week 2- renal & abdominal doppler

Question 1

hepatic ___ accompany course of portal veins

Answer 1

arteries

Question 2

hepatic veins empty into

Answer 2

IVC

Question 3

Liver receives dual blood supply from ___ & ___

Answer 3

Portal veins

Hepatic Arteries

Question 4

source of oxygenated blood into the liver

Answer 4

hepatic arteries

Question 5

Portal veins carry nutrient rich (de-oxygenated) blood to the liver from ___

Answer 5

GI tract

Question 6

supplies 30% of incoming blood to liver

Answer 6

hepatic arteries

Question 7

supplies 70% of incoming blood to liver

Answer 7

portal veins

Question 8

Hepatopetal

Answer 8

blood flow torwards the liver

Question 9

hepatofugal

Answer 9

blood flow away from the liver

Question 10

Hepatopetal or Hepatofugal flow: Portal veins?

Answer 10

Hepatopetal

Question 11

Hepatopetal or Hepatofugal flow: Hepatic veins?

Answer 11

Hepatofugal

Question 12

Hepatopetal or Hepatofugal flow: hepatic arteries?

Answer 12

Hepatopetal

Question 13

Hepatopetal or Hepatofugal flow: splenic vein?

Answer 13

Hepatopetal

Question 14

phasicity in portal veins

Answer 14

monophasic

Question 15

splenic vein shows as ___ on colour doppler because ___

Answer 15

blue

going away from transducer and towards liver

Question 16

splenic artery shows as ___ on colour doppler because ___

Answer 16

red

going towards transducer (spleen)

Question 17

renal arteries arise ___ to SMA

Answer 17

3cm distal

Question 18

flow of blood from renal artery

Answer 18

renal A –> segmental A –> interlobar A–> arcuate A –> interlobular

Question 19

renal veins follow ___ course as arteries

Answer 19

same

Question 20

RRA passes ___ to IVC

Answer 20

posterior

Question 21

what passes between AO and SMA

Answer 21

left renal vein

Question 22

lots of flow during diastole indicates ___ resistance

Answer 22

low

Question 23

renal arteries show ___ resistance

Answer 23

low

Question 24

normal resistive index in renal vessels ___, and the upper limit is ___

Answer 24

0. 6

0. 7

Question 25

renal arteries show __ flow and __ resistance

Answer 25

high | low

Question 26

if there is a stenosis, the velocity will go ___ at the stenosis and go ___ distal to the stenosis

Answer 26

UP | DOWN

Question 27

velocity and pulatility ___ as arteries get progressively smaller from the hilum

Answer 27

decrease

Question 28

colour scale in renal vessels should be set ___

Answer 28

low

Question 29

wall filter in renal vessels should be set ___

Answer 29

low

Question 30

colour gain in renal vessel should be set ___

Answer 30

high

Question 31

High resistive index at the hilum of the kidney indicates what something is going wrong, where?

Answer 31

in the cortex (down the road from the hilum)

Question 32

suprarenal abdominal aorta expected flow

Answer 32

moderate

Question 33

only a portion of the kidney will be affected if there is a renal artery obstruction in the ____ artery

Answer 33

segmental

Question 34

how much of the kidney will be affected if there is a renal artery obstruction in the main renal artery

Answer 34

all of it

Question 35

Atheromatous affects the ___ of the renal artery

Answer 35

proximal 1/3

Question 36

abnormal and reversible accumulation of material in the inner layer of an artery wall.

Answer 36

Atheromatous

Question 37

Atheromatous stenosis leads to hypertension ___ renal failure

Answer 37

and

Question 38

Dysplastic stenosis Leads to hypertension __ renal fa

Answer 38

without

Question 39

Atheromatous relationship with angioplasty (balloon in vessel to open it)

Answer 39

resistant | -use stenting

Question 40

Dysplastic stenosis relationship with angioplasty (balloon in vessel to open it)

Answer 40

responds well

Question 41

Dysplastic stenosis affects what part of renal artery

Answer 41

mid to distal

Question 42

"ring of pearls" in a renal vessel indicates

Answer 42

narrowing of vessels | --> fibromuscular dysplasia

Question 43

Peak systolic velocity is ___ (high/low) at stenosis

Answer 43

HIGH | - trying to push through

Question 44

The following indicate ___: Reduced pulsatility Slower acceleration Longer acceleration times

Answer 44

tardus parvus

Question 45

treatment options for stenosis

Answer 45

- angioplasty | - stent placement

Question 46

aneurysm

Answer 46

dilation of the artery

Question 47

what does an aneurysm look like on US

Answer 47

- cystic mass | - arterial flow

Question 48

AV Fistula

Answer 48

abnormal connection between 2 body parts

Question 49

acquired fistula accounts for __% and congenital fistula accounts for __%

Answer 49

75 | 25

Question 50

turbulent diastolic arterial flow with high flow velocity indicates

Answer 50

AV fistula

Question 51

symptoms of acute & chronic renal vein thrombosis

Answer 51

``` acute -flank pain -hematuria chronic -asymptomatic ```

Question 52

renal vein thrombosis shows flow ___ in diastole

Answer 52

reversal

Question 53

Abnormal increase in portal venous pressure due to obstruction of blood flow through liver

Answer 53

portal hypertension

Question 54

Portal veins characteristics: - ___ pulsatility - flow velocity ___ reach zero - ___ reversal

Answer 54

- moderate - does NOT - No

Question 55

mild portal hypertension has ___ -phasic flow

Answer 55

monophasic

Question 56

moderate portal hypertension has ___-phasic flow

Answer 56

biphasic

Question 57

severe portal hypertension has ___ flow

Answer 57

reversed

Question 58

sonographic findings of portal hypertension

Answer 58

- ascites - splenomegaly - varices - portal vain diameter >13mm - increased hepatic flow

Question 59

cause of portal hypertension

Answer 59

cirrhosis due to alcohol consumption or hepatitis

Question 60

5 major sites of portosystemic venous collaterals

Answer 60

1. GE junction 2. paraumbilical vein 3. splenorenal & gastrorenal 4. intestinal 5. hemorrhoidal

Question 61

acronym for a portosystemic shunt used to treat portal hypertension, usually between right portal and right hepatic veins

Answer 61

TIPS | transjugular intrahepatic portosystemic shunt

Question 62

thrombus within portal vein lumen appears as

Answer 62

echogenic

Question 63

what is Cavernous transformation

Answer 63

numerous worm like vessels at the porta hepatis

Question 64

when does Cavernous transformation occur

Answer 64

chronic thrombosis

Question 65

Rare syndrome where there is occlusion of the lumen of the hepatic veins and/or the IVC

Answer 65

budd-chiari syndrome

Question 66

clinical presentation of Budd-Chiari syndrome

Answer 66

- RUQ pain - Ascites - hepato & splenomegaly

Question 67

sonographic appearance of Budd-Chiari syndrome

Answer 67

- thickened hepatic vein walls - enlarged caudate lobe - stenosis with prox dilation - developed intrahepatic collaterals

Question 68

doppler findings of Budd-Chiari syndrome

Answer 68

- flow in IVC/ hepatic veins changes from phasic to continuous, reversed, turbulent or absent - PV flow slow or reversed

Question 69

spectral broadening is seen in the ___ artery

Answer 69

splenic

Question 70

tortous artery

Answer 70

splenic

Question 71

portal veins ___ (should/ should not) exhibit pulsation

Answer 71

SHOULD NOT

Question 72

With portal hypertension, the portal vein may ___ and phasic variation in the portal and splenic/superior mesenteric veins may be lost.

Answer 72

dilate

Question 73

The hepatic veins and IVC demonstrate a pulsatile flow pattern with a ___ configuraion. Flow is predominately ____

Answer 73

- triphasic | - hepatofugal

Question 74

Transmitted cardiac pulsations ___ (are/are not) evident in the renal veins near the IVC.

Answer 74

are

Question 75

The size of the IVC varies markedly with respiration and throughout the cardiac  cycle, but seldom exceeds __ cm in diameter

Answer 75

2.5