Week 7

Question 1

How often does a lab need to get re-accredited?

Answer 1

Every 3 years

Question 2

What is the accrediting body for most vascular labs?

Answer 2

IAC (Intersocietal accreditation commission)

Question 3

What are the five types of accreditation?

Answer 3

Extracranial cerebrovascular (carotid duplex)
Intracranial cerebrovascular (Transcranial Doppler)
Peripheral arterial (LE and UE arterial exams)
Peripheral venous (LE and UE venous exams)
Visceral vascular (Abdominal)

Question 4

What are two aspects of an accreditation application?

Answer 4

details on all daily lab operations

case studies

Question 5

What are the 4 things that could happen after applying for accreditation?

Answer 5

• Grant
• Delay
• Require a site visit
• Deny

Question 6

What are protocols?

Answer 6

the minimum amount of images that need to be taken during an exam

Question 7

Why are protocols important?

Answer 7

maintain quality assurance in a lab

help with cohesion for follow up exams

Question 8

What is the IAC protocol for LE venous duplex for B-Mode?

Answer 8

1. Transverse Grayscale with and without compressions for:

CFV, SFJ, PROX/MID/DIST FV, POPV, PTVS, PERVS, Additional images for suspected thrombus, Lab required additional images

Question 9

What is the IAC protocol for LE venous duplex for Doppler waveforms?

Answer 9

Waveforms demonstrating spontaneous, phasic, and augmentable flow for: R and L CFV, POPV, Additional waves per lab protocol

Question 10

Define Fully compressible

Answer 10

near and far walls fully touch and the vein is completely compressed

Question 11

Define Partially compressible

Answer 11

vein only compresses partially down

Question 12

Define Non-compressible

Answer 12

vein does not compress at all

Question 13

What are the characteristics of a normal venous doppler waveform?

Answer 13

Spontaneous, Phasic, Augmentation, Competency, Non-pulsatile

Question 14

Define Spontaneous

Answer 14

Venous signal should be heard automatically

Question 15

Define Phasicity

Answer 15

Doppler signal should vary with respiration

Question 16

Describe a phasic waveform

Answer 16

• signal reduced or absent with inspiration
• signal returns with expiration
• sounds similar to waves/ocean

Question 17

Describe a non-phasic waveform

Answer 17

• no change with respiration
• continuous flow
• thrombus present or compressed vein

Question 18

Define Augmentation

Answer 18

Increase in venous flow with distal compression

Question 19

What conditions could cause a venous flow to be pulsatile?

Answer 19

venous HTN or CHF

Question 20

What are two parts to a good interpretation?

Answer 20

• Findings/analysis

- Impression

Question 21

What are some parts to your Findings/anaylsis section of your interpretation?

Answer 21

Compressibility
Doppler waveform anaylsis
Incidental findings

Question 22

What is the Impression part of your interpretation?

Answer 22

the overall summary of your findings

Question 23

What should you state in your impression?

Answer 23

• the presence or absence of thrombus
• age of thrombus (acute or chronic)
• location of thrombus

Question 24

Why do we perform follow-up exams?

Answer 24

to check for:

• progression/extension
• recanalization
• resolution
• no change

Question 25

What is the final very important step in your exam?

Answer 25

Reporting results to a physician and documenting that the results were reported