Chapter 13: Abdominal Duplex

Question 1

Renal artery stenosis patients usually present with

Answer 1

uncontrolled/controlled hypertension

Question 2

many patients who have hypertension have

Answer 2

renovascular hypertension due to renal artery stenosis

Question 3

renal artery stenosis is usually caused by

Answer 3

atherosclerosis
fibromuscular dysplasia
occlusion

Question 4

renin

Answer 4

enzyme that converts angiotensinogen to angiotensin

Question 5

renal artery stenosis study native kidneys obtain this information

Answer 5

celiac and sma velocities
PSV of aorta near SMA
kidney size
PSV and EDV of prx, mid, dst renal arts, upper lower pole segmental arteries

Question 6

renal arteries are usually

Answer 6

low resistant

Question 7

the aorta is usually

Answer 7

higher resistant

Question 8

RAR (renal to aorta ratio) equation

Answer 8

highest renal artery PSV / Aorta PSV

Question 9

Normal RAR

Answer 9

<3.5

Question 10

Abnormal RAR

Answer 10

> or = to 3.5

suggests 60% diameter reduction

Question 11

You cannot use RAR if:

Answer 11

AAA present
Aorta PSV >90cm/sec or <40cm/s
look for renal artery PSV >/= 180-200 cm/sec

Question 12

End diastolic Ratio (EDR) Parencyma Resistance Ratio (PR) equation

Answer 12

end diastolic velocity / PSV

Question 13

Parencyma Resistance Ratio (PR) equation

Answer 13

end diastolic velocity / PSV

Question 14

Normal PR kidneys

Answer 14

> .2

Question 15

Abnormal PR kidneys

Answer 15

<.2

Question 16

Resistivity index (RI) equation

Answer 16

PSV - EDV / PSV

Question 17

Normal RI kidneys

Answer 17

< .8

Question 18

Abnormal RI kidneys

Answer 18

> / = .8

Question 19

acceleration time of what is considered abnormal

Answer 19

> 100msec

Question 20

Proximal stenosis / occlusion of renal artery may result in

Answer 20

dampened, weak doppler signals distally

tardus parvus

Question 21

Celiac band syndrome is

Answer 21

compression of celiac artery origin by median arcuate ligament of diaphragm

Question 22

Mesenteric ischemia protocal

Answer 22

on fasting patient PSV and EDV of
celiac artery
prox mid dist SMA
IMA
Aorta

Question 23

Food challenge test

Answer 23

Mesenteric Ischemia study done and then feed pt high caloric liquid (ensure)
repeat exam 20-30 min or sooner if symptomatic
obtain PSV and EDV of SMA post prandial

Question 24

what to document after food challenge test

Answer 24

amount of liquid ingested
onset type and duration of symptoms
time began the post prandial study

Question 25

Fasting SMA

Answer 25

High PSV
Low EDV
Flow reversal

Question 26

Post Prandial SMA

Answer 26

PSV increased
EDV increased
loss of flow reversal

Question 27

Celiac Artery fasting

Answer 27

High PSV
High EDV
no flow reversal

Question 28

Post prandial celiac artery

Answer 28

No change in PSV or EDV

no flow reversal

Question 29

SMA normal velocity

Answer 29

110-177cm/sec

Question 30

Stenosis of SMA

Answer 30

PSV > / = to 275cm/sec means 70% diameter reduction

Question 31

Normal Celiac artery velocity

Answer 31

50-160cm/sec

Question 32

Stenosis of Celiac artery velocity

Answer 32

PSV >/= to 200cm/sec means 70% diameter reduction

Question 33

if IMA is easily observed what should be considered

Answer 33

SMA occlusion

Question 34

how many vessels have to be abnormal for mesenteric ischemia to be considered

Answer 34

2 to 3 vessels

Question 35

Celiac band syndrome is

Answer 35

compression of celiac artery origin by median arcuate ligament of diaphragm

Question 36

What do you see in celiac band syndrome

Answer 36

stenosis occurs during expiration

deep inspiration improves high velocity signals

Question 37

renal transplant anastomosis to

Answer 37

EIA or IIA

vein transplanted to EIV

Question 38

Signs of renal transplant rejection

Answer 38

increased size
increased cortical echogenicity
increased arterial resistance