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CCI RVS Exam | Questions and Verified
Answers| 100% Correct- A Grade (New 2024/
2025 Update)
QUESTION
The term hemiparesis means: a) paralysis of one side b) weakness of one side c) numbness/tingling on one side d) spasm of voluntary muscle on one side e) dizziness Answer: b) weakness on one side
QUESTION
The NASCET (North American Symptomatic Carotid Endarterectomy Trial) used the following arteriographic criterion/criteria to classify internal carotid artery disease: a) Area and diameter stenoses calculated by dividing the minimal area and diameter at the internal carotid artery by the area and diameter at the common carotid artery. b) Area percentage stenosis calculated by dividing the minimal area by the original area at the site of stenosis. c) Diameter percentage stensosis calculated by dividing the minimal diameter by the original diameter at the site of stensosis d) Diameter percentage stenosis calculated by dividing the minimal diameter by the diameter of the un=stenosed distal internal carotid artery. e) Area percentage stenosis calculated by dividing the minimal area by the normal area of the distal internal carotid artery. Answer: d) Diameter percentage stenosis calculated by dividing the minimal diameter by the diameter of the un=stenosed distal internal carotid artery.
QUESTION
All of the following may represent symptoms from the brain stem or posterior circulation EXCEPT: a) dizziness b) vertigo c) ectasia d) syncope e) amaurosis fugax Answer: e) amaurosis fugax
QUESTION
A patient relates a 10-mininute episode of loss of vision. He closed each eye and the reduction in the right half of his visual field was present bilaterally. This patient is describing amaurosis fugax. True or false? Answer: false
QUESTION
A TIA of the right anterior hemisphere of the brain will likely affect: a) the entire body b) the left side of the body c) the right side of the body d) the right side of the face e) the back of the head Answer: b) the left side of the body
QUESTION
Amaurosis fugax related to an internal carotid lesion will cause: a) permanent blindness of the contralateral eye b) temporary blindness or shading of the ipsilateral eye c) permanent blindness of the ipsilateral eye
c) migraine d) stroke e) lacunar infarct Answer: d) stroke
QUESTION
. A binocular disturbance that disrupts vision in half the visual field of both eyes is called: a) hemiplegia b) amaurosis duplex c) dysphagia d) homonymous hemianopia e) hemiparesis Answer: d) homonymous hemianopia
QUESTION
. Parasthesia refers to: a) dizziness b) disturbance of speech c) loss of function of a limb d) weakness e) tingling sensation Answer: e) tingling sensation
QUESTION
. A patient describes a 30-minute episode of garbled speech. This is called: a) dysphasia b) aphasia c) paresthesia d) dysphagia e) syncope
Answer: a) dysphasia
QUESTION
. A patient presents with a 30-minute episode of garbled speech. Which area of circulation is suspected? a) right hemisphere b) left hemisphere c) occipital cortex d) vertebrobasilar territory e) brainstem circulation Answer: b) left hemisphere
QUESTION
. Which of the following is true regarding subclavian steal? a) resulting strokes are usually severely disabling. b) it is usually a harmless hemodynamic phenomenon. c) it is caused by arterial obstruction proximal to the origin of the vertebral artery. d) it is caused by arterial obstruction distal to the origin of the vertebral artery. e) A and C f) A and D g) B and C h) B and D Answer: g) B and C
QUESTION
. A hemispheric stroke usually affects: a) The anterior cerebral artery distribution and the ipsilateral side of the body b) The middle cerebellar artery distribution and the ipsilateral side of the body c) The external carotid distribution, and may affect one or both sides of the body d) The anterior cerebellar artery distribution and the contralateral side of the body
Answer: a) aortic valve stenosis
QUESTION
. A stronger pulse is palpated in the right neck than on the left. This could result from all of the following EXCEPT: a) tortuous CCA b) carotid aneurysm on the right c) tech error d) left carotid obstruction e) innominate occlusion Answer: e) innominate occlusion
QUESTION
. Which of the following is/are TRUE regarding the clinical detection of a bruit? a) a bruit is always an indication of disease b) it means that turbulent flow exists c) it may be indicative of valvular dysfunction in the heart d) it may be a normal finding in parts of some vessels and during periods of enhanced flow e) a bruit is present in >90% of vessels with disease f) B, C, and D g) A, B, and E Answer: f) B, C, and D
QUESTION
. During oridinary auscultation of a carotid bifurcation, the detection of a bruit that extends into diastole is: a) insignificant b) marginally significant c) moderately significant d) highly significant e) impossible
Answer: d) highly significant
QUESTION
. Which of these conditions is LEAST likely to cause a bruit in the neck? a) severe stenosis of the itnernal carotid artery b) severe stenosis of the external carotid artery c) hyperdynamic carotid flows d) cardiac valvular disease e) critical preocclusive stenosis of the internal carotid artery Answer: e) critical preocclusive stenosis of the internal carotid artery
QUESTION
. In duplex imaging, the best arterial wall quality is obtained when the beam is at the following angle to the artery walls: a) 90 deg b) 60 deg c) 0 deg d) oblique e) obtuse Answer: a) 90 deg
QUESTION
. TCD findings consistent with vasospasm following subarachnoid hemorrhage would include: a) absence of diastolic flow in the middle cerebral artery b) greatly diminished diastolic flow in the middle cerebral artery c) retrograde flow in the middle cerebral artery d) greatly increased mean velocities in the middle cerebral artery e) this is not a condition for which TCD is a useful modality Answer:
QUESTION
. A localized increase in mean velocity from 50 to 150 cm/sec at a depth of 50 mm with the TCD transducer placed in the temporal window probably indicates: a) significant stenosis of the anterior cerebral artery b) moderate generalized vasospasm c) significant stenosis of the internal carotid at the siphon d) significant vasospasm of the middle cerebral artery e) significant stenosis of the middle cerebral artery Answer: e) significant stenosis of the middle cerebral artery
QUESTION
. In a handheld TCD, the angle of the beam relative to flow is assumed to be: a) 0 deg b) 30 deg c) 45 deg exactly d) 60 deg e) 90 deg Answer: a) 0 deg
QUESTION
. You perform TCD, insonating the left anterior cerebral artery. The flow is toward the beam. This finding suggests: a) ipsilateral carotid obstruction, with right-to-left collateralization b) contralateral carotid obstruction, with left-to-right collateralization c) ipsilateral carotid obstruction, with posterior-to-anterior collateralization d) contralateralsiphon disease e) nothing of diagnostic significance Answer: a) ipsilateral carotid obstruction, with right-to-left collateralization
QUESTION
. In using continuous-wave Doppler with spectral analysis to assess the internal carotid artery, which of the following operator-induced errors would most likely result in a falsely LOW frequency shift? a) overdriving the Doppler signal gain b) allowing the signal beam to overlap both an artery and a vein c) changing to a higher-frequency transducer d) leaving the wall filter on e) increase the beam angle to 70 deg Answer: e) increase the beam angle to 70 deg
QUESTION
The left common iliac vein crosses __________ to the right common artery just distal to the aortic bifurcation. Answer: posterior (the IVC runs posterior and left of the aorta at the distal bifurcation)
QUESTION
Is the fibula the larger or smaller bone in the lower leg? Answer: smaller (tibia is larger bone)
QUESTION
The brachiocephalic vein is found: a) only on the right side b) only on the left side c) on both the right and left sides d) there is no such vein; it is called "innominate" e) this vein is located centrally in the cranium Answer:
QUESTION
Because of the location of the inferior vena cava, the left renal vein crosses _______ to the aorta _______ to the left renal artery. Answer: anterior, inferior
QUESTION
The superior vena cava is formed by the junction of the: Answer: Right and left brachiocephalic veins
QUESTION
A useful landmark for locating the renal arteries is the: a) superior mesenteric artery b) right renal vein c) celiac axis d) common hepatic artery e) inferior mesenteric artery Answer: a) superior mesenteric artery
QUESTION
Another name for the hypogastric artery is: a) external iliac artery b) gastroduodenal artery c) hepatic artery d) internal iliac artery e) celiac artery Answer:
d) internal iliac artery
QUESTION
Regarding capillaries, which is false? a) They have only intima and adventitia layers. b) They measure approximately 8 microns in diameter. c) The transmit time of blood through capillaries is approx one to three seconds. d) They lose fluid at the arteriolar end. e) They resorb fluid at the venular end. Answer: a) They have only intima and adventitia layers.
QUESTION
Artherosclerosis is a disease that begins in the: a) adventitia b) intima c) transverse fibers d) inner media e) outer media Answer: b) intima
QUESTION
Which of the following is NOT considered a risk factor for artherosclerosis? a) hypertension b) female gender c) diabetes mellitus d) lipoprotein abnormalities e) tobacco use Answer: b) female gender
QUESTION
After carotid bifurcation disease, the next most common source of stroke symptoms is: a) cardiac-source embolization b) paradoxical embolizations from DVT via patent foramen ovale c) spinal stenosis d) subclavian stenosis e) aortic dissection Answer: a) cardiac-source embolization
QUESTION
A 24-year-old patient with a history of recent automobile accident arrives in the ICU with symptoms of acute right-side weakness and aphasia. The most likely etiology of these symptoms is: a) carotid dissection b) cerebral aneurysm rupture c) severe internal carotid artery stenosis d) ebolic activity from cardiac mural thrombus e) thrombocytopenia Answer: a) carotid dissection
QUESTION
. Among the chief limitations of continuous-wave Doppler is (are): a) Depth information is not possible; precise location of flow pattern cannot be determined. b) the two-transducer system is inherently more expensive. c) polarity of the reflected signal frequency shift cannot be determined; direction of blood flow cannot be defined. d) FFT spectral analysis cannot be applied to continuous-wave Doppler signal information. e) the sample volume is too small to interrogate deeper vessels. Answer: a) Depth information is not possible; precise location of flow pattern cannot be determined.
QUESTION
. In TCD, the normal direction of flow in the middle cerebral artery is: a) toward the beam b) away from the beam c) bidirectional d) dependent on the cardiac cycle e) not detectable with TCD Answer: a) toward the beam
QUESTION
. Which of the following imaging transducer frequencies could appropriately be used for assessment of the carotid arteries? a) 10 MHz b) 5 MHz c) 2.5 MHz d) 0.3 MHz e) A and B Answer: e) A and B
QUESTION
. Which of the following is (are) true regarding axial resolution in carotid imaging? a) differentiates soft plaque from blood b) resolves two targets positioned one in front of another along the axis of beam propagation c) improves the observer's ability to estimate vessel wall thickness d) determines the absolute depth of penetration of ultrasound beam at a given frequency e) A and D f) B and C g) B and D Answer: f) B and C
Answer: c) retrograde flow in the distal internal carotid artery
QUESTION
. The Doppler diagnostic criterion that is most important for calling greater than 80% stenosis is: a) mean or time-average velocity b) peak-systolic velocity c) end-diastolic velocity d) minimum mid-diastolic average velocity e) percent window reduction Answer: c) end-diastolic velocity
QUESTION
. You are examining hardcopy of a TCD exam. One printout shows a spectral waveform labeled "suboccipital window", and the depth is indicated to be 90 mm. This is most likely the: a) anterior cerebral artery b) posterior cerebral artery c) middle cerebral artery d) vertebral artery e) basilar artery Answer: e) basilar artery
QUESTION
. The components of information on the spectral Doppler display include all EXCEPT: a) pixel brightness, indicating how many red blood cells are reflecting at a given frequency shift. b) frequency shift on the y-axis c) time on the x-axis d) depth on the y-axis e) all of the above are components of the spectral Doppler display. Answer: d) depth on the y-axis
QUESTION
. Of the following, which is NOT one of the main collateral pathways in the event of ICA obstruction? a) posterior to anterior b) genicular to arcuate branches c) contralateral hemisphere d) ECA branches to ophthalmic branches e) all represent major cerebrovascular collateral pathways Answer: b) genicular to arcuate branches
QUESTION
. Conventional arteriography reveals 30% diameter stenosis in a symptomatic patient with severe stenosis by B-mode and peak systolic velocities of 250 cm/sec in the proximal internal carotid artery. Which of the following statements about these findings is TRUE? a) the high velocities were caused by carotid kinking b) even double-projection arteriography may fail to fully determine diameter stenosis, especially in the event of vessel overlap. c) arteriography may fail to reveal small "berry" aneurysms in the brain. d) B-mode "plaquing" may have been background ultrasound noise. e) the ultrasound findings are not as important as the findings of an arch study. Answer: b) even double-projection arteriography may fail to fully determine diameter stenosis, especially in the event of vessel overlap.
QUESTION
. Major complications of cerebrovascular angiography include all of the following EXCEPT: a) death b) stroke c) inadvertent venous puncture d) arterial occlusion at the access site e) renal failure
