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CCI RVS EXAM 2024 TEST BANK |ALL 2 VERSIONS CONTAIN
170 QUESTIONS WITH DETAILED ANSWERS LATEST UPDATE|
ALREADY GRADED A
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 c) on both the right and left sides Vessels and structures of the penis include all of the following except: a) deep artery of the penis b) dorsal artery of the penis c) corpus spongiosum d) inferior vesicle artery e) dorsal vein d) inferior vesicle artery In B-mode imaging of the common femoral artery and its bifurcation into the profunda femoris and superficial femoral arteries, normally the profunda femoris artery courses: a) posterolateral to the SFA b) anterolateral to the SFA c) posteromedial to the SFA d) anteromedial to the SFA e) lateral to the superficial femoral artery a) posterolateral to the SFA This vessel courses along the medial aspect of the psoas muscle: a) femoral artery b) internal iliac artery c) external iliac artery d) inferior mesenteric artery e) none of the above c) external iliac artery
Because of the location of the inferior vena cava, the left renal vein crosses to the aorta to the left renal artery. anterior, inferior The superior vena cava is formed by the junction of the: Right and left brachiocephalic veins 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 a) superior mesenteric artery Another name for the hypogastric artery is: a) external iliac artery b) gastroduodenal artery c) hepatic artery d) internal iliac artery e) celiac artery d) internal iliac artery 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. a) They have only intima and adventitia layers. Artherosclerosis is a disease that begins in the: a) adventitia b) intima c) transverse fibers d) inner media e) outer media b) intima The common carotid divides into its external and internal branches usually at the level of the upper border of the: a) hyoid b) cricoid
a common origin of the innominate and left common carotid arteries The superficial vein that sends flow to the three main perforating veins of the distal calf is called: a) small saphenous vein b) posterior accessory vein c) peroneal vein d) perforator trunk vein e) medial malleolar vein b) posterior accessory vein The paratibial perforating veins (formerly Boyd's perforator) are located: a) in the lower calf b) in the distal thigh c) in the proximal thigh d) on the dorsum of the foot e) below the knee e) below the knee 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 b) female gender Which of the following is NOT true regarding atherosclerosis? a) Atherosclerosis starts as a breakdown of the intima. b) Atherosclerosis usually develops at bifurcations. c) Atherosclerosis is a red blood cell disease. d) Atherosclerosis is a generalized disease. e) Intimal damage/repair may begin in adolescence. c) artherosclerosis is a red blood cell disease. A left arm blood pressure that is 40 mmHg lower than the right can be the result of any of the following EXCEPT: a) thoracic outlet entrapment b) subclavian steal c) coarctation of the aortic arch d) axillary artery embolus e) innominate artery occlusion e) innominate artery occlusion
Which of the following anatomic lesions can produce a vertebral steal? a) innominate artery occlusion b) left subclavian artery origin stenosis c) left vertebral artery stenosis d) right common carotid artery occlusion e) right axillary artery occlusion f) d and e g) a and b g) a and b 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 a) cardiac-source embolization 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 a) carotid dissection 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 b) weakness on one side 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
c) both common carotid arteries d) both internal carotid arteries e) both external carotid arteries a) the vertebrobasilar arteries Which of the following is an anterior circulation symptom? a) ataxia b) drop attack c) syncope d) binocular visual disturbances e) facial asymmetry e) facial asymmetry A 56-year old patient reports loss of vision in her left eye two days ago, with total resolution in 10 minutes. Yesterday morning she developed weakness and numbness in her right hand and was unable to hold her coffee cup. This afternoon her hand strength is about 90% normal, with normal sensation. Clinically she has: a) amaurosis fugax b) transient ischemic attack c) migraine d) stroke e) lacunar infarct d) stroke
- 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 d) homonymous hemianopia
- Parasthesia refers to: a) dizziness b) disturbance of speech c) loss of function of a limb d) weakness e) tingling sensation e) tingling sensation
- A patient describes a 30 - minute episode of garbled speech. This is called: a) dysphasia b) aphasia
c) paresthesia d) dysphagia e) syncope a) dysphasia
- 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 b) left hemisphere
- 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 g) B and C
- 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 e) The middle cerebral artery distribution and the contralateral side of the body e) The middle cerebral artery distribution and the contralateral side of the body
- A decreased pulse at mid neck is suggestive of: a) carotid aneurysm b) common carotid stenosis if the contralateral pulse is normal c) common carotid stenosis if the contralateral pulse is decreased d) Internal carotid stenosis if the contralateral pulse is normal e) Internal carotid stenosis if the contralateral pulse is also decreased c) common carotid stenosis if the contralateral pulse is decreased
- Which is NOT true regarding carotid bruit? a) severe stenosis may cause a bruit
- 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 e) critical preocclusive stenosis of the internal carotid artery
- 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 a) 90 deg
- 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 d) greatly increased mean velocities in the middle cerebral artery
- In TCD, the normal direction of flow in the vertebral artery is: a) toward the beam b) away from the beam c) bidirectional d) dependent on the cardiac cycle e) not detectable with TCD b) away from the beam
- Which of the following is NOT a condition for which TCD might be useful? a) vasospasm following subarachnoid hemorrhage b) determination of brain death c) cerebral artery monitoring during surgery d) carotid siphon stenosis e) temporal arteritis e) temporal arteritis
- In TCD, the normal direction of flow in the anterior 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 b) away from the beam
- 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 e) significant stenosis of the middle cerebral artery
- 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 a) 0 deg
- 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 a) ipsilateral carotid obstruction, with right-to-left collateralization
- 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
d) vertebral artery e) basilar artery c) middle cerebral artery
- A carotid bruit can be detected with color flow and spectral analysis as: a) a mosaic of low red and blue frequencies in color flow in tissue lying outside of the lumen, and oscillatory waveforms above and below baseline in the spectral waveform. b) a mosaic of high red and blue aliasing frequencies in color flow and oscillatory waveforms above and below baseline in the spectral waveform. c) A mosaic of high red and blue aliasing frequencies in color flow; bruits cannot appear on the spectral waveform. d) a mosaic of low red and blue frequencies in color flow; bruits cannot appear on the spectral waveform. e) high-frequency oscillations in the spectral waveform; bruits cannot appear on color flow. a) a mosaic of low red and blue frequencies in color flow in tissue lying outside of the lumen, and oscillatory waveforms above and below baseline in the spectral waveform.
- All of the following are consistent with total occlusion of the internal carotid artery EXCEPT the: a) absence of flow in the ICA lumen b) decreased velocity proximal to occlusion c) retrograde flow in the distal internal carotid artery d) increase in flow through collateral pathways e) inability to be reconstructed surgically c) retrograde flow in the distal internal carotid artery
- 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 c) end-diastolic velocity
- 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
e) basilar artery
- 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. d) depth on the y-axis
- 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 b) genicular to arcuate branches
- 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. b) even double-projection arteriography may fail to fully determine diameter stenosis, especially in the event of vessel overlap.
- 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 c) inadvertent venous puncture
- Major complications of cerebrovascular angiography occur in approximately: a) 10% of patients b) 1% of patients c) 0.1% of patients
d) carry a much lower risk of complications than carotid endarterectomy e) are much less expensive than carotid endarterectomy. b) are technically less demanding than stenting of coronary arteries.
- The NASCET trial indicated that the best treatment for carotid stenosis in the symptomatic patient is: a) aspirin for stenosis greater than 70% in diameter b) aspirin for stenosis greater than 70% in area c) carotid endarterectomy for stenosis greater than 70% in diameter d) carotid endarterectomy for stenosis greater than 70% in area e) warfarin for stenosis less than 70% in diameter c) carotid endarterectomy for stenosis greater than 70% in diameter
- The most common medical treatment of acute ischemic stroke consists of: a) aspirin b) dextran c) Heparin d) rtPA e) dipyridamole d) rtPA
- Hypertension is associated with hyperperfusion syndrome: a) of the lower extremities b) prior to a stroke c) after a stroke d) after carotid endarterectomy e) prior to carotid endarterectomy d) after carotid endarterectomy
- Which of these patients would LEAST likely be considered at high risk for deep venous thrombosis? a) a 62 - year-old woman with a fractured hip b) a 36 - year-old man with Hodgkin's disease c) a 75 - year-old woman admitted for transient ischemic attack d) an 18 - year-old male recovering from multiple injuries sustained in a motorcycle accident e) a 72 - year-old, overweight woman with congestive heart failure c) a 75 - year-old woman admitted for transient ischemic attack
- The greatest pressure of venous hypertension in secondary varicose veins occurs: a) at rest b) during muscle contraction c) during muscle relaxation
d) while standing quietly e) while sleeping b) during muscle contraction
- Which is NOT a risk factor for DVT? a) cancer b) surgery c) age d) smoking e) bed rest d) smoking
- Varices resulting from deep-venous valvular insufficiency and incompetent perforators are called: a) primary varices b) secondary varices c) congenital varices d) genicular veins e) spider veins b) secondary varices
- A thrombus is found in a gastrocnemius muscular vein approximately a third of the way down the calf from the knee. If this were to propagate proximally, it would next invovle: a) the posterior tibial veins b) the anterior tibial veins c) the peroneal veins d) the popliteal vein e) the superficial veins d) the popliteal vein
- A thrombus is found in a soleal vein, a bit proximal to mid calf. If this were to propagate, it would next involve: a) the posterior tibial veins b) the anterior tibial veins c) the popliteal vein d) the posterior arch vein e) the great saphenous vein a) the posterior tibial veins
- Approximately what percentage of untreated calf-vein thrombosis is thought to propagate to a proximal level (i.e., popliteal or above)? a) 3 - 5% b) 15 - 20%
b) 46 - 62% accurate c) 75 - 80% accurate d) 85 - 90% accurate e) 95 - 100% accurate b) 46 - 62% accurate
- Complaints of chronic unilateral lower extremity swelling, aching, and a sense of heaviness most like suggest: a) cardiac/systemic origin b) lipidemia c) postphlebitic syndrome d) primary varicose veins e) venous ulceration c) postphlebitic syndrome
- A patient with chronic venous insufficiency complains of sudden onset of edema and pain in the affected leg. This may be related to: a) recurrence of acute deep venous thrombosis b) elevated right-heart pressures c) failure to wear surgical support stockings d) lymphedema secondary to chronic venous occlusion e) it is probably not vein-related a) recurrence of acute deep venous thrombosis
- Pitting edema of both lower extremities is likely related to: a) cardiac or systemic origin b) deep venous thrombosis c) primary varicose veins d) secondary varicose veins e) lipidemia a) cardiac or systemic origin What is the major difference between protocols for cardiac treadmill and claudication treadmill testing? Speed is varied during a cardiac treadmill test to increase heartrate to a specific target level. During a treadmill test, patient complains of pain in the left arm and jaw, but denies any other pain. What is the most likely consideration? Angina. What is the normal diameter for the abdominal aorta? 2 - 3 cm.
After walking 5 minutes on treadmill, patient experiences decrease in ankle pressure of 40% on right and 15% on left. These findings suggest? Claudication. What is the correct setting for arterial volume recording? AC-coupled output. What Doppler waveform abnormality in the lower extremity arterial circulation distal to a hemodynamically significant stenosis show? An absent flow recersal component, blunting of the peak velocity and prolonged upslope and downslope. A normal arterial volume waveform may have all EXCEPT: Swift upstroke, sharp peak, rapid downslope bowed toward baseline, dicrotic notch or reverse flow component? Reverse flow component because it is part of a Doppler waveform not volume waveform. T or F- Most analog Doppler analysis is qualitative, assessing for presence or absence of characteristics. True. What is the normal response of ankle pressure to exercise testing? There should be no change if normal. With severe lower extremity arterial occlusive disease, how will distal Doppler waveforms appear? Markedly dampened, possibly making interpretation difficult for distal segments. What is the usual cuff pressure used in arterial volume recording? 65 mmHg. What would the CFA signal look like with aortoiliac occlusion? Low pitched and monophasic. T or F- Diastolic flow reversal is always present in all abnormal limbs. False. It may be absent in vasodialted limbs. What is the most important reason Doppler evaluations should be performed with patient in a basal state and warm temperature? The results are influenced by the patient's peripheral resistence. Audible Doppler venous signals are usually low frequency and vary with respiration, where as normal arterial signals in the arms and legs are.
