c. 250 mmHg

d. 300 mmHg

ans-c

19. For brachial artery reactivity testing, the patient should be fasting,relaxed and

supine.What is the time limit for reactivating hyperemia which is induced by inflating a

cuff on the forearm(or the upper arm) to 250 mmHg?

a. 3-3.5 minutes

b. 3.5-4 minutes

c. 4-4.5 minutes

d. 4.5-5 minutes

ans-d

20. In case of brachial artery reactivity testing, what is the rate of increasing of the diameter

of a brachial artery that has a healthy endothelium when the cuff is on the upper arm?

a. by ≥ 5%

b. by ≥ 10%

c. by ≥ 15%

d. by ≥ 7%

ans-b

21. In case of brachial artery reactivity testing, what is the rate of increasing of the diameter

of a brachial artery that has a healthy endothelium when the cuff is on the forearm?

a. at least 4%

b. at least 5%

c. at least 6%

d. at least 7%

ans-c

Ch 13

1. Which of the followings presence or absence is not determined by using duplex scanning and color flow imaging?a. greater than 50% diameter reduction of stenosisb. arterial diseasec. aneurysmsd. greater than 50% diameter reduction of occlusionsans- b

2. What can be localized by using duplex scanning and color flow imaging of the lower extremities?a. level of obstructionb. tissue oxygen tensionc. stenotic lesion d. arterial stenosisans- c

3. Which one of the followings is not one of the limitations that could stop duplex scanning and color flow imaging technique from being performed?a. incisional tenderness,hematomsb. presence of IV sitec. presence of dressing, skin staples or open woundsd. obesityans- b

4. Which of the following positioning is not appropriate for patient to perform duplex scanning and color flow imaging of the lower extremities technique?a. the patient’s hip is minimally rotated externally, with his or her knee slightly flexedb. the patient is supine with pillow under the headc. the patient’s hip is minimally rotated externally with knee slightly bentd. the extremity to be examined is positioned as close as possible to the examinerans- c

5. Why prone positioning of the patient is necessary during performing duplex scanning and color flow imaging of the lower extremities technique?a. to access the popliteal arteryb. to access the peroneal arteryc. to access the pulmonary spaced. to access the femoral arteryans- a

6. The simplified explanation of the Doppler equation that follows serves as a reminder of the importance of understanding each component as well as the

significance of utilizing an appropriate Doppler angle. This is not applicable to -a. abdominal vesselsb. arteriesc. tissued. peripheral vesselans- c

7. What is the Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference?a. ∆f= Fo V/c Cos θb. ∆f=2Fo V Cos θ/cc. Fo= 2∆f Cos θ/cd. ∆f = 2Fo c Cos θ/Vans- b

8. What is the meaning of ∆f in Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference?a. carrier frequencyb. frequencyc. speed of ultrasound in tissued. Doppler frequency shiftans- d

9. What is the meaning of Fo in Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference?a. frequencyb. Doppler frequency shiftc. carrier frequencyd. velocityans- c

10.What is the meaning of c in Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference?a. frequencyb. carrier frequencyc. Doppler frequency shiftd. speed of ultrasound in tissueans- d

11.What must be known to calculate velocity in Doppler equation for duplex scanning and color flow imaging technique?a. speed of ultrasound in tissueb. Doppler frequency shiftc. carrier frequencyd. angle between the ultrasound beam and the blood flowans- b

12.Which of the following is not one of the terms that are used to represent Fo in Doppler equation for duplex scanning and color flow imaging technique?a. transducerb. carrier frequencyc. frequency shiftd. stationary sourceans- c

13.Which of the following is represented by Fo in Doppler equation for duplex scanning and color flow imaging technique?a. round trip of the ultrasoundb. speed of ultrasound in tissuec. frequency shiftd. receiverans- a

14.To what the Doppler frequency shift in Doppler equation for duplex scanning and color flow imaging technique is proportional?a. round trip of the ultrasoundb. variables in the numeratorsc. speed of ultrasound in tissued. carrier frequencyans- b

15.What is the variation of the Doppler equation in duplex system to calculate velocity in case of duplex scanning and color flow imaging of the lower extremities?a. V=Fo Cos θ/ c ∆fb. V= c ∆f/Fo Cos θc. V= 2Fo Cos θ/ c ∆fd. V=c ∆f/2Fo Cos θans- d

16.What is the source of error for calculating velocity from the variation of the Doppler equation in duplex system?a. Doppler frequency shiftb. Doppler anglec. speed of ultrasoundd. carrier frequencyans- b

17.To what velocity (V) in the variation of the Doppler equation in duplex system is directly proportional?a. ∆f and Fob. Fo and Cos θc. c and ∆f

d. c and Cos θans- c

18.To what velocity (V) in the variation of the Doppler equation in duplex system is inversely proportional?a. Fo and Cos θb. c and Cos θc. ∆f and Fod. c and ∆fans- a

19.What should the Doppler angle be when acquiring velocity information in vascular ultrasound?a. 90 degreesb. 45 degreesc. 120 degreesd. 60 degreesans- d

20.What is well known to prevent usage of 60 degrees Doppler angle for acquiring velocity information in vascular ultrasound and likely to produce Doppler angles of much less than 60 degrees?a. aortoiliac duplexb. vessel curvaturec. stationary sourced. systolic velocityans- b

21.Which of the following vessels are not scanned by the examiner with 7 or 5 MHz linear array transducer using duplex ultrasonography with or without color imaging?a. distal external iliac arteryb. proximal-distal arteryc. ulnar arteryd. common femoral arteryans- c

22.The arteries are scanned by the examiner with 7 or 5 MHz linear array transducer using duplex ultrasonography. What can you assume if the artery is assessed in gray scale? a. normalb. can be normal or abnormalc. plaqued. nothingans- c

23.Peak systolic is measured in each major vessel. What is the meaning of Doppler signals is characterized as monophasic?a. normal b. abnormalc. can be normal or abnormald. nothingans- b

24.Peak systolic is measured in each major vessel. What is the meaning of Doppler signals is characterized as triphasic?a. normal b. abnormalc. can be normal or abnormald. nothingans- a

25.Which of the following is not obtained when a greater than 50% diameter reduction is suspected on the basis of peak systolic velocity and the color flow and/or gray scale image?a. poststenotic signalsb. prestenotic peak systolic velocityc. systolic velocity in the stenotic segmentd. duplex color flow image with spectral waveformsans- d

26.There many types of grafts. Gore-Tex is an example of which type of grafts?a. in situ vein graftsb. reversed saphenous vein graftc. synthetic graftsd. in situ bypass graftsans- c

27.Which of the following sites are not imaged in gray scale and color for synthetic bypass grafts and not obtain peak systolic velocities?a. proximal anastomosisb. anterior tibial arteryc. mid graftd. distal native arteryans- b

28.For vein grafts, all of the aforementioned sites are examined. In addition, the length of the graft is carefully assessed and check for the presence of patent branches that could possibly not form -a. AV fistulasb. stenosis

c. valve cusp sitesd. anastomosisans- d

29.Why it is helpful to know what type of bypass graft was implanted and where the bypass graft was anastomosed proximally and distally?a. for future follow upb. to decrease the frustration level of the technologist/sonographer c. to harvest the saphenous veind. to assess the length of the graftans- b

30.Normal Doppler signals are triphasic. Biphasic signals can be significant although some patients will normally have biphasic flow signals without any evidence of significant - a. stenosisb. occlusive diseasec. arterial disease d. cardiac diseaseans- c

31.The prestenotic peak systolic velocity is compared to the stenotic peak systolic velocity and a ratio is calculated. What is suggested by an increase in velocity greater than 100%?a. a greater than 75% diameter increaseb. a greater than 50% diameter reductionc. a greater than 75% diameter reductiond. a greater than 50% diameter increaseans- b

32.The prestenotic peak systolic velocity is compared to the stenotic peak systolic velocity and a ratio is calculated. What is suggested by a prestenotic to stenotic PSV ratio greater than 4:1?a. a greater than 50% diameter reductionb. increase in velocity greater than 100% c. a greater than 50% diameter increased. a greater than 75% diameter reductionans- d

33.The prestenotic peak systolic velocity is compared to the stenotic peak systolic velocity and a ratio is calculated. What is suggested by a stenotic PSV greater than 400 cm/sec?a. increase in velocity greater than 100%b. a greater than 50% diameter reductionc. a greater than 75% diameter reduction

d. a prestenotic to stenotic PSV ratio greater than 4:1ans- c

34. In where significant stenosis and occlusions commonly do occur at the level of the adductor canal or Hunter’s canal?a. distal superficial femoral artery and proximal popliteal arteryb. proximal native artery and distal native arteryc. deep femoral artery and common femoral arteryd. anterior tibial artery and posterior tibial arteryans- a

The most important e lemen t in the serial assessment of bypass grafts is the comparison of the current study to previous studies. Observe for significant changes. Which of the followings is not fall in to the significant changes? a. A decrease in ABI of greater than 0.15*b. a stenotic PSV greater than 400 cm/secc. A decrease of 30 cm/sec PSV in any graft segmentd. A change in qualityans- b

35.What will be affected by discrepancies in size (vessel diameter) between the graft and the native artery-as well as variations within the vein graft?a. stenotic peak systolic velocityb. velocity of blood flowc. velocity of ultrasoundd. prestenotic peak systolic velocityans- b

36.Postoperative complications of a vein bypass graft Include arteriovenous fistula a n d an intact valve cusp. What can a arteriovenous fistula do?a. produce stenosisb. produce occlusionc. siphon off graft blood volumed. increase in velocity greater than 100%ans- c

37.What is the accepted criterion for the ultrasonographic diagnosis of an aneurysm?a. increase in diameter 50%b. less than the native arteryc. increase in diameter 75%d. greater than popliteal arteryans- a

38.Pseudoaneurysm can also occur in native arteries subsequent to a catheter procedure. Which is not a catheter procedure

a. angiographyb. heart catheterizationc. traumad. ultrasonographyans- d

39.Which of the followings is not a major intraoperative application of duplex scanning and color flow imaging?a. to identify and evaluate any suspicious turbulent areas in the vein bypass graftb. check the patency of the anastomotic sitesc. to identify and evaluate any suspicious occlusion in the vein bypass graftd. to identify and evaluate any suspicious stenotic areas in the valve sitesans- c

40.No matter which kind of vein graft has been placed the entire length of the graft must be assessed. What is important for in situ graft during evaluation?a. the anastomotic sites must be carefully evaluatedb. to observe for branches that may not have been ligatedc. to check the patency of the anastomotic sitesd. to identify and evaluate any suspicious turbulent areas in the vein bypass graftans- b

Chap14

1. In which part the duplex scanning and color flow imaging of the abdominal vessels is needed to determine the presence/absence of significant stenosis,follow up bypass grafts and evaluate aneurysms?a. renal arteryb. liverc. aortoiliac vesselsd. kidneyans-c

2. In which part the duplex scanning and color flow imaging of the abdominal vessels is needed to determine the presence/absence of significant stenosis,which may account for or cause mesenteric bowel ischemia?a. mesenteric arteriesb. liverc. aortoiliac vesselsd. renal arteryans-a

3. Which one of the following is not the limitation of duplex scanning and color flow imaging of the abdominal vessels?a. bowel gasb. previous abdominal surgeryc. nonfasting patientd. regular breath and respirationans-d

4. Which one of the following is the right patient positioning of duplex scanning and color flow imaging of the abdominal vessels?a. LLD for access to the left flankb. LLD for access to the right flankc. RLD for access to the right flankd. supine,with head elevation of 45 degreeans-b

5. What kind of transducer and duplex ultrasonography with or without color flow imaging is used for general remarks by the examiner who begins scanning for the vessels of interest?a. 2.25 MHz transducerb. 4.25 MHz transducerc. 6.25 MHz transducerd. 4 MHz transducerans-a

6. What kind of transducer and duplex ultrasonography with or without color flow imaging is used for children or thin elderly by the examiner who begins scanning for the vessels of interest?a. 2.25 MHz transducerb. 3 MHz transducerc. 4 MHz transducerd. 7 MHz transducerans-d

7. Combining longitudinal and transverse approaches,and other approaches,as necessary,the examiner evaluates the gray scale and color flow patterns,observing for

aneurysm,plaque and other pathologies and findings.The transverse approach includes-a. 30 degree viewb. 45 degree viewc. 60 degree viewd. 90 degree viewans-d

8. Using longitudinal approach in order to accurately and appropriately set the Doppler angle,the examiner also assesses the Doppler waveform qualities,peak systolic velocity and when appropriate, the end diastolic velocity of the arteries under examination.What is the Doppler angle?a. ≤ 600

b. ≤ 500

c. ≤ 400

d. ≤ 300

ans-a9. In case of aneurysm of aortoiliac arteries,for the aorta,what is the qualified dialation of

designation as an aneurysm?a. ≥ 1 cmb. ≥ 2 cmc. ≥ 3 cmd. ≥ 4 cmans-c

10. For the aorta, a dilation of greater than 3 cm qualifies for designation as an aneurysm.In general, what percentage of increase in diameter qualifies an artery as aneurysmal?a. 20% or moreb. 30% or morec. 40% or more d. 50% or moreans-d

11. It is helpful to know that many of the patients undergoing this study present with hypertension(controlled or not well controlled) and that many of these hypertensive patients have-a. Heart attackb. Cerebral hemorrhagec. renovascular hypertensiond. Strokeans-c

12. In case of renal artery and kidney-technique,the aorta is evaluated proximally as needed.How the peak systolic velocity of the aorta is obtained?a. proximal to the inferior mesenteric arteryb. distal to the inferior mesenteric arteryc. proximal to the superior mesenteric arteryd. distal to the superior mesenteric arteryans-d

13. In case of renal artery and kidney-technique,using a transverse approach,the examiner locates the renal arteries.What is a good landmark for identifying the left renal artery?a. left brachial veinb. left renal vein c. left axillary veind. left femoral veinans-b

14. The renal arteries and kidney arteries(i.e., segmental,interlobar) are normally characterized by their low-resistance .Which of the following artery is not included with normally low-resistance flow patterns?a. celiac arteryb. hepatic arteryc. splenic arteryd. common carotid arteryans-d

15. In case of renal artery and kidney-technique,how the renal-to-aortic ratio(RAR) is calculated?a. (Renal artery PSV/Aortic PSV)b. (Renal artery PSV+Aortic PSV)/2c. (Renal artery PSV-Aortic PSV)/2d. (Renal artery PSVxAortic PSV)ans-a

16. The renal-to-aortic ratio(RAR) is calculated by dividing the highest peak systolic velocity of the renal artery by the peak systolic velocity of the aorta.What is the normal interpretation?a. < 2.5b. < 3.5c. < 4.5d. < 5.5ans-b

17. The renal-to-aortic ratio(RAR) is calculated by dividing the highest peak systolic velocity of the renal artery by the peak systolic velocity of the aorta.What is the abnormal interpretation?a. ≥ 2.5b. ≥ 3.5c. ≥ 4.5d. ≥ 5.5ans-b

18. The renal-to-aortic ratio(RAR) is calculated by dividing the highest peak systolic velocity of the renal artery by the peak systolic velocity of the aorta.What is indicated by the abnormal interpretation?a. 40% or greater diameter reductionb. 50% or greater diameter reductionc. 60% or greater diameter reductiond. 70% or greater diameter reductionans-c

19. The RAR may not be accurate in the presence of an aortic aneurysm or when the peak systolic velocities af the aorta are-a. < 20 cm/secb. < 30 cm/secc. < 40 cm/secd. < 50 cm/secans-c

20. The RAR may not be accurate in the presence of an aortic aneurysm or when the peak systolic velocities af the aorta are-a. > 60-70 cm/secb. > 70-80 cm/secc. > 80-90 cm/sec

d. > 90-100 cm/secans-d

21. The RAR may not be accurate in the presence of an aortic aneurysm or when the peak systolic velocities af the aorta are < 40 cm/sec or > 90-100 cm/sec.In either scenario,what is the peak systolic velocities along with poststenotic turbulence is considered by some to be abnormal?a. ≥ 90-100 cm/secb. ≥ 140-1600 cm/secc. ≥ 160-180 cm/secd. ≥ 180-200 cm/secans-d

22. The kidney is examined for morphologic abnormalities (cyst,cortex thinning,other defects).What is the range of normal pole-to-pole measurements of length?a. 8-10 cmb. 10-12 cmc. 12-14 cmd. 11-13 cmans-b

23. The arteries of the kidney (i.e.,segmental,interlobar,arcuate) are normally characterized by their low resistance.Ratios such as end diastolic ratio(EDR)-also known as the parenchymal resistance ratio(PRR) can be applied to determine if flow resistance has increased.How is it measured?a. (End diastolic velocity-Peak diastolic velocity)/2b. (End diastolic velocity/Peak diastolic velocity)x0.5c. (End diastolic velocity+Peak diastolic velocity)/2d. (End diastolic velocity/Peak diastolic velocity)ans-d

24. The arteries of the kidney (i.e.,segmental,interlobar,arcuate) are normally characterized by their low resistance.Ratios such as end diastolic ratio(EDR)-also known as the parenchymal resistance ratio(PRR) can be applied to determine if flow resistance has increased.What is the normal measurement?a. > 0.2b. > 0.3c. > 0.4d. > 0.5ans-a

25. The arteries of the kidney (i.e.,segmental,interlobar,arcuate) are normally characterized by their low resistance.Ratios such as end diastolic ratio(EDR)-also known as the parenchymal resistance ratio(PRR) can be applied to determine if flow resistance has increased.What is the abnormal measurement?a. < 0.2b. < 0.3c. < 0.4d. < 0.5ans-a

26. For the lesser degree, to determine whether resistance is increasing in the kidney (specially the transplanted kidney) is Pourcelot’s ratio/resistivity index(RI).How is it calculated?a. (PSV+EDV)PSVb. (PSV-EDV)PSVc. (PSV-EDV)/PSV

d. (PSV+EDV)/PSVans-c

27. For the lesser degree, to determine whether resistance is increasing in the kidney (specially the transplanted kidney) is Pourcelot’s ratio/resistivity index(RI).What is the normal range?a. < 0.5b. < 0.6c. < 0.7d. < 0.8ans-c

28. For the lesser degree, to determine whether resistance is increasing in the kidney (specially the transplanted kidney) is Pourcelot’s ratio/resistivity index(RI).What is the abnormal range?a. ≥ 0.7b. ≥ 0.8c. ≥ 0.9d. ≥ 0.10ans-a

29. Suppose, we get from Doppler findings:PSV=60,EDV=15 and End diastolic ratio=0.25.What is the resistivity index(RI)?a. 0.55b. 0.65c. 0.75d. 0.85ans-c

30. The renal resistanceindex value(RRIV) uses the peak systolic velocity and the end diastolic velocity obtained from the kidney’s segmental arteries.What is the value of lower resistance which is associated with improvement in both blood pressure and renal function after the correction of renal artery stenosis?a. < 80b. < 70c. < 60d. < 50ans-a

31. The renal resistanceindex value(RRIV) uses the peak systolic velocity and the end diastolic velocity obtained from the kidney’s segmental arteries.How RRIV is calculated?a. (1-EDV/PSV)x100b. (EDV/PSV-1)x100c. (1-EDV)/PSVx100d. (1+EDV/PSV)x100ans-a

32. The acceleration time is the time interval from the onset of the systole to the initial peak and is reported in milliseconds(msec).A proximal stenosis of ≥ 60% diameter reduction is most likely to produce an AT of-a. ≥ 70 msecb. ≥ 80 msecc. ≥ 90 msecd. ≥ 100 msecans-d

33. The acceleration index describes the slope of the Doppler velocity waveform.It is calculated as the change in velocity between the onset of systole and the systolic peak

divided by the AT.What is the unit of measure for AI?a. cm/secb. cm/sec2

c. cm2/secd. cm2/sec2

ans-b34. The acceleration index describes the slope of the Doppler velocity waveform.It is

calculated as the change in velocity between the onset of systole and the systolic peak divided by the AT.How a positive result is defined?a. ≤ 291 cm/sec2

b. ≤ 270 cm/sec2

c. ≤ 245 cm/sec2

d. ≤ 279 cm/sec2

ans-a35. Suppose a patient has come who present with a history of dull,achy or crampy

abdominal pain 15-30 minutes after meals ma suffer from mesenteric ischemia.It is also known as mesenteric angina.After fasting study, the patient is given high calorie liquid meal.When the study is repeated again?a. 10-20 minutes after the mealb. 20-30 minutes after the mealc. 30-40 minutes after the meald. 15-35 minutes after the mealans-b

36. In case of mesenteric arteries interpretation,at which range the published variances of peak systolic velocity in the celiac artery vary with end diastolic velocities of ≤ 55 cm/sec?a. 80 to 160 cm/secb. 50 to 100 cm/secc. 50 to 160 cm/secd. 40 to 120 cm/secans-c

37. In case of mesenteric arteries interpretation, the published variances of peak systolic velocity in the celiac artery vary from 50 to 160 cm/sec with end diastolic velocities of-a. ≤ 55 cm/secb. ≤ 45 cm/secc. ≤ 35 cm/secd. ≤ 25 cm/secans-a

38. In case of mesenteric arteries interpretation, the published variances of peak systolic velocity in the celiac artery vary from 50 to 160 cm/sec with end diastolic velocities of ≤ 55 cm/sec.What is the abnormal fasting peak systolic velocity at ≥ 70-99% diameter reduction?a. ≥ 125 cm/secb. ≥ 150 cm/secc. ≥ 175 cm/secd. ≥ 200 cm/secans-d

39. In case of mesenteric arteries interpretation, the published variances of peak systolic velocity in the celiac artery vary from 50 to 160 cm/sec with end diastolic velocities of ≤ 55 cm/sec.An abnormal fasting peak systolic velocity of ≥ 200cm/sec is predictive of a a. 40-69% diameter reduction

b. 50-79% diameter reductionc. 60-89% diameter reductiond. 70-99% diameter reductionans-d

40. In case of mesenteric arteries interpretation,at which range the published variances of peak systolic velocity in the superior mesenteric artery (SMA) vary?a. 90-137 cm/secb. 100-157 cm/secc. 110-177 cm/secd. 120-177 cm/secans-c

41. In case of mesenteric arteries interpretation, published variances of peak systolic velocity in the superior mesenteric artery (SMA) vary from 110-177 cm/sec.What is the meaasurement of abnormal fasting peak systolic velocities of a 70-99% diameter reduction?a. ≥ 225 cm/secb. ≥ 250 cm/secc. ≥ 275 cm/secd. ≥ 295 cm/secans-c

42. In case of mesenteric arteries interpretation, published variances of peak systolic velocity in the superior mesenteric artery (SMA) vary from 110-177 cm/sec.What is the range of diameter reduction at abnormal fasting peak systolic velocities of ≥ 275 cm/sec?a. 40-69% diameter reductionb. 50-79% diameter reductionc. 60-89% diameter reductiond. 70-99% diameter reduction ans-d

43. In case of mesenteric arteries interpretation,additional criteria utilizing the SMA end diastolic velocities has also been validated.What is the best indicator of severe stenosis in the fasting SMA?a. EDV of > 45 cm/secb. EDV of > 35 cm/secc. EDV of > 25 cm/secd. EDV of > 15 cm/secans-a

44. In case of mesenteric arteries interpretation,additional criteria utilizing the SMA end diastolic velocities has also been validated.In a particular case,an EDV of > 45 cm/sec is the best indicator of severe stenosis in the fasting SMA.Also used along with other useful thresholds in identifying patients with severe stenosis:the absence of a triphasic SMA waveform and fasting PSV of-a. > 100 cm/secb. > 200 cm/secc. > 300 cm/secd. > 400 cm/secans-c

45. The celiac artery branches into the hepatic and splenic arteries.The liver and spleen have fixed metabolic requirements and are not likely to be influenced by the postprandial state.What are normally evident in these vessels at all times?a. high peak systolic and end diastolic velocities

b. low peak systolic and end diastolic velocitiesc. high peak systolic and reverse diastolic velocitiesd. low peak systolic and reverse diastolic velocitiesans-a

46. Because of the small caliber, it is quite difficult to locate the inferior mesenteric artery(IMA),which branches off the distal aorta.Easy detection and ultrasonographic dominance of the inferior mesenteric artery may suggest occlusion of the-a. Internal iliac arteryb. Popliteal arteryc. Peroneal arteryd. superior mesenteric arteryans-d

47. Studies indicate that duples evaluation of the mesenteric arteries suggests chronic mesenteric ischemia when there are abnormal findings for at least two of the three mesenteric vessels.Which of the following is not one of them?a. celiac arteriesb. superior mesenteric arteriesc. splenic arteriesd. inferior mesenteric arteriesans-c

48. Liver transplantation is becoming a more frequently utilized procedure to treat patients with end-stage liver disease.What kind of transducer is used in the pre and post operative assessment of these patients?a. 1 or 2 MHz transducerb. 2 or 4 MHz transducerc. 3 or 5 MHz transducerd. 6 or 8 MHz transducerans-c

49. Liver transplantation is becoming a more frequently utilized procedure to treat patients with end-stage liver disease.Which of the following is not included for the preoperative duplex evaluation of candidates for liver transplantation?a. portal veinb. splenic veinc. hepatic veind. renal veinans-d

50. Postoperatively,duplex ultrasonography is used to document patency of portal vein,splenic vein,superior mesenteric vein,hepatic veins,inferior vena cava, and hepatic artery,as well as portal vein flow direction and vessel size.What is the ideal vein size?a. ≤ 0.5-1.0 cmb. ≤ 1-1.5 cmc. ≤ 1.5-2 cmd. 0.5-1.5 cmans-b

51. Posroperative complications include allograft rejection,pseudoaneurysm,hepatic infraction and thrombosis of the portal vein,inferior vena cava, and/or hepatic artery.The hepatic artery inflow becomes crucial to the viability of the-a. liverb. kidney c. appendix

d. heartans-a

52. The location of the hepatic artery provides a challenge to obtaining a proper Doppler angle.If the Doppler angle is high, no flow may be detected because of the poor or nonexistent Doppler shift.What is the hogh range?a. 50-60 degreesb. 60-70 degreesc. 70-80 degreesd. 80-90 degreesans-d

53. In case of renal transplant(Allograft),what kind of transducer is used for duplex evaluation ?a. 3 MHzb. 5 MHzc. 7 MHzd. 9 MHzans-b

54. Which of the following is not the technique of renal transplant-allograft?a. duplex evaluationb. longitudinal and transverse approachesc. B-mode observationd. preoperative followupans- d

55. In case of renal transplant(Allograft),which of the following is not the B-mode sign of rejection?a. increased renal transplant sizeb. decreased renal transplant sizec. increased cortical echogenicityd. hypeochoic regions in the parenchymaans-b

56. With respect to the other vascular complications suplex scanning also has diagnostic value.Its applications include the following except-a. renal artery stenosisb. renal vein thrombosisc. arterivenous thrombosis d. pseudoaneurysmans-c

Ch 15

1. The deep superior epigastric artery is the terminal branch of the internal mammary artery. What is the diameter at its origin?a. about 0.6 mmb. about 1.6 mmc. about o.6 cmd. about 1.6 cmans- b

2. The deep superior epigastric artery is the terminal branch of the internal mammary artery. From where does the deep superior epigastric artery arise?a. internal iliac artery in the lower abdomenb. external iliac artery in the lower abdomenc. internal mammary arteryd. internal iliac artery in the upper abdomenans- b

3. Smaller branches of mammary and iliac arteries anastomose in a region known as the watershed area. Where does this watershed area located?a. between the internal and external iliac arteries in the lower abdomen b. between the internal and external mammary arteriesc. between the superior and inferior epigastric arteriesd. between internal and external iliac arteries in the upper abdomenans- c

4. What is used for the transverse rectus abdominis myocutaneous (TRAM) flap in autogenous breast reconstruction?a. the muscle with best arterial blood supplyb. the muscle with subcutaneous fatc. the muscle with overlying skind. rectus abdominis muscleans- a

5. What type of linear array transducer is used for preoperative epigastric artery mapping technique?a. a 5 MHz linear arrayb. a 5.5 MHz linear arrayc. a 7.5 MHz linear arrayd. a 6.5 MHz linear arrayans- c

6. What type of phase array transducer is used for preoperative epigastric artery mapping technique?a. a 5.5 MHz phase arrayb. a 7.5 MHz phase array

c. a 8.5 MHz phase arrayd. a 5 MHz phase arrayans- d

7. What kind of Doppler is not used to identify location and obtain velocities of the epigastric arteries and their preferators?a. power Dopplerb. laser Dopplerc. low flow setting Dopplerd. color flow Dopplerans- b

8. How deep the epigastric arteries that are located below the skin surface?a. 4-5 cmb. 4 cmc. 3-4 cmd. 1 cmans- c

9. The epigastric arteries are approximately 3-4 cm below the skin surface. What is the diameter of the preferators?a. less than 1 cmb. less than 3cmc. less than 3 mmd. less than 1 mmans- d

10.Which of the following is not responsible for limiting the success of preoperative epigastric artery mapping technique?a. scarringb. presence of dressing, skin staplesc. depthd. effect of radiation treatmentans- b

11.From where the internal mammary artery also known as the thoracic artery does arise?a. arch of the s superficial arteryb. arch of the common femoral arteryc. arch of the subclavian arteryd. arch of the carotid arteryans- c

12.Sonographically, the internal mammary artery appears as a tubular structure and it is characterized by low-resistance flow. What is the diameter of that tubular structure?a. 2 mm

b. 1 mmc. 1 cmd. 2 cmans- a

13.From where radial artery does originate which travels down the lateral side of the forearm in to the hand?a. subclavian arteryb. brachial arteryc. thoracic arteryd. carotid arteryans- b

14.What is used evaluate the brachial, ulnar and radial arteries for gray-scale and Doppler flow qualities in preoperative radial artery mapping technique?a. color flow Dopplerb. laser Dopplerc. duplex ultrasonographyd. ultrasonographyans- c

15.What kind of abnormalities are not generally observed in case of preoperative radial artery mapping techniquea. increased PSVsb. abnormal Doppler qualityc. calcification of the artery walld. abnormal effect of radiation treatmentans- d

16.Preoperative vein mapping may be performed in the upper and/or lower extremities. In the lower extremity, what kinds of veins are mapped to assess their acceptability for use in grafting procedures?a. cephalic veinsb. saphenous veinsc. basilica veinsd. pulmonary veinsans- b

17. In case of preoperative vein mapping in the upper extremities the entire length of the vein is evaluated at increments for compressibility, diameter and continuity. Which are the increments typically?a. high, mid, distal thighb. knee and below kneec. wristd. ankleans- c

18.Preoperative vein mapping may be performed in the upper and/or lower extremities. In the upper extremity, what kinds of veins are mapped to assess their acceptability for use in grafting procedures?a. pulmonary veinsb. great saphenous veinsc. small saphenous veinsd. cephalic veinsans- d

19. In case of preoperative vein mapping in the upper extremities proximal tourniquet often assists with -a. expansion of the vein sizeb. vein wall compressibilityc. coaptation of vein walld. vein wall thickeningans- a

20.Which of the followings can be included as abnormal findings during Preoperative vein mapping in the upper extremity?a. inadequate diameterb. excessive vein wall thickeningc. the basic vein is largerd.incompressibility ans- c

Ch 16

1. Arteriovenous fistulae can be congenital or traumatic. Between which two they set up an abnormal connection and causing rather marked anatomic and hemodynamic changes?a. high pressure venous system and low pressure arterial systemb. low pressure venous system and high pressure arterial systemc. low pressure proximal arterial system and low pressure distal arterial systemd. high pressure proximal arterial system and low pressure distal arterial systemans- b

2. When fistula is located close to the heart, the potential for cardiac failure increases. Which of the followings more likely to cause if fistulae is located peripherally?a. traumab. congestive heart failurec. muscle necrosisd. ischemiaans- d

3. An arteriovenous fistula’s diameter and length predict the resistance it offers. What may be involved by an arteriovenous fistula?a. high pressure arterial system and low pressure venous systemb. arterial system and venous systemc. proximal arteries and distal arteriesd. high pressure proximal arterial system and low pressure distal arterial systemans- c

4. By which of the following flow through the fistula (connection between the artery and the vein) is not usually characterized? a. the flow pattern is often bidirectionalb. elevated peakc. phasicity is presentd. diastolic velocities associated with spectral broadeningans- c

5. Venous flow approaching the AVF has somewhat elevated velocities. Phasicity is present, but the venous signal has somewhat increased pulsatility. Why venous signal has somewhat increased pulsatility?a. because of the mixed arterial and venous flowb. because of the connection with artery via AVFc. because diastolic velocities associated with spectral broadeningd. because a large, chronic fistula tends to elevate venous pressureans- b

6. Venous flow moving away from the AVF has elevated velocities throughout. Phasicity is present, as well as increased pulsatility. Why pulsatility is increased?a. because of the mixed arterial and venous flowb. because a large, chronic fistula tends to elevate venous pressurec. because of the connection with artery via AVFd. because diastolic velocities associated with spectral broadeningans- a

7. What are caused by swelling within the osteofascial compartments of the leg or arm? a. popliteal artery entrapment syndromesb. arteriovenous fistulaec. compartment syndromesd. cystic adventitial diseaseans- c

8. Which of the following is not responsible for causing compartment syndromes which most commonly occur following revascularization to correct prolonged ischemia? a. embolicb. occlusion of the vesselc. bleeding within a compartmentd. traumaticans-b

9. Which one of the followings is a late sign of compartment syndromes which is found after clinical findings?a. loss of pulsesb. paresthesiasc. weakness of involved muscled. tension of the compartmentans- a

10.Following repair of an occluded or traumatized tibial artery, swelling may become evident. Because the compartment is bound by bone, fascia, and interosseous membrane, outward swelling is impossible. Swelling therefore may compress tibial arteries and what is not caused because of this?a. necrosis of the muscles and severe painb. occlusion of the vesselc. foot dropd. neurological changesans- b

11.Which one of the followings is appropriate treatment for compartment syndromes by swelling within the osteofascial compartments of the leg or arm?a. surgical treatment

b. endaterectomyc. sympathectomyd.fasciotomy ans- d

12.With cystic adventitial disease process cystic fluid accumulates in the wall of the peripheral artery. What can be caused by this?a. loss of pulsesb. narrowing of the vesselc. foot dropd. necrosis of the musclesans- b

13.The etiology of cystic adventitial disease – most common in males. What is age range of these males?a. 35-40 yearsb. youngc. 40-50 yearsd. oldans- c

14.Deviating medially around a normally positioned gastrocnemius muscle or the medial head of the gastrocnemius muscle may have an abnormal location. What is caused by this?a. cystic adventitial diseaseb. popliteal artery entrapment syndromesc. compartment syndromesd. thoracic outlet syndromesans- b

15.Popliteal artery entrapment syndromes are most commonly found in males. What is age range of these males?a. 35-40 yearsb. oldc. 40-50 yearsd. youngans- d

16.Young male complains of pain in the calf muscle following exercise. The vascular laboratory findings reveal normal pressures, pulses and plethysmographic waveforms at rest, but appreciably abnormal decrease during active planter flexion or passive dorsiflexion of the foot. From what disease patient is suffering?a. cystic adventitial diseaseb. arteriovenous fistulaec. popliteal artery entrapment syndromes

d. compartment syndromesans- c

17.What occurs when there is neurovascular bundle compression by the shoulder structures (cervical rib, costoclavicular, and scalene muscle)?a. thoracic outlet syndromeb. popliteal artery entrapment syndromesc. compartment syndromesd. arterial compartment syndromesans- a

18.What techniques are utilized to detect arterial changes of a patient suffering from thoracic outlet syndrome?a. arteriographyb. angiographyc. ultrasonographyd. plethysmographic ans- d

19.Patient’s shoulders back with the head turned sharply toward the arm being tested; then turned sharply away from the arm being tested. what is the name of this position?a. causative positionb. Adson maneuver positioningc. Fowler’s positiond. prone positionans- b

20.Which one of the followings is appropriate treatment for thoracic outlet syndrome which occurs when there is neurovascular bundle compression by the shoulder structures? a. surgical treatmentb. endaterectomyc. sympathectomyd.fasciotomyans- a

21.Which of the followings is a clinical presentation of trauma which can cause arterial injuries?a. necrosis of the muscles and severe painb. occlusion of the vesselsc. long bone fractures that secondarily injure vessels d. compression of the popliteal arteryans- c

Ch 17

1. Which one of the followings are not most commonly employed types of arteriography technique?a. intraarterial injectionb. computed tomographyc. intravenous digital technologyd. a rapid film changer techniqueans- c

2. Which artery are the most commonly used and the safest approach for arteriography technique?a. axillary arteryb. common femoral arteryc. superficial arteryd. brachial arteryans- b

3. In arteriography technique once the catheter is positioned properly, a liquid contrast agent is injected and flows with the moving blood. Which of the followings can be imaged in such situation?a. arterial wallb. small vesselc. arterial lumend. collateral vesselsans- c

4. In arteriography technique following removal of the catheter, pressure is applied to the puncture site and patient is positioned for 6-8 hours of bed rest. How patient is positioned?a. proneb. lateral recumbentc. fowler’s positiond. supineans- d

5. By what percentage the diameter of the arterial lumen is decreased by a hemodynamically significant stenosis for many large muscular arteries?a. 75%b. 50%c. 25%d. 60%ans- b

6. Atherosclerotic plaque appears as irregular or smooth negative images on arteriogram wherever the plaque displaces the contrast media. Which of the

followings is not the common location for Atherosclerotic plaque?a. aortic archb. adductor canalc. brachial arteryd. femoral arteryans- b

7. In which location aneurysms are not most commonly develop?a. axillary arteryb. femoral arteryc. infrarenal aorta d. popliteal arteryans- a

8. What may develop along the dilated wall of the aneurysmal artery, creating the appearance of a straight tube on arteriography? a. tortuosity of the vesselb. occlusionc. thrombusd. vasospasmans- c

9. What is appears as severe narrowing of the arterial lumen, usually without occlusion?a. thrombusb. vasospasmc. aneurysmsd. fibromuscular dysplasiaans- b

10.Which are caused by medial hyperplasia and which create the appearance of a “string of beads”?a. aneurysmsb. thrombusc. vasospasmd. fibromuscular dysplasiaans- d

11.There are few limitations of arteriography technique. One of them is it may not be possible to perform arteriography on a paitient who is-a. paitient in kidney failureb. paitient of high blood pressurec. allergic to contrast agentd. claustrophobiaans- c

12.Which the followings are not one of the complications that could arise during arteriography technique?a. pseudoaneurysmsb. kidney failurec. local arterial occlusiond. puncture site hematomaans- b

13.Which technique is capable of distinguishing flood flow from soft tissue without the use of contrast agent?a. magnetic resonance imaging and angiographyb. ultrasoundc. MRId. computed tomographyans- a

14.Which disease can be evaluated by magnetic resonance imaging (MRI) and angiography (MRA)?a. abdominal aortic diseaseb. popliteal arterial diseasec. occlusion diseased. peripheral arterial diseaseans- d

15.What may be overestimated because of nonlaminar or slow flow states, which can result in the loss of the magnetic signals?a. pulsesb. blood pressurec. stenosesd. obstructionans- c

16. It is difficult to undergo the magnetic resonance imaging (MRI) and angiography (MRA) with paitient who has -a. allergy to contrast agentb. claustrophobiac. high blood pressured. occlusionans- b

17.Which one uses ionizing radiation to obtain cross-sectional images of the aorta and other body structures and can be performed with or without the use of contrast agent?a. magnetic resonance imaging and angiography b. MRIc. ultrasound

d. computed tomographyans- d

18.Which of the following technique have to be used to evaluate aneurysms in patient and determine the size of the aneurysms?a. CTb. MRIc. MRAd. Ultrasoundans- a

19.Which one of the followings cannot be evaluated by the computed tomography (CT) technology?a. hemorrhageb. stenosesc. arteriovenous malformationd. cerebral infractionsans- b

20.Surgical treatment is to operate depends on the extent and severity of interest. What are removed by surgical therapy named endarterectomy?a. aneurysmsb. arteriovenous malformationc. atherosclerotic materialsd. cerebral infractionsans- c

21.Surgical treatment is to operate depends on the extent and severity of interest. Which surgical treatment is used to provide an alternate pathway for distal blood flow?a. sympathectomyb. endarterectomy c. fasciotomyd. bypass graftsans- d

22.Which of following vein is not used in surgical therapy, bypass grafts which provide an alternate pathway for distal blood flow?a. axilliary veinb. saphenous veinc. in-situ veind. cephalic veinans- a

23.Surgical treatment is to operate depends on the extent and severity of interest. One of them is bypass graft. Which one of the following is not a common bypass grafts?

a. femoral to poplitealb. aorta to bifemoralc. aorta to axillaryd. femoral to femoralans- c

24.What is used to dilate precisely that segment of a vessel that contains a focal atherosclerotic lesion?a. stents and stents graftb. percutaneous transluminal angioplastyc. embolectomyd. atherectomyans- b

25.What kind of catheter is used in percutaneous transluminal angioplasty technology?a. balloon-tipped catheter b. Foley catheterc. peripheral venous catheterd. a very thin catheterans- a

26.Balloon angioplasty cannot be applied to all vessels or all types of lesions. In which vessels balloon angioplasty cannot be applied?a. popliteal arteriesb. femoral arteriesc. peroneal arteriesd. iliac arteriesans- c

27.Which particular sent has been used to repair specific types of aneurysms disease, especially in the aorta?a. balloon expandable b. covered stentc. thermal expandingd. self-expandingans- b

28.A particular sent has been used to repair specific types of aneurysms disease, especially in the aorta. Which of the followings is not a type of aortic sent graft?a. tube graftsb. aortoiliac graftsc. bifurcated graftsd. self expanding graftsans- d

29.Which are most often used to repair aneurysms disease of the aorta and also to treat stenosis and maintain patency of vessels?a. bypass graftsb. endarterectomyc. stent graftsd. medical therapyans- c

30.Which may identify the complications of endovascular aortic stents including endoleak, graft stenosis or thrombosis, dissection, problems at the attachment sites resulting in migration and twisting of the limbs of a bifurcated graft?a. magnetic resonance imaging and angiographyb. duplex ultrasoundc. computed tomographyd. ultrasonographyans- b

31.Which of the following is a minimally invasive endovascular procedure that may be used in some patients who are not candidates for traditional surgical or endovascular treatment?a. balloon angioplastyb. stent placementc. subintimal angioplastyd. angiographyans- c

32.Which technology is routinely performed for post interventional evaluation of aortic stent grafts?a. computed tomography angiographyb. magnetic resonance imaging and angiographyc. computed tomographyd. duplex ultrasoundans- a

33.Which of the following noninvasive technique is used to evaluate stents (for iliac, renal, femoral arteries) or stents grafts (for aortic aneurysm)?a. computed tomography angiographyb. duplex imagingc. ultrasonographyd. computed tomographyans- b

34.The stent graft is used to repair an abnormal aortic aneurysm. A successful procedure should reduce the size of the aneurismal sac. If blood flow is observed in the sac, or if the size of the sac fails to diminish or grows larger, there could be an endoleak. These leaks are divided into five types. Which of the following leak

is Type III?a. branch leaksb. attachment endoleaks at proximal and distal attachment sitesc. modular connect endoleakd. transgraft endoleaksans- c

35.All leaks are confirmed with spectral Doppler. What kinds of leaks have reproducible arterial waveforms that differ from the graft flow waveforms?a. branch leaksb. attachment endoleaksc. transgraft endoleaksd. true leaksans- d

36.Which of the following technology is used to extract embolus from the affected arterial segment?a. angioplastyb. duplex ultrasoundc. thrombectonomyd. atherectomyans- c

37.What is an alternative percutaneous transluminal angioplasty that cuts through or pulverizes the plaque with a rotational device at the end of the catheter? a. balloon angioplastyb. atherectomyc. subintimal angioplastyd. thrombectonomyans- b

38.Vascular duplex ultrasound is also used to assess patency of the vessel following peripheral endovascular procedures. Protocols vary with regard to frequency of this post procedure evaluation, depending of on the method endovascular intervention. Which of the following is not a method endovascular intervention? a. percutaneous transluminal angioplastyb. atherectomyc. endarterectomyd. stentans- c

39.Which of the following is not a one of the important factors in determining whether a pseudoaneurysm is an appropriate candidate for ultrasound-guided compression?a. pseudoaneursym spontaneously thrombosesb. the size of the pseudoaneurysm

c. ability to uniformly and appropriately compress the neckd. the location of the pseudoaneurysmans- a

40.What is important to do during the pseudoaneursym treatment procedure to determine whether the compressions are working?a. to firmly compress the transducer against the skinb. closing off the neck of the aneurysm for ten minutesc. to observe the duplex or color flow imaged. to observe the native vessels and aneurysmans- c

41.Which system is needed to be observed as it is an important component of overall pseudoaneursym treatment to make certain patency is maintained during the compression maneuver?a. vascular systemb. deep venous systemc. arterial systemd. carotid systemans- b

42.Thrombonin injection is a promising alternative to manual compression techniques in most cases. Which of the followings is not a adverse effect of thrombin to patient?a. allergic to drugsb. clotting mechanismc. anaohylaxisd. microemobolization of pulverized particlesans- d

43.What other option you should chose if the pseudoaneurysm is too large to be repaired by manual compression of the necka. thrombonin injectionb. medical therapyc. surgical treatmentd. do nothingans- c

Ch 18

1. The internal carotid artery originates from common carotid artery and then travels in to the base of the skull. What is the name of the first major branch of internal carotid artery?a. anterior cerebral arteryb. anterior choroidal arteryc. ophthalmic arteryd. posterior communicating arteryans- c

2. Which arteries are given off before the internal carotid artery finally divides into the middle cerebral artery and anterior cerebral artery?a. ophthalmic artery and anterior choroidal artery b. anterior choroidal artery and posterior communicating arteryc. ophthalmic artery and posterior auricular arteryd. anterior choroidal artery and occipital arteryans- b

3. Which of the following distributes blood to the anterior brain, the eyes, the forehead and the nose?a. the common carotid arteryb. the internal carotid arteryc. anterior cerebral arteryd. the external carotid arteryans- b

4. The external carotid artery originates from common carotid artery and gives off eight branches. Which of the following is the branch of external artery?a. anterior choroidal arteryb. ophthalmic arteryc. anterior cerebral arteryd. posterior auricular arteryans- d

5. Which of the following supplies blood to the neck, face and scalp all of which are high-resistance vascular beds?a. the internal carotid arteryb. the common carotid arteryc. the external carotid arteryd. ascending pharyngeal arteryans- c

6. The external carotid artery originates from common carotid artery and gives off eight branches. What is the name of the first major branch of external carotid artery?

a. superior thyroid arteryb. facial arteryc. ophthalmic arteryd. ascending pharyngeal arteryans- a

7. The right and left vertebral arteries are asymmetrical in size with right usually smaller than left. From where do they originate?a. the common carotid arteryb. the subclavian artery c. aortic archd. brachiocephalic artery ans- b

8. What is formed by the union of the right and left vertebral arteries after they enter the skull through the foramen magnum?a. posterior cerebral arteriesb. posterior communicating arteryc. the basilar arteryd. the circle of Willisans- c

9. Which of the following provides an important collateral pathway that maintains blood flow to the brain in cases of stenosis or occlusion?a. posterior cerebral arteriesb. the circle of Willisc. posterior communicating arteryd. the basilar artery ans- b

10.Which of the following vessels is not included as the major branch of the ophthalmic artery?a. the frontal arteryb. the supraorbital arteryc. the nasal arteryd. superior thyroid arteryans- c

11.The supraorbital artery arises from the ophthalmic artery and travels interiorly and superiorly to the globe. Through branches of which artery the supraorbital artery joins the external artery?a. facial arteryb. superficial temporary arteryc. superior thyroid arteryd. maxillary arteryans- b

12.Which of the followings is appropriate intracranial-extracranial anastomosis for the internal carotid artery and the external carotid artery connections?a. the occipital arteries and the atlantic arteriesb. the deep cervical and ascending cervical branchesc. anterior cerebral artery and superior thyroid arteryd. ophthalmic and orbital arteriesans- d

13.Which of the following branches of the cerebral arteries are connected by leptomeningeal collaterals from the meningeal border-zone network?a. chorodial branchesb. occipital cortical branchesc. terminal cortical branchesd. central branchesans- c

14.Poiseuille’s law describes flow through a rigid tube as being parabolic or laminar. Which of the following is the equation of Poiseuille’s law?a. Q=(P)πr4/8ηLb. Q=(P)πr/ηLc. P=(Q)πr4/8ηLd. P=(Q)πr/ηLans- a

15.Poiseuille’s law describes flow through a rigid tube as being parabolic or laminar. To what the quantity of flow is inversely proportional to in Poiseuille’s law?a. pressure gradient across a arterial systemb. measurement of radiusc. the size of the vesseld. viscosity of the fluidans- d

16.Poiseuille’s law describes flow through a rigid tube as being parabolic or laminar. To what the quantity of flow is directly proportional to in Poiseuille’s law?a. viscosity of the fluidb. pressure gradient across a arterial systemc. length of the vesseld. viscosity of the bloodans- b

17.The blood must change direction as the flow stream narrows at the stenosis and enlarges as it exits the stenosis. Velocity increase through a stenosis since-a. velocity and area are directly proportionalb. velocity and radius are directly proportionalc. velocity and area are inversely proportional

d. velocity and radius are inversely proportionalans- c

Ch 19

1. Which of the following is a fleeting neurologic dysfunction without lasting effects and its symptoms usually lasts for a few minutes to a few hours but never more than 24 hours?a. cerebrovascular accidentb. reversible ischemic neurologic deficitc. transient ischemic attackd. vertebrobasilar insufficiencyans- c

2. Which of the following symptoms occur in patients when they are suffering from vertebrobasilar insufficiency?a. motor dysfunction of an armb. paresthesiac. speech impairmentd. monovascular visual disturbancesans- b

3. Which one of the following produces a permanent neurological deficit?a. TIAb. VBIc. CVAd. RIND ans- c

4. Which one may be a causative factor in the development of atherosclerosis or may enhance the development of the atherosclerotic process?a. smokingb. hyperlipidemiac. traumad. Hypertensionans- d

5. The two most common mechanisms of cerebrovascular insufficiency are ischemia and hemorrhage. Due to what hemorrhage can occur?a. stenosisb. ruptured aneurysmc. thromboembolic eventd. embolismans- b

6. The two most common mechanisms of cerebrovascular insufficiency are ischemia and hemorrhage. Which one is not a leading cause of ischemia?a. atherothromboembotic pathologiesb. lacunar strokes

c. ruptured aneurysmd. cardiogenic pathologyans- c

7. Which one of the following is a thin layer of lipid material on the intimal layer of the artery?a. a fibrous plaqueb. a fatty streakc. a complicated lesiond. an ulcerative lesionans- b

8. Which one is an accumulation of lipids that is covered by more lipid material, collagen and elastic fiber deposits?a. a fibrous plaqueb. a fatty streakc. a complicated lesiond. an ulcerative lesion ans- a

9. A fibrous plaque is an accumulation of lipids, which fibrous plaque contains fibrous tissue, more collagen, calcium and cellular debris?a. an ulcerative lesionb. embolismc. a fatty streakd. a complicated lesionans- d

10.What is the name of the fibrous plaque that is characterized by the deterioration of the normally smooth surface of the fibrous cap?a. a complicated lesionb a fatty streak. c. an ulcerative lesiond. embolismans- c

11.What is a piece of thrombus that moves through the circulatory system until it lodges in a distant blood vessel, resulting in complete or partial obstruction of the vessel?a. aneurysmb. embolismc. thrombosisd. a fibrous plaqueans- b

12.The aggregation of blood factors is compressed primarily of platelets trapped within a network of fibrin. What is the name of this aggregation which is one of

the most common causes of stroke? a. embolism b. aneurysm c. thrombosisd. atherosclerosisans- c

13.Which of the following is an abnormal, localized dilation of a blood vessel due to congenital defects or weakness of the vessel wall and may be caused by trauma or infection?a. aneurysmb. thrombosisc. atherosclerosisd. embolismans- a

14.Arteritis is an inflammation of an artery. Takayasu’s arteritis a chronic inflammation that results in narrowing of the arteries. What are involved by typeII lesion?a. pulmonary vesselsb. thoracic and abdominal aortac. aortic arch and its branchesd. superficial temporal arteries and its branchesans- b

15.What may be caused by the inflammation of the distal superficial temporal artery and its branches known as temporal arteritis?a. traumab. infectionc.severe headache d. atherosclerosisans- c

16.What s function as a chemoreceptor sensitive to changes in the oxygen tension of the blood and signals necessary changes in respiratory activities?a. thrombosisb. carotid body tumorc. fibromuscular dysplasiad. aneurysmans- b

17.Tumors are highly vascular structures that develop between the internal and external carotid arteries. What usually feds them?a. the common carotid arteryb. the aortic archc. the internal carotid artery

d. the external carotid arteryans- d

18.What is most commonly caused by trauma that results in a sudden tear in the intimal wall and creates a false lumen?a. carotid body tumorb. fibromuscular dysplasiac. dissectiond. neointimal hyperplasiaans- c

19.Fibromuscular dysplasia most commonly caused by dysplasia of the media along with over growth of collagen. Where does dysplasia occur? a. origin of the vesselsb. mid to distal segment of vesselc. vessel walld. proximal to distal segment of vesselans-b

20.What is a response to vascular injury, which may be result of vascular reconstruction such as carotid ebdarterectomy? a. dissectionb. fibromuscular dysplasiac. carotid body tumord. neointimal hyperplasiaans- d

21.Traumatic damage to vessels and surrounding tissue can produce variety of conditions. Which of the following is not caused due to traumatic damage?a. fibromuscular dysplasiab. occlusionc. dissectiond. pseudoaneurysmans- a

22.Normally anterior vessels – internal carotid, anterior cerebral, middle cerebral and anterior communicating arteries- supply blood to the brain’s cerebral hemispheres. Neurological deficits may be attributing to problems with anterior circulation. Which of the following can be included as problems of anterior circulation?a. diplopiab. bilateral paresthesiac. dysphasiad. vertigoans- c

23. What cause behavioral abnormalities which frequently accompany ischemia of the temporal lobe?a. the ipsilateral carotid arteryb. infraction of the right middle cerebral arteryc. a lesion in the left middle cerebral arteryd. an stroke affecting cerebral cortexans- b

24.Which of the following cause dysphasia (impaired speech) and aphasia (inability to speak) in a right handed person?a. a lesion in the left middle cerebral arteryb. infraction of the right middle cerebral arteryc. an stroke affecting cerebral cortexd. a lesion in the right middle cerebral arteryans- a

25.Normally posterior vessels- vertebral, basilar, posterior cerebral and posterior communicating arteries supply blood to the brain stem, cerebellum, and occipital lobe of brain. Symptoms of brain ischemia may be attributable to the problems of the posterior circulation. Which of the following can be included as problems of posterior circulation? a. dysphasiab. unilateral paresthesiac. bilateral anesthesiad. amaurosis fugaxans- c

26.Which of the following is a frequently seen sign and symptoms of affected artery named vertebrobasilar artery?a. dysphasiab. dysphagiac. paralysisd. dyslexiaans- b

27.Which of the following are a frequently seen sign and symptoms of affected artery named anterior cerebral artery?a. confusional stateb. ipsilateral amaurosis fugaxc. poor coordinationd. impaired motor and sensory functionans- d

28.Which of the following are not a frequently seen sign and symptoms of affected artery named middle cerebral artery?a. behavioral changes

b. dyslexiac. agitated deliriumd. dysarthriaans- b

Ch 20

1. Which examination can detect hemodynamically significant lesion of the internal carotid artery by evaluating the flow to some of its terminal branches around the eye? a. laser Dopplerb. periorbital Dopplerc. Doppler segmental pressured. Doppler shiftans- b

2. What is the frequency of Doppler that is used by an examiner to locate the frontal artery at the inner canthus of the eye? a. 9-10 MHzb. 8-10 Hzc. 8-10 MHzd. 9-10 Hzans- c

3. A series of compression maneuvers are performed to detect the presence of abnormal collateral channels that suggests disease. In which of the following artery these compression maneuvers are not performed both ipsilaterally and contralaterally?a. superficial carotid arteryb. thoracic arteryc. facial arteryd. infraorbital arteryans- b

4. In which of the following situation it can be interpreted that it is normal in case of periorbital Doppler examination?a. compression of the facial, superficial temporal and infraorbital arteries should not diminishb. ipsilateral compression of common carotid artery should diminish in the frontal artery c. antegrate flow should be evident in the frontal arteryd. diminish or reverse flow during compression of facial, superficial temporal and infraorbital arteriesans- d

Ch 21

1. Which of the following detects hemodynamically significant lesions of the internal carotid artery by evaluating flow in one of its terminal branches?a. periorbital Doppler examinationb. plethysmographyc. oculopneumoplethysmographyd. magnetic resonance imaging and angiographyans- c

2. Which technology cannot differentiate occlusion from a tight stenosis and also incapable of determining the ocular systolic pressure in patient with severe headache? a. periorbital Doppler examinationb. oculopneumoplethysmographyc. duplex scanningd. plethysmographyans- b

3. Which of the following technique is a technique that records changes in volume and the fluctuations in volume are related to changes in blood flow during systole or diastole such as when arterial inflow exceeds venous outflow?a. intravenous digital technologyb. angioplastyc. oculopneumoplethysmographyd. plethysmographyans- d

4. A through patient history must be obtained to rule out the contradictions to perform plethysmography test. Which of the followings is not considered as contradiction to perform this test?a. a past spontaneous renal detachmentb. allergies to local anesthesiac. conjunctivitisd. unstable glaucomaans- c

5. What measurement of vacuum maybe required to occlude inflow in a patient with systemic systolic pressure of <140 mmHg?a. 300 mmHgb. 500 mmHgc. 600 mmHgd. 200 mmHgans- a

6. What is the maximum vacuum requirement to occlude inflow in a patient with systemic systolic pressure of >140 mmHg?a. 300 mmHgb. 500 mmHgc. 600 mmHgd. 200 mmHg ans- b

7. When a maximum vacuum of 500 mmHg is usually required to occlude inflow in a patient during plethysmography test?a. systemic systolic pressure of <140 mmHgb. systemic systolic pressure of ≥140 mmHgc. systemic systolic pressure of >140 mmHgd. systemic systolic pressure of ≤140 mmHgans- c

8. The examiner must never compress both common carotid arteries simultaneously. Why the compression is never performed in the area of the carotid sinus?a. increase blood pressureb. loss of pulsesc. alter heart rated. occlusion of vesselsans- c

9. The first phase consists of 3-5 second compression while the OPG maintains an intraocular pressure. What is the measurement of intraocular pressure that is maintained by OPG?a. 300 mmHgb. 60 mmHgc. 500mmHgd. 110 mmHgans- b

10.The second phase is only performed if pulsations are noted during the first phase consists of ≤15 seconds compression while the OPG decreases intraocular pressure. What is the measurement of intraocular pressure that is decreased by OPG?a. 300 mmHgb. 60 mmHgc. 500mmHgd. 110 mmHgans- d

11. In what measurement ophthalmic systolic pressure should not differ to interpret normal in case of oculopneumoplethysmography (OPG)?

a. ≥5 mmHgb. <5 mmHgc. ≤5 mmHgd. >5 mmHgans- a

12.A normal ratio of ophthalmic systemic pressure should exit during oculopneumoplethysmography (OPG). Which one is correct for normal ratio of ophthalmic systemic pressure?a. OSP – 39 ÷brachial systolic pressure (BSP≤ 0.429b. OSP – 39 ÷brachial systolic pressure (BSP) ≥0.429c. OSP – 39 ÷brachial systolic pressure (BSP) ≥ 0.430d. OSP – 39 ÷brachial systolic pressure (BSP≤ 0.430ans- c

13. If the OSP are greater than 140 mmHg, the examiner measures the amplitude of the first pulse. What should be the difference in amplitude of the tracings?a. >2 mmb. <2 mmc. 10 mmd. <10 mmans- b

14.OSP differ by ≥5 mmHg have an abnormal ratio of ophthalmic to systemic pressure. Which of the following is correct form of an abnormal ratio of ophthalmic to systemic pressure?a. OSP – 39 ÷brachial systolic pressure (BSP≤ 0.430b. OSP – 39 ÷brachial systolic pressure (BSP) ≥0.429c. . OSP – 39 ÷brachial systolic pressure (BSP) ≥ 0.430d. OSP – 39 ÷brachial systolic pressure (BSP≤ 0.429ans- d

15. If the OSPs exceed 140 mmHg, the examiner measures the amplitude of the first pulse. What is the difference of amplitude that considered as abnormal?a. ≥ 2 mmb. ≤ 2mmc. >2 mmd. <2 mmans- c

Ch 22

1. What is an accurate means of localizing the presence of arterial disease in the extracranial carotid arteries and can differentiate an occlusion from a tight stenosis? a. oculopneumoplethysmographyb. MR angiographyc. computed tomologyd. Duplex scanningans- d

2. Which of the following factors do not affect adversely to perform duplex ultrasonography?a. patient movementb. the size of the contour in the neckc. stressd. the presence of dressingans- c

3. Which of the following is responsible for both overestimating and underestimating disease by duplex ultrasonography?a. artifact is mistaken as plaqueb. an inappropriate Doppler anglec. a high bifurcation precludes through evaluation of the internal carotid arteryd. hyperemiaans- b

4. What combines physiologic information based on Doppler-shifted frequencies with the anatomic in formation of real time, high resolution, B-mode ultrasonographic imaging?a. color flow imagingb. continuous wave Doppler c. duplex ultrasoundd. color Doppler ans- c

5. Which of the following technology has limited use in carotid evaluation and may be the only means available to accurately display very high velocities such as severely elevated peak systolic velocities in some cases?a. continuous wave Dopplerb. duplex ultrasoundc. pulsed Doppler ultrasoundd. color Dopplerans- a

6. Reproducible and consistent velocity measurements require an angle. What is the value of this required angle?a. zero (0) degreesb.60 degrees c. 45-60 degreesd. 0- 60 degreesans- c

7. What is a method of displaying the variety of frequencies of the flowing blood during systole and diastole?a. color Dopplerb. continuous wave Dopplerc. spectral analysisd. color flow imagingans- c

8. Color flow Doppler information is displayed on the image after it is evaluated for its frequency content and its face. What frequency content is determined?a. intensity of the signalsb. the hue or shade of the colorc. error productiond. direction toward and away from the transducerans- b

9. Which of the following transducer is not used for performing duplex scanning in a patient?a. 7 MHz transducerb. 10 MHz transducerc. 7.5 MHz transducerd. 5 MHz transducerans- a

10.The sample volume of the pulsed Doppler is usually kept as small as possible. What is the sample volume of the pulsed Doppler?a. 0.5-1 mmb. 1-1.5 mmc. 0.5-1 cmd. 1-1.5 cmans- b

11.Reproducible and consistent velocity measurements require an angle. Which of the following angle of insonation provides the greatest Doppler shift but not used in clinical application?a. zero (0) degreesb.60 degrees c. 45-60 degrees

d. 0- 60 degreesans- a

12. In which of the following situation it can be interpretated that B-mode is normal in case of duplex scanning technology?a. low-mid level echoes of similar appearanceb. thrombosisc. A solid color should be evident in the vessel wallsd. calcificationans- c

13.What is the name of the low- medium-level echoes (heterogeneous) indicating soft and dense areas?a. fibrous plaqueb. complex plaquec. fatty streaksd. calcificationans- b

14.Which of the following is characterized as very bright and highly reflective echoes?a. fibrous plaqueb. complex plaquec. fatty streaksd. calcificationans- d

15. In spectral analysis, the band evident along the top of the waveform during systole may fill in the spectral window. This vertical thickening is considered spectral broadening and is consistent with -a. percentage stenosisb. multiple frequenciesc. velocitiesd. phasesans- b

16.An occlusion of which artery is usually consistent with the loss of a diastolic component in the ipsilateral common carotid artery? a. the internal carotid arteryb. posterior auricular arteryc. the external carotid arteryd. anterior cerebral arteryans- a

17.What is the diameter of stenosis if peak systolic frequency is <4khz and peak systolic velocity is <125 cm/sec? a. 16-49%

b. 1-15%c. 50-79%d. 80-99%ans- b

18.What is the diameter of stenosis if peak systolic frequency is >4 kHz, peak systolic velocity is >125 cm/sec, end diastolic velocity is <140, and end diastolic frequency is <4 kHz?a. 16-49%b. 1-15%c. 50-79%d. 80-99%ans- c

19.What is the diameter of stenosis if peak systolic frequency is >4 kHz, peak systolic velocity is >125 cm/sec, end diastolic velocity is >140, and end diastolic frequency is >4 kHz?a. 80-99%b. 16-49%b. 1-15%c. 50-79% ans- a

20.What is the diameter of stenosis if peak systolic frequency, peak systolic velocity, end diastolic velocity and end diastolic frequency are absent?a. occludedb. 1-15%c. normald. 80-99%ans- a

21.Two important clinical trials evaluating the efficiency of carotid endarterectomy established therapeutic benefit for asymptomatic patients and for symptomatic patient. Which of the following is the Asymptomatic Carotid Atherosclerosis Study, ACAS)?a. PSV of ≥290 cm/sec and EDV of ≥ 80 cm/sec is consistent with ≥60% diameter reduction to external carotid arteryb. ICA PSV/CCA PSV ratio ≥ 4 is consistent with ≥60% diameter reduction to external carotid arteryc. PSV of ≥290 cm/sec and EDV of ≥ 80 cm/sec is consistent with ≥60% diameter reduction to internal carotid arteryd. ICA PSV/CCA PSV ratio ≥ 4 is consistent with ≥60% diameter reduction to internal carotid arteryans- c

22.Two important clinical trials evaluating the efficiency of carotid endarterectomy established therapeutic benefit for asymptomatic patients and for symptomatic patient. Which of the following is the North American Symptomatic Carotid Endarterectomy Trial (NASCET)?a. PSV of ≥290 cm/sec and EDV of ≥ 80 cm/sec is consistent with ≥60% diameter reduction to internal carotid arteryb. ICA PSV/CCA PSV ratio ≥ 4 is consistent with ≥60% diameter reduction to external carotid arteryc. PSV of ≥290 cm/sec and EDV of ≥ 80 cm/sec is consistent with ≥60% diameter reduction to external carotid arteryd. ICA PSV/CCA PSV ratio ≥ 4 is consistent with ≥60% diameter reduction to internal carotid arteryans- d

23.The key to successful physician interpretation of carotid duplex exams is the use of consistent protocols and application of validated diagnostic criteria. For what percentage of stenosis Doppler is not accurate for subcategorizing?a. >50%b. ≥50%c. <50%d. ≤ 50%ans- c

24.What is the percentage of diameter reduction if , peak systolic velocity is <125, end diastolic velocity is <40 and ICA/CCA ratio <2?a. <50%b. 50-69%c. 10%d. 70-99%ans- a

25.What is the percentage of diameter reduction if , peak systolic velocity is >230, end diastolic velocity is >100 and ICA/CCA ratio >4?a. >10%b. 70-99%. c. <50%d. 50-69%ans- b

26.What is the percentage of diameter reduction if , peak systolic velocity is 125-230, end diastolic velocity is 40-100 and ICA/CCA ratio 2-4?a.10-50%b. 70-99%. c. <50%

d. 50-69%ans- d

Ch 23

1. What is capable of detecting intracranial stenoses and occlusions and can evaluate the onset, severity and time course of vasoconstriction caused by subarachnoid hemorrhage? a. periorbital Dopplerb. transcarnial Dopplerc. laser Doppler d. power Doppler ans- b

2. What is the frequency of the Doppler that is used in transcarnial Doppler system with spectrum analyzer?a. 4 MHzb. 7.5 MHzc. 5 MHzd. 2 MHzans- d

3. What is the value of assumed angle of insonation that is used in transcarnial Doppler system?a. zero (0) degreesb. 60 degreesc. 45-60 degreesd. 0-60 degreesans- a

4. What is used to evaluate the status of the carotid arteries before common carotid artery compression or oscillation maneuvers are performed?a. ultrasound waveformsb. duplex ultrasonographyc. MR angiographyd. computed tomologyans- b

5. What is the name of the accurate vessel if the depth of sample is 55-65, direction of the blood flow is bidirectional and velocity of the blood flow is 55+/-12 cm/sec?a. posterior cerebral arteryb. anterior cerebral arteryc. terminal internal carotid arteryd. middle cerebral arteryans- c

6. What is the name of the accurate vessel if the depth of sample is 60-70, direction of the blood flow is antegrade and velocity of the blood flow is 39+/-10 cm/sec?a. anterior cerebral artery

b. posterior cerebral artery c. terminal internal carotid arteryd. ophthalmic arteryans- b

7. What is the name of the accurate vessel if the depth of sample is 60-90, direction of the blood flow is retrograde and velocity of the blood flow is 38+/-1o cm/sec at right and left of midline?a. ophthalmic arteryb. internal carotid arteryc. vertebral arteryd. basilar arteryans- c

8. Which of the following is the accurate vessel if the depth of sample is 60-80, direction of the blood flow is parasellar and velocity of the blood flow is 47+/-14 cm/sec and its angle varies?a. ophthalmic arteryb. internal carotid arteryc. vertebral arteryd. basilar arteryans- c

9. What is the name of the accurate vessel if the depth of sample is 40-60, direction of the blood flow is antegrade and velocity of the blood flow is 21+/-5 cm/sec?a. ophthalmic arteryb. middle cerebral arteryc. posterior cerebral arteryd. vertebral arteryans- a

10.Which of the following is the accurate vessel if the depth of sample is 60-80, direction of the blood flow is retrograde and velocity of the blood flow is 55+/-11 cm/sec and the approach is transforamenal?a. basilar arteryb. anterior cerebral arteryc. middle cerebral arteryd. vertebral arteryans- b

11.What occurs when there is antegrade flow in the ipsilateral ophthalmic artery and can be attributed to flow from the contralateral interior cerebral artery via the anterior communicating artery?a. external to internal collateralizationb. internal to external collateralizationc. crossover collateralization

d. posterior to anterior collateralizationans- c

12.Posterior to anterior collateralization is evident when flow velocities in the ipsilateral posterior cerebral artery exceeds those of the ipsilateral middle cerebral artery by -a. >150b. >125c. <125d. <150ans- b

13.The diagnosis of vasospasm is most accurate in the middle cerebral artery. Serial recordings of middle cerebral arterial flow pattern are necessary to document the increase in velocities associated with a vasospasm. What are the values of normal velocities?a. <150b. >125c. <120d. <125ans- c

Ch 24

1. Normally in case of subclavian steal condition brachial blood pressure is greater from one side to other. What is the measurement of brachial blood pressure difference?a. 10-15 mmHgb. 15-20 mmHgc. 25-30 mmHgd. 20-25 mmHgans- b

2. Which of the following of surgical treatment is used to treat the subclavian steal condition?a. stent graftb. sympathectomyc. endaterectomyd. steroid therapyans- c

3. Temporal arteritis is the inflammation of distal segment of the superficial temporal artery. What is the appropriate treatment for temporal arteritis?a. stent graftb. bypass graftc. endaterectomyd. steroid therapyans- d

Ch 25

1. Which of the following uses real-time digital video processing to detect small amounts of the contrast medium that has been injected to artery?a. A rapid film changer techniqueb. digital subtraction angiographyc. magnetic resonance angiographyd. computed tomographyans- b

2. Which of the following equation is used in percentage stenosis calculation- diameter reduction? a. [1-(d2/D2)]×100b. (d/D)×100c. [1-(d/D)]×100d. [1-( D2/ d)]×100ans- c

3. Which of the following equation is correct to determine percentage stenosis calculation- area reduction?a. [1-( D2/ d)]×100b. [1-(d/D)]×100c. (d/D)×100d. [1-(d2/D2)]×100ans- d

4. In cases of symmetrical lesions, what is considered to be homodynamically significant?a. 75% area reduction=50% diameter reductionb. 75% diameter reduction=50% area reductionc. 50% area reduction=75% diameter reductiond. 25% diameter reduction=50% area reductionans- a

5. Suppose there is a symmetrical lesion where D= 6 mm and d= 2 mm. what is percentage of diameter reduction?a. 89b. 71c. 67d. 45ans- c

6. Suppose there is a symmetrical lesion where D= 6 mm and d= 2 mm. determine the area reduction.a. 67b. 89

c. 92d. 83ans- b

7. Which of the following technology provides high quality images of blood flow without x-ray and required the use of contrast agent?a. magnetic resonance imagingb. duplex ultrasonographyc. magnetic resonance angiographyd. color flow imagingans- c

8. Which of the following used to evaluate the presence and absence of cerebral infarctions, tumors, masses, or anatomic variation?a. computed tomography angiographyb. magnetic resonance angiographyc. digital subtraction angiographyd. computed tomographyans- d

9. Which of the following is the pharmacologic treatment for occlusive disease which decreases platelet aggregation?a. stentb. aspirinc. the cessation of smokingd. bypass graftans- b

10.Which of the following is the appropriate surgical treatment for a patient who is suffering from stenosis?a. endaterectomy b. bypass graftc. sympathectomyd. angioplastyans- a

Chap26

1. For the lower extremity veins,the paired proneal veins empty the lateral region of the leg and carry blood cephalad into the tibioperoneal trunk.The paired deep veins of the calf follow the arteriees and what are they called?a. pulmonary veinsb. superior veinsc. jugular veinsd. corresponding veinsans-d

2. The paired anterior tibial veins empty the front of the leg.From which of the following veins the anterior tibial and tibioperoneal trunk veins join just below the knee?a. coronary veinb. renal veinc. popliteal veind. radial veinans-c

3. Large mascular veins empty the soleal muscles into the posterior tibial and peroneal veins and the gastrocnemius muscle into the-a. coronary veinb. renal veinc. popliteal veind. radial veinans-c

4. The popliteal vein becomes the femoral vein at the adductor canal or Hunter’s canal.What vein is formed by the confluence of the femoral vein and deep femoral /profunda femoris vein?a. common femoral veinb. radial veinc. ulnar veind. brachial veinans-a

5. For the lower extremity veins,what becomes the external iliac vein just above the inguinal ligament?a. common femoral veinb. radial veinc. ulnar veind. brachial veinans-a

6. For the lower extremity veins,at what level of the lumbar vertebra the confluence of the common iliac veins form the inferior vena cava and continues to the right atrium of the heart?a. 3rdb. 4tdc. 5thd. 6thdans-c

7. Which vein is the longest vein in the body originating on the dorsum of the foot and traveling medially to the saphenofemoral junction in the groin just below the inguinal ligament?

a. popliteal veinb. saphenous veinc. ulnar veind. jugular veinans-b

8. In case of the lower extremity veins, which of the following veins forms communication between the superficial and deep systems?a. coronary veinsb. mesenteric veinsc. perforating veinsd. jugular veinsans-c

9. In case of perforating veins how many valve(s) is/are there in each perforating veins?a. oneb. twoc. threed. fourans-a

10. In case of perforating veins, how many important perforators do the posterior tibial veins have near the medial malleolus?a. oneb. twoc. threed. fourans-b

11. In case of perforating veins, the posterior communicating branch of the great saphenous vein in the medial lower calf is connected to a -a. first preforatorb. second preforatorc. third preforatord. fourth preforatorans-c

12. Which of the following vein represents a superficial connection of the three ankle perforating veins-an anatomic fact of the major importance in the development of a venous stasis ulcer?a. splenic veinb. axillary veinc. hepatic veind. posterior arch veinans-d

13. In the brain,venous sinuses are spaces between the dura mater and periosteum that receive venous rerturn.Where do they eventually terminate?a. internal jugular veinsb. renal veinsc. mesenteric veinsd. hepatic veinsans-a

14. In thee lower extremities,the venous sinuses are dialeted channels located in the calf muscles that allow venous blood to accumulate and then to drain into the peroneal veins and-a. common iliac vein

b. pulmonary veinsc. subclavian veinsd. posterior tibial veinsans-d

15. For the upper extremity veins,the paired radial veins travel along the lateral aspect of the forearm.The paired deep veins of the arm and forearm collow the arteries and what are they called?a. pulmonary veinsb. superior veinsc. jugular veinsd. corresponding veinsans-d

16. In case of upper extremity veins,which of the following veins travel along the medical aspect of the forearm?a. paired ulner veinsb. popliteal veinsc. femoral veinsd. hepatic veinsans-a

17. In case of upper extremity veins,which of the following veins become the axillary vein usually near the armpit or axilla?a. common femoral veinb. radial veinc. ulnar veind. brachial veinans-d

18. In case of upper extremity veins,which of the following veins become subclavian vein when it is joined by the cephalic vein usually near the lateral boeder of the first rib?a. splenic veinb. axillary veinc. hepatic veind. posterior arch vein ans-b

19. In case of upper extremity veins,which of the following vein joins the internal jugular to form the brachiocephalic or innominate vein?a. common iliac veinb. pulmonary veinc. subclavian veind. posterior tibial veinans-c

20. For the superficial veins,which of the following vein is formed by the digital veins on the lateral aspect of the forearm and arm with the basilic vein on the medial aspect?a. splenic veinb. axillary veinc. hepatic veind. cephalic veinans-d

21. In case of the superficial veins,the cephalic vein travels literally up athe arm and at its confluence with the axillary vein, becomes the-a. common iliac veinb. pulmonary vein

c. subclavian veind. posterior tibial veinans-c

22. In case of the superficial veins,the basilic vein ascends medially up the arm,becoming the axillary vein where it joins the-a. common femoral veinb. radial veinc. ulnar veind. brachial veinans-d

23. For the abdominal veins,the portal system drains blood from the abdominal part of the digestive tract, i.e., the pancreas,spleen,gall bladder and mesentery and carries it into the-a. femoral veinb. iliac veinc. jugular veind. portal veinans-d

24. For the structural and functional anatomy of veins, which of the following is the inner, single layer of endothelial cells?a. tunica adventitiab. tunica media c. tunica intimad. tunica albugineaans-c

25. For the structural and functional anatomy of veins, which of the following is the middle,thicker layer of smooth muscles and collagenous fiber?a. tunica adventitiab. tunica media c. tunica intimad. tunica albugineaans-b

26. For the structural and functional anatomy of veins, which of the following is the outer, thin, fibrous layer surrounding elastic tissue?a. tunica adventitiab. tunica media c. tunica intimad. tunica albugineaans-a

27. For the structural and functional anatomy of veins, how many valves are there in the great saphenous vein?a. approximately 8b. approximately 10c. approximately 12d. approximately 14ans-c

28. For the structural and functional anatomy of veins, how many valves are there in the small saphenous vein?a. 2-12b. 2-8c. 4-10

d. 6-12ans-d

29. For the structural and functional anatomy of veins, how many valve(s) is/are there in each perforators ?a. 1b. 2c. 3d. 4ans-a

30. For the structural and functional anatomy of veins, how many valves are there in each infrapopliteal (deep) veins?a. 2-12b. 2-8c. 4-10d. 7-12ans-d

31. For the structural and functional anatomy of veins, how many valves are there in each popliteal and femoral veins?a. 1-3b. 2-4c. 3-5d. 4-6ans-a

32. For the structural and functional anatomy of veins,what is the percentage of containing valves of external iliac vein?a. 20%b. 15%c. 12%d. 10%ans-c

33. For the structural and functional anatomy of veins, how many valve(s) is/are there in common femoral vein?a. 1b. 2c. 3d. variableans-a

34. For the structural and functional anatomy of veins, how many valve(s) is/are there in internal jugular vein?a. 4b. 3c. 2d. 1ans-d

35. For the structural and functional anatomy of veins, how many valve(s) is/are there in axillary vein?a. fourb. threec. twod. oneans-d

36. For the structural and functional anatomy of veins, how many valve(s) is/are there in cephalic vein?a. 7-12b. 1-3c. variabled. 1ans-c

37. For the structural and functional anatomy of veins, how many valve(s) is/are there in basilic vein?a. 1b. variablec. 6-12d. 1-3ans-b

38. In case of the structural and functional anatomy of veins,Which of the following is the vein with valves?a. soleal sinusesb. innominate veinsc. axillary veinsd. subclavian veinsans-c

39. In case of the structural and functional anatomy of veins,Which of the following is the vein without valves?a. cephalic veinb. superior vena cavac. internal jugular veind. saphenous veinans-b

Chap27

1. Because the veins are seldom completely full of blood as well as the arteries are,their flattened shape offers a great deal of flow resistance.On the other hand,because the fully distended cross-sectional area of a vein is about-a. two to three timesb. three to four timesc. four to five times d. two to five timesans-b

2. Hydrostatic pressure is equivalent to the weight of a column of blood extending from the heart to the level where the pressure is being measured.What is the formula?a. HP=pghb. HP=pg/hc. HP=p/ghd. HP=h/pgans-a

3. Hydrostatic pressure is equivalent to the weight of a column of blood extending from the heart to the level where the pressure is being measured.Which one of the following is the hydrostatic pressure in the supine individual?a. 0 mmHgb. 25 mmHgc. 50 mmHgd. 100 mmHgans-a

4. Hydrostatic pressure is equivalent to the weight of a column of blood extending from the heart to the level where the pressure is being measured.Which one of the following is the hydrostatic pressure when the individual stands?a. 0 mmHgb. 25 mmHgc. 50 mmHgd. 100 mmHgans-d

5. In case of pressure/volume relationships, by which of the following pressure, the shape of the veins is determined?a. intraluminal pressureb. interstitial pressurec. transmural pressured. hydrostatic pressureans-c

6. For the effects of muscles pump mechanism,the contraction of leg muscles squeezes the veins and propels the blood toward the heart.If the venous valves are competentthe blood will travel in only one direction.What happens to the normal pattern of blood flow?a. decreases venous pressure, pooling and venous returnb. decreases venous pressure and pooling and increases venous returnc. increases venous pressure and pooling and decreases venous returnd. increases venous pressure pooling and venous returnans-b

7. Which of the following is not the symptom during the valsalva maneuver?a. intrahoracic pressure increases

b. intraabdominal pressure increasesc. all venous return is haltedd. increase in volume of bloodreturning to heartans-d

Chap28

1. In the past,the clinical diagnosis of acute deep venous thrombosis(DVT) based on the patient’s medical history and physical exam was considered notoriously unreliable.Which of the following is not the most common findings?a. Swellingb. pressurec. paind. redness of erythemaans-b

2. Differential diagnosis in patients with a clinically suspected with deep venous thrombosis includes the following except one-a. heat failureb. complications of chronic venous insufficiencyc. extrinsic compressiond. swellingans-d

3. Differential diagnosis in patients with a clinically suspected with deep venous thrombosis includes the following except one-a. muscle strainb. heavinessc. direct injury to the legd. muscle tearans-b

4. Differential diagnosis in patients with a clinically suspected with deep venous thrombosis includes the following except one-a. Baker’s cystb. cellulitisc. ulcerationsd. lymphangitisans-c

5. Which of the following may not have been possessed by patients with chronicvenous disease?a. varicositiesb. swellingc. heavinessd. cellulitisans-d

6. In case of risk factors and contributing diseases, the development of venous thrombosis is based on how many factors known as Virchow’s triad?a. twob. threec. fourd. fiveans-b

7. In case of risk factors and contributing diseases,which of the following is not the example of venous stasis?a. hypotensionb. pregnancyc. obsity

d. cancerans-d

8. In case of risk factors and contributing diseases,which of the following is not included in the examples of surgery?a. patient is immobileb. calf muscle pump activatedc. mechanical ventilation may alter pressure gradientsd. injury to endotheliumans-b

9. In case of risk factors and contributing diseases,which of the following is not included in the examples of hypercoagulability?a. pregnancyb. hormone replacement therapyc. paraplegiad. cancerans-c

10. In case of the mechanisms of thrombosis, Paget-Schroetter syndrome, also known as stress or effort thrombosis, usually involves thrombosis of the subclavian or-a. axillary veinb. brachial veinc. coronary veind. pulmonary veinans-a

11. In some cases, the artery causes enough compression to thicken the vein well as well as alter flow to the point of thrombosis.Which of the following vein by the right common iliac artery is the May-Thurner syndrome?a. left common iliac veinb. femoral veinc. splenic veind. redial veinans-a

12. In case of valvular incompetence, valves no longer maintain undirectional movement of the blood. What do the incompetence venous valves do from the following except one?a. allow blood to travel antegradeb. decreasing pressurec. creating venous hypertensiond. allow blood to travel retrogradeans-b

13. In case of congenital disease, which of the following is not an example of congenital venous disease that patients may also have?a. avalvular vein(s)b. incompetent valves c. valve containing veind. arteriovenous malformationsans-c

14. The elevated pressure in the portal vein is often the result of an obstruction of blood flow.Although it is related to some form of advanced chronic liver disease such as cirrhosis, it can also be caused by severe congestive heart failure or a proximal venous occlusion of, for example-a. jugular vein b. renal vein

c. hepatic veind. femoral veinans-c

15. Which of the following is not the characteristics of venous ulcer?a. brawny discolorationb. lipodermatosclerosisc. varicositiesd. loss of hairans-d

16. Which of the following is not the characteristics of arterial ulcer?a. shiny skinb. varicositiesc. loss of haird. thickened toenailsans-b

17. Edema is one of the most consistent signs of elevated peripheral venous pressure.It is a condition in which the body tissue contains-a. less fluidb. excessive fluidc. normal fluidd. no fluidans-b

18. Pitting edema is an accumulation of fluid in the subcutaneous tissue.When manual pressure is applied on the tissue, some fluid is dis placed.It may be secondary to-a. fluid retentionb. renal dysfunctionc. an electrolyte balanced. congestive heart failureans-c

Chap29

1. Impedence plethysmography (IPG) can detect thrombi in some veins. Which of the following is not one of them?a. popliteal veinb. axillary veinc. femoral veind. iliac veinans-b

2. Which of the following is not the limitation of Impedence plethysmography (IPG)?a. pregnancyb. pain or anxietyc. improper patient positioningd. detection of thrombians-d

3. Which of the following is not included in the positioning of patient of Impedence plethysmography (IPG)?a. should be supine in a bedb. hips and knees should be flexedc. legs internally rotatedd. calves above the level of heartans-c

4. In the peripheral vasculature, the changes are caused by changes in blood. Plethysmography is any technique that measures -a. color changesb. temperature changesc. pressure changesd. volume changesans-d

5. Ohm’s Law provides the basis of the Impedence plethysmography (IPG).Which of the following is not the exact relationship of voltage, current and resistance?a. I=V/Rb. R=V/Ic. V=RxId. I=R/Vans-d

6. Ohm’s Law is very similar to the concept of Poiseulle’s equation, which describes the relationship among pressure, volume flow and resistance. Which of the following is not related to the Poiseulle’s equation?a. Q=P/Rb. P=Q/Rc. R=P/Qd. P=RxQans-b

7. DC coupling is an electrical voltage that is either positive or negative with current flowing in only one direction.AC coupling, on the other hand, is an electrical voltage that reverses its polarity in a second.How many times does it change?a. 40 timesb. 50 timesc. 60 times

d. 70 timesans-c

8. Used in arterial studies, AC coupling requires more intense changes to produce a measurable signal.In the Unoted States, what volts of AC current is delivered in standard household outlets?a. 100 voltsb. 110 voltsc. 120 voltsd. 130 voltsans-c

9. Abnormal results following the initial run require that the test be repeated.Which of the following job is not required before the study can not be considered to be abnormal?a. patient positionb. patient temperaturec. adjustment to cuff placementd. subsequent repetitionsans-b

10. Outflow is the amount of venous emptying that occurs after deflation of the occluding thigh cuff.The tracing should fall to the baseline within which of the following time limit of thigh cuff deflation?a. 3 secondsb. 5 secondsc. 7 secondsd. 10 secondsans-a

Chap30

1. Strain gauge plethysmography (SPG) is used to detect venous obstruction in the large veins above the-a. footb. anklec. kneed. thighans-c

2. The extreme sensitivity of strain gauge plethysmography limits its usefulness in some clinical applications.Extrinsic compression can result from the following occurances except one. Which one is that?a. pregnancyb. loose clothingc. improper positioningd. tumorsans-b

3. Which of the following is not the limitations of the strain gauge plethysmography (SPG)?a. extreme sensitivityb. extrinsic compressionc. COPDd. detection of venous obstructionans-d

4. Which of the following is not included in the positioning of patient of Impedence plethysmography (IPG)?a. should be supine in a bedb. hips and knees should be flexedc. legs internally rotatedd. calves above the level of heartans-c

5. Strain gauge plethysmography utilizes a mercury-in-Silastic strain gauge that indirectly senses changes in blood volume by measuring the circumference of the limb.What kind of rubber tube is used here?a. platinumb. titaniumc. silicond. ironans-c

6. Strain gauge plethysmography utilizes a mercury-in-Silastic strain gauge that indirectly senses changes in blood volume by measuring the circumference of the limb.What kind of electrode is used here?a. zincb. copperc. irond. carbonans-b

7. In case of the technique of the Strain gauge plethysmography, a pneumatic cuff is placed around the thigh and a gauge is wrapped around the widest part of the cuff.What kind of gauge?a. iron-in-Silastic

b. zinc-in-Silasticc. copper-in-Silasticd. mercury-in-Silasticans-d

8. In case of the technique of the Strain gauge plethysmography, a pneumatic cuff is placed around the thigh and mercury-in-Silastic gauge is wrapped around the widest part of the cuff.What should be the length of the unstretched gauge of the circumference of the limb?a. 75%b. 70%c. 80%d. 90%ans-d

9. As the volume increase stabilizes, the occluding cuff is quickly deflated.The rate at which the cuff empties is also recorded and is considered maximum venous outflow.How much time usually it takes?a. 15 secondsb. 30 secondsc. 45 secondsd. 60 secondsans-c

10. Outflow is the amount of venous emptying that occurs after deflation of the occluding thigh cuff. The tracing should fall to the baseline within a time of thigh cuff deflation.What is the time?a. 2 secondsb. 3 secondsc. 5 secondsd. 7 secondsans-b

11. As with impedance plethysmography, the absence or presence of venous obstruction is determined by where the outflow and capacitance values fall on the scoring grid.Where are the values plotted when they are within normal limits?a. above the discriminating lineb. below the discriminating linec. along with the discriminating lined. just below the discriminating lineans-a

Chap31

1. Which of the following is not the limitations of the photoplethysmography (PPG)?a. improper placement of PPG sensorb. thickening of skinc. evaluation of venous insufficiencyd. must be placed on intact skinans-c

2. The photoplethysmography photocell which consists of a light emitting diode and a photosensor , transmits light into thea. epithelial tisssuesb. connective tissuesc. neural tissuesd. subcutaneous tissuesans-d

3. DC coupling is an electrical voltage that is either positive or negative with current flowing in only one direction.AC coupling, on the other hand, is an electrical voltage that reverses its polarity in a second.How many times does it change?a. 40 timesb. 50 timesc. 60 timesd. 70 timesans-c

4. Used in arterial studies, AC coupling requires more intense changes to produce a measurable signal.In the Unoted States, what volts of AC current is delivered in standard household outlets?a. 100 voltsb. 110 voltsc. 120 voltsd. 130 voltsans-c

5. Although photoplethysmography can not be calibrated volumetrically as some other types of plethysmography, it is important to maintain the same size or gain setting throughout the entire study to ensure that a significant difference in the tracing can be reliably interpreted as a significant difference in the-a. blood volumeb. blood colorc. blood temperatured. blood pressureans-a

6. The photoplethysmography sensor is applied to the patient’s lower leg.Care must be taken so that the sensor is not over a varicosity.Which one of the following is the approximate range?a. 5-10 cm above the medial malleolusb. 2-5 cm above the medial malleolusc. 3-8 cm above the medial malleolusd. 10-12 cm above the medial malleolusans-a

7. If the venous refill time is greater than a particular time, the study is considered to be normal.If the VRT is less than the particular time, a tourniquest is applied just above the

knee to eliminate the influence of the superficial venous system.What is the particular time?a. 10 secondsb. 20 secondsc. 30 secondsd. 40 secondsans-b

8. If the venous refill time is greater than 20 seconds time, the study is considered to be normal.If the VRT is less than 20 seconds, a tourniquet is applied just above the knee to eliminate the influence of the superficial venous system.If a blood pressure cuff is used instead of tourniquet, the examiner inflates it to-a. 20 mmHgb. 30 mmHgc. 40 mmHgd. 50 mmHgans-d

9. If a blood pressure cuff is used instead of tourniquet, the examiner inflates it to 20 mmHg. The dorsiflexions are repeated to determine the VRT. Please refer to the manufacturer’s interpretation guidelines for the laboratories partiular type of equipment since normal may vary from-a. 4-15 secondsb. 10-20 secondsc. 18-25 secondsd. 25-30 secondsans-c

10. Very fast refilling indicates that the vessel is filling via retrograde venous flow. Which of the following indicates that it is in normal limits without tourniquet?a. VRT > 10b. VRT > 20c. VRT < 10d. VRT < 20ans-b

11. Very fast refilling indicates that the vessel is filling via retrograde venous flow. Which of the following indicates that it is insufficient of the deep system with and without tourniquet ?a. VRT > 10b. VRT > 20c. VRT < 10d. VRT < 20ans-d

Chap32

1. Which of the following is not included in the limitations of air plethysmography?a. if the patient is not able to perform exerciseb. the presence of castc. determination of venous insufficiencyd. can not be used to to diagnose incompetent perforatorsans-c

2. In case of physical principles of air plethysmography, the pneumatic cuff wrapped around the limb is connected to a pressure transducer that detects changes. What kind of changes are detected?a. pressure changeb. volume changec. color changed. temperature changeans-b

3. With the patient supine, a large cuff is applied to the lower leg and inflated to about 6mmHg.The test leg is somewhat elevated with foot positioned on a hard cushion measuring-a. 5-7 inches in heightb. 7-10 inches in heightc. 10-12 inches in heightd. 12-15 inches in heightans-d

4. With the patient supine, a large cuff is applied to the lower leg and inflated to about 6mmHg.The test leg is somewhat elevated with foot positioned on a hard cushion measuring 12-15 inches in height. The leg is passively elevated to empty the venous system and what venous volume is documented?a. zerob. onec. twod. threeans-a

5. For the technique of air plethysmography, the patient stands with weight distributed equally over both feet and what exercise is performed to activate the calf muscle pump?a. 10 tip-toe exerciseb. 5 tip-toe exercisec. 3 tip-toe exercised. 1 tip-toe exerciseans-d

6. For the technique of air plethysmography, the patient stands with weight distributed equally over both feet and 1 tip-toe exercise is performed to activate the calf muscle pump.How many maneuvers are then completed?a. 10 tip-toe exerciseb. 5 tip-toe exercisec. 3 tip-toe exercised. 2 tip-toe exerciseans-a

7. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.Which of the following is the

exact equation?a. VFI=VFT90/90%VVb. VFI=90%VVxVFT90c. VFI=90%VV/VFT90d. VFT90=VFIx90%VVans-c

8. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.The exact equation is VFI=90%VV/VFT90.What is the normal range of VFI?a. ≤ 1.0b. ≤ 2.0c. ≤ 3.0d. ≤ 4.0ans-b

9. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.The exact equation is VFI=90%VV/VFT90.What is the minor-to-moderate reflux range of VFI?a. ≥ 1.0b. ≥ 2.0c. ≥ 3.0d. ≥ 4.0ans-b

10. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.The exact equation is VFI=90%VV/VFT90.What is the severe reflux range of VFI?a. > 3.0b. > 5.0c. > 8.0d. > 10.0ans-d

11. The ejection fraction measures the calf muscle pump function after one toe-up exercise by quantifying how much venous blood is left in the leg after one contraction of the calf muscle pump. Which of the following is the exact equation?a. EF=EV/W100b. EF=EVxW100 c. EF= W100/ EVd. W100=EVxEFans-a

12. The ejection fraction measures the calf muscle pump function after one toe-up exercise by quantifying how much venous blood is left in the leg after one contraction of the calf muscle pump. The exact equation is EF=EV/W100. What is the normal range?a. > 40%b. > 50%c. > 60%d. > 70%ans-c

13. The residual volume fraction is calculated as the percentage of venous volume remaining after 10 toe-up movements and is equivalent to the ambulatory venous pressure in mmHg. Which of the following is the exact equation?a. VV=RVFxRVb. RVF=RVxVV

c. RVF=VV/RVd. RVF=RV/VVans-d

14. The residual volume fraction is calculated as the percentage of venous volume remaining after 10 toe-up movements and is equivalent to the ambulatory venous pressure in mmHg. The exact equation is RVF=RV/VV. What is the normal range?a. < 30%b. < 35%c. < 40%d. < 45%ans-b

Chap33

1. In case of continuous wave Doppler, which of the following is not the limitation?a. difficulties to differentiateb. paired deep veinsc. sources of a false positive studyd. venous incompetence evaluationans-d

2. In case of continuous wave Doppler, which of the following is not the sources of false positive study?a. chronic obstructive pulmonary diseaseb. paired deep veinsc. peripheral arterial diseased. extrinsic compressionans-b

3. In case of continuous wave Doppler, which of the following is not the sources of false negative study?a. partial thrombosisb. improper Doppler anglec. collateral developmentd. presence of bifid systemans-b

4. In case of continuous wave Doppler, which of the following is not the proper positioning of the patient?a. the body slightly shifted to the side being evaluatedb. the leg should be extremely rotatedc. the extremities should be lower than the level of the heartd. abnormal venous should be repositionedans-b

5. Continuous wave Doppler uses two piezoelectric crystals, one to continuously emit ultrasound and the other to continuously receive the reflected waves.What probe should be held to maximize the quality of the Doppler venous signal?a. 2 MHz probeb. 3 MHz probec. 5 MHz probed. 10 MHz probeans-c

6. Continuous wave Doppler uses two piezoelectric crystals, one to continuously emit ultrasound and the other to continuously receive the reflected waves. To maximize the quality of the Doppler venous signal, a 5 MHz probe should be held at approximately-a. 1-15 degreesb. 15-30 degreesc. 30-45 degreesd. 45-60 degreesans-d

7. In case of the technique of continuous wave Doppler, the Examiner begins with the asymptomatic side, placing the probe at the inguinal ligament.Which of the common pulsatile artery then identified?a. pulmonaryb. renal

c. femorald. brachialans-c

8. In case of the technique of continuous wave Doppler, the Examiner begins with the asymptomatic side, placing the probe at the inguinal ligament,identifying the pulsatile common femoral artery,and then moving the probe medially in order to insonate the common-a. pulmonary veinb. renal veinc. femoral veind. brachial veinans-c

9. In case of the qualitative interpretation of spontaneity, the venous signal must be clearly heard at all sites with the exception of the-a. femoral veinb. popliteal veinc. saphenous veind. posterior tibial veinans-c

10. In case of the qualitative interpretation of patency, spontaneous flow or flow following distal augmentation in some veins provide documentation that the vessel is patient,i.e., open.Which of the following is not that vein?a. ulnar veinb. radial veinc. tibial veind. femoral veinans-d

11. In case of the qualitative interpretation for respiratory patterns/phasicity of continuous wave Doppler, the lower extremity venous signal is normally phasic with respiration-a. both increasing with expiration b. decreasing with expiration and increasing with inspirationc. increasing with expiration and decreasing with inspirationd. both decreasing with inspirationans-c

12. When venous flow is augmented following the maneuver, decreased augmentation suggests obstruction. Augmentation during the maneuver signifies reflux.What is it called?a. proximal compressionb. valsalva maneuver c. extrinsic compressiond. venous pulsatilityans-b

13. Pressure on the vessels from surrounding tissues and/or structures (e.g., tumors, pregnancy, ascites, etc.) can alter normal flow patterns. Which of the following is related with this description?a. proximal compressionb. valsalva maneuver c. extrinsic compressiond. venous pulsatility ans-c

14. Pulsatile venous flow is commonly -and normally- heard in the subclavian vein because of its close proximity to the heart. Which of the following is related with this description?a. proximal compressionb. valsalva maneuver c. extrinsic compressiond. venous pulsatilityans-d

Chap34

1. For the duplex scanning and color flow imaging, which of the following is not the capabilities of peripheral veins?a. it can differentiate an acute from a subacute processb. it can be used to evaluate nonocclusive thrombosisc. it can reveal recanalized channelsd. it can reveal venous thrombosisans-d

2. For the duplex scanning and color flow imaging, which of the following is not the capabilities of abdominal and pelvic veins?a. it can reveal venous thrombosisb. it can evaluate the patency of inferior vena cavac. it can reveal recanalized channelsd. it is capable of assessing protocaval shuntsans-c

3. It may be difficult to thoroughly evaluate all of the infrapopliteal veins secondary to edema, scarring, recent surgery or obesity. Which of the following limitation is related with this description?a. peripheral veins of the lower extremityb. peripheral veins of the upper extremityc. abdominal and pelvic veinsd. false positive studiesans-a

4. It may be difficult to thoroughly evaluate the subclavian and brachiophelic/innominate veins because of the bony structures of the chest.Which of the following limitation is related with this description?a. peripheral veins of the lower extremityb. peripheral veins of the upper extremityc. abdominal and pelvic veinsd. false positive studiesans-b

5. It may be difficult to thoroughly evaluate all of the abdominal veins because of the depth of vessels and the presence of bowel gas.Which of the following limitation is related with this description?a. peripheral veins of the lower extremityb. peripheral veins of the upper extremityc. abdominal and pelvic veinsd. false positive studiesans-c

6. Which of the following is not included in the limitations of the sources of false positive studies of the duplex scanning and color flow imaging?a. extrinsic compressionb. peripheral arterial diseasec. improper Doppler angled. abdominal and pelvic veinsans-d

7. Which of the following is not the correct positioning for the the duplex scanning and color flow imaging?a. turned toward the symptomic side

b. left and/or right lateral decubitus with headc. trendelenburg positiond. supine with head slightlyans-c

8. Which of the following is not the physical principle of the the duplex scanning and color flow imaging?a. combination of straight and sagittal viewb. velocity signals should be obtainedc. the peripheral vein must be clearly visualizedd. the vein must be properly identifiedans-a

9. The femoral vein is evident as the probe is slowly moved down the medial aspect of the thigh.How the Doppler venous signals are obtained?a. straight viewb. horizontal viewc. sagittal viewd. vertical viewans-c

10. In case of the the duplex scanning and color flow imaging, for the distal third of the thigh, which of the following vein dives deep?a. axillary veinb. hepatic veinc. renal veind. femoral veinans-c

11. In case of the the duplex scanning and color flow imaging, the probe is moved slowly through out the popliteal fossa to evaluate the popliteal vein. It is also necessary to observe any cystic structures or masses.Which of the following vein is difficult to visualize in this approach?a. anterior tibial veinb. radial veinc. pulmonary veind. jugular veinans-a

12. After evaluating the calf vessels for a review of the anatomy, the examiner moves the probe to the space between the medial malleolus and Achilles tendon. Which of the following vein is located by this process?a. jugular veinsb. splenic veinsc. femoral veinsd. posterior tibial veinsans-d

13. In case of the duplex scanning and color flow imaging, for the peripheral veins of the lower extremity-chronic venous insufficiency,if reflux is not evident reversed Trendelenburg Position, the study must be repeated with the -a. patient supineb. patient supine at 45 degreec. patient sittingd. patient standingans-d

14. In case of manual standing position technique of the peripheral veins of the lower extremity-chronic venous insufficiency, which of the following is not concerned?a. the leg to be examined is not bearing weightb. Doppler color flow imaging is not usedc. spectral analysis is activatedd. manual compression is appliedans-b

15. In case of standing position: using an automatic cuff inflator for peripheral veins of the lower extremity-chronic venous insufficiency, the leg to be examined is not to be bearing weight. What is the measurement of the cuff which is applied to the high-thigh portion of the leg?a. 12x30 cmb. 10x40 cmc. 12x40 cmd. 10x30 cmans-c

16. In case of standing position: using an automatic cuff inflator for peripheral veins of the lower extremity-chronic venous insufficiency, the duplex system is used to obtain an image and continuous Doppler spectral analysis of the common femoral vein. The transducer is positioned proximal to and within-a. 3 cm of the cuffb. 5 cm of the cuffc. 8 cm of the cuffd. 10 cm of the cuffans-b

17. Although it is crucial to maintain probe position over the site of interest so the signal is not lost during the cuff inflation and deflation.Once the optimal Doppler signal is obtained, the examiner tries to maintain the probe at what degree?a. 60 degreeb. 70 degreec. 80 degreed. 90 degreeans-a

18. Although it is crucial to maintain probe position over the site of interest so the signal is not lost during the cuff inflation and deflation.Once the optimal Doppler signal is obtained, the examiner tries to maintain the probe at 60 degree.At what range, the cuff is iinflated?a. 70 mmHgb. 80 mmHgc. 90 mmHgd. 100 mmHgans-b

19. Although it is crucial to maintain probe position over the site of interest so the signal is not lost during the cuff inflation and deflation.Once the optimal Doppler signal is obtained, the examiner tries to maintain the probe at 60 degree, the cuff is iinflated to 80 mmHg. How long it is maintained?

a. 1-2 secondsb. 2-5 secondsc. 5-8 seconds

d. 8-10 secondsans-a

20. In case of standing position: using an automatic cuff inflator for popliteal and great saphenous veins of the lower extremity-chronic venous insufficiency, the leg to be examined is not to be bearing weight. What is the measurement of the cuff which is applied to the knee of the leg?a. 12x30 cmb. 10x40 cmc. 12x40 cmd. 10x30 cmans-c

21. To evaluate the popliteal vein and great saphenous vein to the knee, the 12x40 cm cuff is placed at the cuff level.At what range, the cuff is iinflated?a. 70 mmHgb. 80 mmHgc. 90 mmHgd. 100 mmHgans-d

22. In case of standing position: using an automatic cuff inflator for posterior tibial veins of the lower extremity-chronic venous insufficiency, the leg to be examined is not to be bearing weight. What is the measurement of the cuff which is applied to the TM of the leg?a. 12x30 cmb. 10x40 cmc. 12x40 cmd. 10x30 cmans-c

23. To evaluate the posterior tibial vein to the knee, the 12x40 cm cuff is placed at the cuff level.At what range, the cuff is iinflated?a. 70 mmHgb. 80 mmHgc. 90 mmHgd. 120 mmHgans-d

24. For the peripheral veins of the upper extremity, in a transverse orientation, the examiner begins imaging the internal jugular vein along the lateral side of the neck, moving toward and under a clavicle, where the internal jugulat vein joins the subclavian vein to form the-a. mesenteric veinb. splenic veinc. radial veind. innominate veinans-d

25. In case of the peripheral veins of the upper extremity, the examiner instructs the patient to raise the arm so that the probe can be placed in the axilla. Which of the following vein is evaluated in this way?a. axillary veinb. jugular veinc. femoral veind. hepatic veinans-a

26. In case of the peripheral veins of the upper extremity, travelling towards the hand, which of the following veins are evident formed by the confluence of the paired radial and ulnar veins?a. axillary veinsb. brachial veins c. jugular veinsd. popliteal veinsans-b

27. In case of the peripheral veins of the upper extremity, which of the following vein runs down while the basilic courses medially?a. renal veinb. femoral veinc. hepatic veind. cephalic veinans-d

28. The evaluation of the inferior vena cava and pelvic veins begins at the level of the umbilicus. Evaluation of the other abdominal vessels begins in the-a. transverse viewb. vertical viewc. horizontal viewd. sagittal viewans-a

29. Veins must be completely compressible to be considered normal. Slightly more than usual pressure or changes in probe position may be necessary to completely compress the common-a. brachial veinb. ulnar veinc. radial veind. femoral veinans-d

30. In case of normal peripheral veins of the upprer extremity, pulsatile venous Doppler signals in the internal, jugular, subclavian and innominate veins are-a. semi-normalb. normalc. semi-abnormald. abnormalans-b

31. In case of normal peripheral veins of the upprer extremity, if the patient has a patent dialysis access graft in the extremity being evaluated, what kind of changes are expected from the following except one?a. pulsatile flowb. no response to distal compressionc. decreased flow velocityd. incompressible vesselans-c

32. In case of normal abdominal and pelvic veins, which of the following vein is formed by the superior mesenteric vein and splenic veins carries blood into the sinusoids of the liver?a. brachial veinb. axillary veinc. portal vein

d. jugular veinans-c

33. In case of normal abdominal and pelvic veins, which of the following vein is characterized by the flow patterns that exhibit minimally phasic, almost continuous Doppler signals?a. brachial vein flowb. axillary vein flowc. portal vein flowd. jugular vein flowans-c

34. In case of normal abdominal and pelvic veins, which of the following veins carry blood from liver into the vena cava?a. hepatic vein b. axillary vein c. portal vein d. jugular vein ans-a

35. In case of normal abdominal and pelvic veins, which of the following vein is characterized by the flow patterns that exhibit a minimally phasic, bidirectional or pulsatile appearing Doppler signal?a. hepatic vein b. axillary vein c. portal vein d. jugular veinans-a

36. In case of normal abdominal and pelvic veins, which of the following veins carry blood liver into the vena cava and is characterized by the flow patterns that exhibit a minimally phasic, bidirectional or pulsatile appearing Doppler signal?a. renal vein b. axillary vein c. portal vein d. jugular vein ans-a

37. In case of acute thrombosis for the duplex scanning and color flow imaging, which of the following is not evident as abnormal Doppler signals?a. if flow is not spontaneousb. if flow is not phasicc. if there is no augmentation with distal compressiond. if flow decreases during proximal compressionans-d

38. In case of CVI, no reflux should be observed with Doppler spectral analysis,during proximal manual compression, or the valsalva maneuver, nor should there be reflux following distal compression. Which of the following time is considered as normal?a. < 0.5 secb. < 1.0 secc. < 2.5 secd. <3.0 secans-a

39. In case of CVI, no reflux should be observed with Doppler spectral analysis,during proximal manual compression, or the valsalva maneuver, nor should there be reflux following distal compression. Which of the following time is considered as abnormal?

a. > 1 secb. > 2 secc. > 3 secd. > 4 secans-a

40. Which of the following has a structure, composed primarily of synuvial fluid is found posterior and medial to the knee joint and may account fot the patients pain and swelling?a. Baker’s cystb. hematomac. muscle teard. lymph nodeans-a

41. Which of the following is not true about the portal hypertension within the portal vein for the miscellaneous findings in the abdomen?a. B-mode findingsb. includes cirrhosis, cancer, pancreatitis, thrombosis and traumac. results hepatopetal flowd. increased resistance to blood flowans-c

42. In case of chronic venous insufficiency, which of the following has various appearances from well-to-ill cefined, heterogenous sonographic presentation ?a. hematomab. effusionc. cystd. abscessans-d

43. In case of chronic venous insufficiency, which of the following has well defined structure filled with synovial fluid, usually anechoic, connection to joint space is evident, if ruptured, fluid leaking into tissue has appearance of rat-tail?a. hematomab. effusionc. Baker’s cystd. abscessans-c

44. In case of chronic venous insufficiency, which of the following is anechoic, placed at near joint, usually midline and symptoms are shown near or at the joint?a. hematomab. effusionc. Baker’s cystd. abscessans-b

45. In case of chronic venous insufficiency, which of the following has various appearances from well- to –ill defined, usually heterogeneous with low level echoes initially, may become anechoic over time, little or no through-transmission?a. hematomab. effusionc. Baker’s cystd. abscessans-a

46. In case of chronic venous insufficiency, which of the following has hyperechoic with shadowing, placed at recess of knee and most often associated with calcium?a. hematomab. effusionc. Baker’s cystd. loose bodies in synovial fluidans-d

47. In case of miscellaneous findings in the extremities, which of the following has hyperechoic oval-shaped center encircled by a hypoechoic halo, blood flow usually seen in center of node, flow around perimeter may indicate neoplasm/a. tendonb. nervec. meniscal cystd. lymph nodeans-d

48. In case of miscellaneous findings in the extremities, which of the following has variable presentation and location and noted neuroma, sarcoma and schwannoma?a. tendonb. mass superficialc. meniscal cystd. lymph nodeans-b

49. In case of miscellaneous findings in the extremities, which of the following has heterogeneous presentation, placed at lateral knee area and mixed echoes?a. tendonb. mass superficialc. meniscal cystd. lymph nodeans-c

50. In case of miscellaneous findings in the extremities, which of the following is related to amount of bleeding in size and shape, initially hyperechoic with decreasing echogenicity over time and placed at site of injury?a. tendonb. muscle tearc. meniscal cystd. lymph nodeans-b

51. In case of miscellaneous findings in the extremities, which of the following is heterogeneous with straitions seen in sagittal view and travels adjacent to vessels?a. nerveb. muscle tearc. meniscal cystd. lymph nodeans-a

52. In case of miscellaneous findings in the extremities, which of the following is hyperechoic, echigenicity changes with angulation of transducer and does not travel adjacent to vessels?a. tendonb. muscle tearc. meniscal cyst

d. lymph nodeans-a

Chap35

1. In case of invasive tests and therapeutic interventions, which of the following is not the D-dimer capability?a. it is a measurable product of the thrombotic processb. a negative result implies the absence of a thrombotic processc. a negative result is consistent with breakdownd. a positive result is consistent with lysisans-c

2. In case of invasive tests and therapeutic interventions, which of the following is not the D-dimer limitation?a. many different methods are availableb. may be elevated with pregnancyc. a positive finding is not highly sensitived. should not be used with caution on inpatientsans-d

3. Although contrast venography may still be considered the gold standard by which all other venous tests are compared, its use has markedly decreased because of duplex scanning. How many venograms are performed?a. fourb. threec. twod. oneans-c

4. Although contrast venography may still be considered the gold standard by which all other venous tests are compared, its use has markedly decreased because of duplex scanning.Which of the following is not the limitation of the contrast venography?a. it is highly technical in techniqueb. it is relatively expensivec. it may be comfortable for the patientd. it can produce adverse effectans-c

5. Although contrast venography may still be considered the gold standard by which all other venous tests are compared, its use has markedly decreased because of duplex scanning.Which of the following is not the technique of contrast venography?a. a radiopaque contrast material is injectedb. ascending venographyc. descending venographyd. one x-ray is takenans-d

6. In case of the invasive tests and therapeutic interventions, which of the following is not the capability of lung perfusion scan?a. firstly lodges in the small vesselsb. it is a screening testc. detection of the perfusion defects of the lungsd. most commonly attributed to a pulmonary embolismans-a

7. In case of the invasive tests and therapeutic interventions, which of the following is not the limitation of lung perfusion scan?a. emphysema

b. asthmac. multiple blood transfusiond. pretoperative phenomenaans-d

8. In case of the invasive tests and therapeutic interventions, which of the following is not the technique of lung perfusion scan?a. radioactive contrast medium is injectedb. images of lung perfusion is takenc. scans are interpretedd. scans may be considered primaryans-d

9. In case of the invasive tests and therapeutic interventions, all risk factors fall into the one of the three causes of venous thrombosis. Which of the following name is related with this law?a. Victor’s triadb. Virchow’s triadc. Addison’s triadd. Herbert’s triadans-b

10. In case of the anticoagulant therapy for prophylaxis for invasive tests and therapeutic interventions, low-dose unfractionated heparin is given.What is the time period for 5000 units?a. 8 hours before and after the surgeryb. 10 hours before and after the surgeryc. 12 hours before and after the surgeryd. 6 hours before and after the surgeryans-c

11. In case of the anticoagulant therapy for acute DVT and/or PE, a loading dose of 10000 units of heparin followed by continuous intravenous infusion may be recommended for the treatment. What is the period?a. 1-3 daysb. 3-5 daysc. 5-10 daysd. 1-7 daysans-c

12. In case of the anticoagulant therapy for acute DVT and/or PE, dosage is regulated to ensure that the patient’s partial thromboplastin time (PTT)-the time needed for a fibrin clot to form is -a. 1-1.5 times nrmalb. 1.5-2 times nrmalc. 2.5-3 times nrmald. 3.5-4 times nrmalans-b

13. In case of the anticoagulant therapy for acute DVT and/or PE, oral anticoagulation is also administered. The dosage is regulated to ensure that the patient’s prothrombin time is-a. 1-1.5 times nrmalb. 1.5-2 times nrmalc. 2.5-3 times nrmald. 3.5-4 times nrmalans-b

14. In case of the anticoagulant therapy for acute DVT and/or PE, heparin can be discontinued if there has been sufficient overlap with the coumadin, if the PT and PTT remain at therapeutic levels. After how many days it can be discontinued?a. 1-3 daysb. 2-5 daysc. 5-10 daysd. 7-15 daysans-c

15. In case of chronic venous insufficiency for surgical and endovascular therapy, which of the following may not be treated for nonhealing venous ulcers?a. medicated wrapb. hyperbaric oxygen therapyc. ligation of incompetent perforatorsd. valvular reconstructionans-d

16. In case of varicose veins for the for surgical and endovascular therapy, follow-up duplex scans are performed to ascertain that the vein has been ablated and that other vessels have not been affected by the particular procedure. Which of the following time limit is concerned here?a. 12-24 hoursb. 12-48 hoursc. 24-48 hoursd. 48-72 hoursans-d

17. In case of varicose veins for the for surgical and endovascular therapy, follow-up duplex scans are performed to ascertain that the vein has been ablated and that other vessels have not been affected by the particular procedure.Subsequent venous duplex studies may also be scheduled for-a. 1-2 monthsb. 1-3 monthsc. 3-6 monthsd. 6-9 monthsans-c

18. TIPS or TIPSS is a percutaneous procedure to create a shunt/communication to between the portal and hepatic veins to decompress the portal veins. Which of the following is not the procedure of TIPSS?a. inserting a catheterb. advancing the catheter into right hepatic veinc. creating bridge into hepatic veind. supporting the bridge with endoprosthesisans-c

Chap36

1. Realistically, noninvasive studies that by all measures correlate with the gold standard 90% or more of the time are good. How many measures are there by which the comparisons are analyzed?a. 3b. 4c. 5d. 6ans-c

2. The ability of a test to detect disease. The abnormal noninvasive test result is confirmed or supported by an abnormal result of the gold standard. Which of the following measure is related with this description?a. negative predictive valueb. positive predictive valuec. specificityd. sensitivityans-d

3. The ability of a test to identify normality. The normal test result is confirmed or supported by a normal gold standard result. Which of the following measure is related with this description?a. negative predictive valueb. positive predictive valuec. specificityd. sensitivityans-c

4. The percentage of non invasive test results that accurately predict abnormality. Which of the following measure is related with this description?a. negative predictive valueb. positive predictive valuec. specificityd. sensitivityans-b

5. The percentage of non invasive test results that accurately predict normality. Which of the following measure is related with this description?a. negative predictive valueb. positive predictive valuec. specificityd. sensitivityans-a

6. Percentage of correct noninvasive diagnoses. Which of the following measure is related with this description?a. positive predictive valueb. accuracyc. specificityd. sensitivityans-b

7. In case of comparing noninvasive and gold standard results, what kind of table provides a well-accepted method of calculating statistics appropriate for the vascular laboratory?a. 2x2

b. 3x3c. 4x4d. 5x5ans-a

8. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating sensitivity?a. TP/(TP+FN)b. (TP+FN)/TPc. TP/(TP-FN)d. (TP-FN)/TPans-a

9. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating specificity?a. (TN-FN)/TNb. TN/(TN-FN)c. (TN+FN)/TNd. TN/(TN+FN)ans-d

10. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating positive predictive value?a. (TP+FP)/TPb. (TP-FP)/TPc. TP/(TP+FP)d. TP/(TP-FP)ans-c

11. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating negative predictive value?a. TN/(TN-FN)b. TN/(TN+FN)c. (TN+FN)/TNd. (TN-FN)/TNans-b

12. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating accuracy?a. (TP+TN)/(TP+FP+FN+TN)b. (TP-TN)/(TP+FP+FN+TN)c. (TP+FP+FN+TN)/ (TP+TN)d. (TP+FP+FN+TN)/ (TP-TN)ans-a

13. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the number of true

positive?a. 120b. 132c. 98d. 34ans-b

14. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the number of true negative?a. 120b. 132c. 98d. 34ans-c

15. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the sensitivity percentage?a. 97%b. 95%c. 93%d. 98%ans-d

16. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the specificity percentage?a. 97%b. 95%c. 93%d. 98%ans-c

17. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal

limits by duplex had significant disease on angiography. What is the positive predictive value?a. 97%b. 95%c. 93%d. 98%ans-b

18. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the negative predictive value?a. 97%b. 95%c. 93%d. 98%ans-a

19. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the accuracy?a. 97%b. 95%c. 93%d. 96%ans-d

Chap37

1. In case of general guidelines for the universal precautions and high-level disinfection, gluteraldehyde and hydrogen peroxide is included. What is the percentage of hydrogen peroxide?a. ≥ 3%b. ≥ 4%c. ≥ 5%d. ≥ 6%ans-d

2. In case of general guidelines for the universal precautions and low-level disinfection, quarternary ammonium and N-alkyl is included. Which of the following example is not included?a. T-Sptay IIb. Sani-Clothc. Cidexd. hydrogen peroxide (≥ 3%)ans-c