Download RVT ARDMS exam review Questions and Answers (Latest Update 2025) 100% Verified Answers and more Exams Nursing in PDF only on Docsity!
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3 causes of venous thrombosis also called, Virchow's Triad - Correct Answer ✅Venous stasis, trauma/endothelial damage, hypercoagulability Venous stasis - Correct Answer ✅Slowed blood flow in veins. Caused by immobility, myocardial infarction, CHF, hypotension, COPD, obesity, pregnancy, previous DVT, extrinsic compression, SVC syndrome, paraplegia, surgery associated conditions. 2 types of Trauma/endothelial damage - Correct Answer ✅Intrinsic and extrinsic Intrinsic trauma is - Correct Answer ✅Damage to the vessel wall from intravenous drugs or a catheter. Increased use of PICC line results in higher incidence of upper extremity thrombus, usually developing at most proximal portion of PICC line. Extrinsic trauma is - Correct Answer ✅Damage caused by an accident, which can occur at any site of the body. Hypercoagulability is associated with - Correct Answer ✅Pregnancy, cancer, oral contraceptives and/or hormone replacement therapy, inherited states,e.g., factor V Leiden or protein C, protein S, or Antithrombin III deficiency
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Sensitivity, and How to calculate? - Correct Answer ✅-Ability of a test to detect disease, how many tests are correctly called positive.
of true positives divided by # of all positive tests by gold
standard, or TP/TP+FN Specificity, and how to calculate? - Correct Answer ✅-Ability of a test to identify normality, or how many results were correctly called negative.
of true negative divided by # of all negative tests by gold
standard, or TN/TN+FP Positive predictive value, and how to calculate? - Correct Answer ✅-percentage of test results that accurately predict abnormality, or what % correctly predicted disease.
of true positive test divided by # of all positive tests, or
TP/TP+FP Negative predictive value, and how to calculate? - Correct Answer ✅- percentage of test results that accurately predict normality, or what % correctly predicted absence of disease.
of true negatives divided by # of all negative tests, or
TN/TN+FN
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SMA supplies blood to what organs? - Correct Answer ✅Small intestine, cecum, ascending colon, part of transverse colon. SMA location? - Correct Answer ✅1cm distal to celiac artery. IMA supplies what organs? - Correct Answer ✅Left half of transverse colon, the descending, iliac, and sigmoid colon, and part of rectum IMA arises from? - Correct Answer ✅Distal abdominal aorta 3-4cm above aortic bifurcation and can act as a collateral connection. May-Thurner syndrome - Correct Answer ✅Compression of left common iliac vein by the right common iliac artery as the artery crosses over it, increases likelihood of left common iliac deep vein thrombosis. Paget-Schroetter syndrome - Correct Answer ✅-(Stress or effort thrombosis) thrombosis of subclavien or axillary vein secondary to intense, repetitive activity. -Associated with motion of upper extremity as seen with heavy lifting or strenuous throwing of a baseball or football.
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Nutcracker syndrome - Correct Answer ✅Compression of the left renal vein between the aorta and the SMA. Renal arteries supply what? - Correct Answer ✅Kidneys, suprarenal glands, ureters. Landmarks for renal artery and vein? - Correct Answer ✅Left renal vein crosses the aorta anteriorly and is superior to renal artery. Right renal artery crosses posteriorly to IVC. Two main categories for alternative diagnostic tests related to venous disease are? - Correct Answer ✅1. Evaluation for possible venous thrombosis or venous reflux.
- Evaluation of a pulmonary embolism (PE). What is a D-dimer test? - Correct Answer ✅D-dimer is a protien fragment produced when a blood clot dissolves in the body and is normally undetectable, but it is measurable when a clot is breaking down. With an increase of product breakdown, the level of D-dimer in blood rises. -high level of D-dimer suggests presence of thrombus.
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Descending venography is? - Correct Answer ✅Image the veins from proximal to distal and assess valve function and venous reflux. Capabilities of venography? - Correct Answer ✅-helps evaluation of acute DVT. -evaluates congenital venous disease and/or anomalies. -assists in evaluation of chronic venous changes. -can detect and quantify reversed flow. Limitations of venography? - Correct Answer ✅-highly technical in technique and interpretation. -expensive -may be uncomfortable for patients -can have allergic reactions in patients with severe allergies to iodine, troublesome in patients with severe peripheral vascular occlusive disease -exposes patients to radiation How is ascending venography preformed? - Correct Answer ✅Requires contrast agent to be injected into a distal superficial vein and directed into the deep system. -lower extremity study, a vein on dorsum of foot is used. -upper extremity study, the basilic or cephalic may be used.
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-Serial x-rays are taken as contrast material passes through some of the deep veins. How is descending venography performed? - Correct Answer ✅-evaluates lower extremity only. -contrast agent usually injected into common femoral vein. -Serial x-rays are taken as contrast material passes through some of the deep veins. What is a lung ventilation/perfusion scan? - Correct Answer ✅Measures air and blood flow in the lungs and is a screening test for detection of perfusion defects of the lungs. -referred to as a V/Q scan or "ventilation quotient": a mathematical equation for calculating both air and blood flow. Capabilities of V/Q scan? - Correct Answer ✅Detects defects attributed to PE, usually originating from DVT, that lodges in the small vessels of the lungs and prevents adequate perfusion. -can detect poor blood flow in pulmonary vessels. Limitations of V/Q scan? - Correct Answer ✅Other disorders besides microembolism can cause perfusion defects like:
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-patients with localized areas of low blood flow may have other lung diseases, like COPD. What is pulmonary angiography? - Correct Answer ✅Evaluating pulmonary arteries for PE What is a computed tomographic angiography(CTA)? - Correct Answer ✅-more often used to evaluate PE. STUDY OF CHOICE FOR PE. -uses ionizing radiation to obtain cross sectional images of vasculature. -can be performed with or without contrast agents, but it allows more discrete evaluation of the vessels, pulmonary arteries and it's branches. Limitations of pulmonary angiography? - Correct Answer ✅Similar to angiography -allergic reaction to contrast medium -complications like hematoma at puncture site. Limitations of computed tomographic angiography? - Correct Answer ✅-can have allergic reaction to contrast medium -images can be degraded by patient motion
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Technique for pulmonary angiography? - Correct Answer ✅- IV inserted -catheter is advanced through veins passing through right atrium into the pulmonary artery -contrast injected and images taken as contrast moves through Arteries in lung Technique for CTA? - Correct Answer ✅-Contrast injected through superficial peripheral vein (cephalic) Images obtained as contrast moves through Arteries in lung. How do you decrease risk for venous stasis? - Correct Answer ✅-limiting long periods of inactivity or bed rest, promoting venous drainage when inactive -leg elevation -support stockings -pneumatic compression devices -weight management What are varicose veins? - Correct Answer ✅Enlarged veins that appear as purple or blue and may appear twisted and/or bulging near skin surface. -very small varicosities,"spider veins(telangiectasias)", usually not medically significant.
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What is sclerotheraphy? - Correct Answer ✅The injection of a sclerosing solution, an irratant, into the vessel, resulting in its closure -larger veins may be treated with this but foam sclerotheraphy is more successful. What is foam sclerotheraphy? - Correct Answer ✅A solution is injected as a foam instead of a liquid. Advantages of foam sclerotheraphy? - Correct Answer ✅1. Better visualization while it spreads through targeted veins
- Ability to use smaller amounts of solution
- Better contact inside the veins due to the foam medium (it stays longer and is not diluted by mixing with blood inside vein.) What is surface laser treatment? - Correct Answer ✅-Uses a precise amount of light that is pulsed through a special hand piece in order to target the vein or reddened skin area -The absorbed light causes thermocoagulation of the treated blood vessel What are reticular veins? - Correct Answer ✅1-3mm in diameter vein, dilated, purple or bluish colored
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What are primary varicose veins? - Correct Answer ✅Dilated, torturous superficial veins that may be hereditary (result of congenital absence of one or more valves.) -increased venous pressure that causes primary varicose vein s is unrelated to obstruction of deep venous system What are secondary varicose veins? - Correct Answer ✅Caused by obstructive conditions of the deep venous system, such as previous DVT, or pregnancy; obesity May also be considered. Why would you use a vena caval interruption device? - Correct Answer ✅In patients with acute DVT who cannot be anticoagulated to prevent PE. -main purpose is to catch thrombus that may break loose from deep vein and embolize to heart and lungs How is interruption device inserted? - Correct Answer ✅Using fluroscopy, device is placed in IVC via the jugular or femoral vein Where is IVC placed in body? - Correct Answer ✅Just below renal veins
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How is TIPSS accomplished? - Correct Answer ✅1. Insert catheter in right internal jugular vein
- Under fluroscopic guidance, advance catheter into right hepatic vein
- Create bridge into portal vein (advance from hepatic vein into portal vein)
- Support bridge with an endoprosthesis(stent) What causes portal hypertension? - Correct Answer ✅pathology of portal vein, Small intrahepatic portal vein radicals, Hepatic parenchyma, or the hepatic veins.
- Cirrhosis
- Cancer
- Pancreatitis
- Thrombosis
- trauma
- Advanced liver disease
- Severe congestive heart failure
- Proximal venous obstruction (hepatic vein or IVC obstruction)
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Budd-chiari syndrome? - Correct Answer ✅Results from hepatic vein occlusion, causes vary with regard to primary site of obstruction(hepatic vein level, sinusoids, or IVC) Abnormal clinical findings for Budd-chiari syndrome? - Correct Answer ✅1. hepatomegaly
- Abdominal pain
- Sudden onset of ascites
