DMS 2230 Vascular II Final Exam Review

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Question Answer
List and explain all of the risk factors for DVT (Be sure to include Virchow's Triad)
Discuss the clinical symptoms of acute DVT; Are the symptoms reliable in predicting DVT? Why?
iscuss Superficial Thromphlebitis. How is it different from DVT? How are the anatomy and symptoms different than DVT?
Discuss the B-mode scan technique of venous imaging above the knee for DVT. Include a review of the venous anatomy and the specific techniques for obtaining an optimal exam using the compression maneuver.
Discuss the Doppler scan technique of venous imaging for DVT above the knee. Explain the normal and abnormal lower extremity venous waveform criteria found in DVT patients.
Discuss the scan techniques of venous imaging below the knee for DVT. Review the anatomy and the specific techniques for obtaining an optimal exam using the compression maneuver.
Discuss the Doppler scan techniques of venous imaging for DVT below the knee. Explain the normal and abnormal lower extremity venous waveform criteria found in DVT patients.
Discuss the Calf intramuscular veins anatomy and involvement in venous thrombosis. How do they differ from deep veins and DVT symptoms?
Discuss the difference in sonographic findings between the acute and chronic DVT.
Discuss the differential diagnosis of Bakers Cyst and Hematoma (muscle tear) in sonographic findings, symptoms, and scan technique.
Discuss Lymph Nodes, their physiologic purpose, normal sonographic findings and abnormal Lymph-edema sonographic findings.
Discuss the following differential diagnosis' that may contribute to DVT: Compression syndromes Abdominal Tumors Abscess AV Fistulas
Discuss the differences between arterial and venous symptoms
Discuss the difference between Primary and Secondary Venous Insufficiency. List and explain the symptoms of venous insufficiency.
Discuss the Doppler criteria exhibited in Venous Insufficiency and how it differs from normal. Include the different methods or maneuvers commonly used for Venous Insufficiency evaluation.
Explain the scan technique for evaluating the superficial venous system for reflux. How does this differ from the deep venous system evaluation?
Explain how vein ablation is helpful in the treatment of chronic superficial venous insufficiency. What does the pre-op protocol consist of? Include the vein mapping technique.
Discuss the common exam indications for the upper extremity venous exam. What are the most common etiologies or causes of thrombosis in the upper extremity?
List the different venous systems in the upper extremity and central system. Explain the normal Doppler waveform criteria and scan techniques to evaluate these criteria for venous thrombosis.
Discuss Venous thrombosis in the upper extremity and sonographic findings needed to document this condition. What the major collateral venous routes for Subclavian or Innominate venous thrombosis.
Discuss Paget-Schroetter syndrome. Explain the scan techniques used in documenting this condition.
Discuss Bernoulli's law and how it relates to Stenosis.
Discuss Poiseuilles' Law and how it relates to Stenosis.
Discuss the difference between laminar flow and turbulent flow. How does friction affect flow? Explain the spectral Doppler difference in Plug and Parabolic flow.
Discuss arterial resistance in the lower extremity. Explain arterial anatomy down to the capillary bed. Include normal at rest, normal in exercise and abnormal Doppler waveforms.
Discuss Atherosclerosis and how it contributes to Peripheral Arterial Disease (PAD). Include the different categories of disease and expected clinical symptoms along with sonographic findings.
Discuss the advantages/disadvantages of indirect testing vs duplex imaging in the lower extremities. Explain the different test methods (ABI, Seg Pressures, CW Doppler waveforms, PVR). What are the pros and cons of using a PPG clip versus a CW probe?
Discuss the indication for exercise stress testing in lower extremity indirect testing. Explain the procedure and contraindications as well. Include the Post Occlusive Reactive Hyperemia technique and Toe raises. When would these be used?
Review and explain Case study 3 (pg 185) and Case study 8 (pg 193).
Explain the scan technique for evaluating the lower extremity arteries. How does the AT (acceleration time) offer suggest disease? Where?
Explain the mapping of a Stenosis in the lower extremity exam. How is the systolic velocity ratio helpful in quantifying % Stenosis in the lower extremity? Describe the documented sonographic findings of a total arterial occlusion in the lower extremity
Discuss Popliteal aneurysms and scan techniques for documenting this condition. What are the common risk associated with this condition? How does this condition differ from Pseudoaneurysm in sonographic findings and risks?
Explain the scan technique for the abdominal aorta exam. When should this exam be performed? What other testing modalities are available that will give the needed information if the abdominal aorta exam is not diagnostic?
Discuss the UE arterial anatomy. Include the difference between art and venous anatomy. List/explain the most common exam indications. Why is it possible to perform a PVR exam on a patient who has a dialysis shunt if seg pressures are contraindicated?
Define the difference between large vessel and small vessel occlusive (fixed) disease. What would the exam testing methods available for evaluating for these disorders?
Explain the common indications for the UE duplex imaging exam. Discuss the scan techniques for both Subclavian and Innominate artery. Include the normal/abnormal Doppler waveform. Why is the radial/ulnar arteries resistance so variable?
Discuss the etiologies of Cerebrovascular Accident (CVA). Define the different degrees of CVA. List and explain the common hemispheric symptoms to their associated brain hemispheres and Carotid vessels.
Discuss the scan techniques for Carotid imaging. Include the different scanning windows available and when each are used. Review the Carotid vessels resistance in the normal patient. Explain the temporal tap maneuver. When would it be indicated?
Discuss plaque characterization (surface contour/texture). List/explain the different terms used to describe plaque on the tech sheet. Explain the % Diameter Stenosis. How does the reliability compare to Doppler velocities/waveform morphology?
How does Color Flow assist the sonographer in evaluating for Stenosis? What are the machine parameters or knobology that must be optimized during the exam and why are they important for finding disease? What is post stenotic turbulence in color flow?
How does the spectral Doppler waveform resistance change from normal to abnormal in the Carotid system in the presence of Stenosis? What is spectral broadening? What is Doppler post stenotic turbulence?
How does the treatment differ for the patient who has a total occlusion versus a 95% Stenosis? How would determine the difference sonographically? Explain how Power Doppler might be helpful.
How does Carotid dissection affect the spectral Doppler waveforms? How is it different from Carotid Stenosis? What are the most common causes?
Discuss Fibromuscular Dysplasia. What other vessels is it also found in? Describe the scan technique.
Discuss the indications for Carotid stents. Explain the scan technique for their evaluation.

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