Chapters 2, 3, 4 and 15

Question 1

The first branch off of the Aortic Arch is?

Answer 1

The Innominate Artery

Question 2

Which normal cerebrovascular vessel demonstrates the highest flow resistance?

Answer 2

ECA

Question 3

A Transient Ischemic Attach (TIA) usually resolves within?

Answer 3

24 hours

Question 4

Aphasia means?

Answer 4

Inability to speak

Question 5

The vertebral artery usually arises from the:

Answer 5

Subclavian Artery

Question 6

The ECA _______ lies posterior in the neck compared to the ICA?

Answer 6

Rarely

Question 7

Bilateral brachial blood pressures should not show a greater than ______ mmHg difference.

Answer 7

20

Question 8

All of the following are true of the ECA except…
It has multiple branches coming off of the neck.
Is usually smaller than the ICA.
Generally provides blood to the face.
Cannot be seen with ultrasound.

Answer 8

Cannot be seen with Ultrasound.

Question 9

For carotid doppler velocity assessment the ideal doppler angle should be ____ degrees or less.

Answer 9

60

Question 10

The appearance of "early systolic deceleration" or a "hesitant" waveform in the left vertebral artery waveform is usually due to which of the following conditions?
Proximal left subclavian stenosis
Basilar artery obstruction
left distal vertebral obstruction 
proximal right vertebral artery stenosis

Answer 10

Proximal left subclavian stenosis

Question 11

The first branch off the ascending aorta is the

Answer 11

coronary artery

Question 12

Generally, at what percentage of stenosis will velocities begin to actually decrease?

Answer 12

95%

Question 13

How many doppler samples should you obtain in a hemodynamically significant stenosis?

Answer 13

3 or more.

Question 14

Which of the following is NOT considered a risk factor for atherosclerosis? 
Smoking
Diabetes
Hypertension
Female Gender

Answer 14

Female Gender

Question 15

Which of the following is a complication of plaque ulceration? 
Thrombosis
Intraplaque hemorrhage
Embolization
All of the above

Answer 15

All of the above

Question 16

Where are carotid body tumors located?

Answer 16

Between the ECA and ICA

Question 17

All of the following may represent symptoms from the posterior circulation stroke EXCEPT?
Dizziness
Drop attacks
Diplopia
Amaurosis Fugax

Answer 17

Amaurosis Fugax

Question 18

A patient describes a 30 minute episode of garbled speech. This is called:

Answer 18

Dysphasia

Question 19

Which of the following anatomic lesions can produce a subclavian steal? 
innominate artery occlusion
proximal left subclavian artery stenosis
right common carotid artery occlusion 
right axillary artery occlusion
a & b

Answer 19

A&B

Question 20

An arterial stenosis would show post-stenotic turbulence beginning at what percentage stenosis?

Answer 20

50%

Question 21

What percentage of arterial stenosis would be measured best by B-mode transverse measurement as opposed to velocity measurement?

Answer 21

40%

Question 22

The characteristics of flow in the different carotid artery segments are?

Answer 22

High-resistance in the ECA, low-resistance in the ICA, mixed in the CCA.

Question 23

The angle correct cursor for velocity estimates is best:

Answer 23

adjusted parallel with the arterial wall

Question 24

You perform percussion maneuvers on the superficial temporal artery and see oscillations on the spectral display. The artery being insonated is most likely:

Answer 24

ECA

Question 25

``` A patient presents with the classic cerebrovascular symptoms of left amaurosis fugax. Of the choices below, what is the most likely cause? Emboli from the left ICA Emboli from the right ICA Occlusion of the left vertebral artery Occlusion of the left ICA ```

Answer 25

Occlusion of the left ICA

Question 26

Fibromuscular Dysplasia predominantly occurs in...

Answer 26

Women in their ICA

Question 27

In the presence of an innominate artery occlusion, the ipsilateral common carotid artery is often supplied by _______ flow in the right ________ artery.

Answer 27

Retrograde, subclavian.

Question 28

What does a high resistance flow pattern in the ICA indicate?

Answer 28

A severe stenosis or occlusion distal to the segment being insonated.

Question 29

Calculate the % stenosis using the bulb method. RL is 2 cm. TL is 8 cm. Distal ICA TL is 4 cm.

Answer 29

75%

Question 30

Calculate the % stenosis using the NASCET method. RL is 2 cm. TL is 8 cm. Distal ICA TL is 4 cm.

Answer 30

50%

Question 31

Dissections usually occur in the:

Answer 31

Aorta into carotids

Question 32

``` All of the following techniques should utilized to differentiate string sign flow from complete vessel occlusion except? Power doppler High color gain Low color scale High wall filters ```

Answer 32

High wall filters

Question 33

Which type/frequency of transducer is most appropriate for the majority of carotid duplex ultrasound studies?

Answer 33

7-4MHz linear

Question 34

Which finding would rule out a hemodynamically significant subclavian artery stenosis? Absence of spectral broadening in the waveform Asymmetrical brachial systolic pressures Abnormal vertebral artery doppler waveform contour Elevated flow velocity with poststenotic turbulence

Answer 34

Absence of spectral broadening in the waveform

Question 35

Restenosis of a carotid endarterectomy site that occurs after 1 month postop and within the first 2 years after surgery is most likely due to

Answer 35

Neointimal hyperplasia

Question 36

Which of the following is not a diagnostic finding with external carotid to internal carotid collateral flow through reversed ophthalmic artery? Retrograde flow in the ophthalmic artery Increased resistive index in the ophthalmic artery Decreased pulsatility in the ophthalmic artery Reversal of flow in the ophthalmic artery with compression of external carotid artery branches

Answer 36

Increased resistive index in the ophthalmic artery

Question 37

Which of the following are not normal findings of the ophthalmic artery? If providing collateral flow from the ECA to the brain, flow is directed from the eye orbit toward the brain It is visualized between 40 and 60 mm using a transorbital approach It normal displays from the brain toward the orbit of the eye It normally displays high velocity diastolic flow

Answer 37

It normally displays high velocity diastolic flow

Question 38

The third branch off the aortic arch is the?

Answer 38

left subclavian