Vascular technology mcq questions 1000 mcq questions on vascular technology containing 37 chapters

Chapter: 1 1. The aortic arch has several branching vessels. Among them the brachiocephalic artery is the first branch off of the aortic arch. Where does it arise? a) on the left only b) on the right only c) either on the right side or on the left side d) on the both sides [Ans. b] 2. The left subclavian artery is the branch of the aortic arch. Which one is correct for the Left subclavian artery? a) It divides in to right common carotid and subclavian arteries b) It terminates at the carotid bifurcation c) It divides in to left common carotid and subclavian arteries d) It terminates at the thoracic outlet [Ans. d] 3. The aortic arch has several branching vessels. What are the correct orders of the branches of the aortic arch? a) The left subclavian artery, the innominate artery, the left common carotid artery b) The left common carotid artery, the brachiocephalic artery, the left subclavian artery c) The innominate artery, the left common carotid artery, the left subclavian artery. d) The brachiocephalic artery, the left subclavian artery, the left common carotid artery [Ans. c] 4. Which of the following information is true for the left common carotid artery? a) It is the third branch of the aortic arch b) It terminates at the carotid bifurcation c) It is the first branch of the aortic arch d) It terminates at the thoracic outlet [Ans. b] 5. What is the name of the artery that travels along the shoulder to the upper arms and becomes the axiliary? a) The left common carotid artery

b) The brachiocephalic artery c) The subclavian artery. d) Thoracic artery. [Ans. c] 6. The axillary artery becomes the brachial after giving off seven branches. Which one is not among the seven branches? a) Superior artery b) Radial artery c) Subscapular artery d) Thoracodorsal artery [Ans. b] 7. The brachial artery courses down to upper arm, ending about 1 cm beyond the bend of the elbow where it divides intoa) Anterior and posterior arteries b) Thoracic and lateral thoracic arteries c) Radial and ulnar arteries d) Superior and subscapular arteries [Ans. c] 8. The antecubital fossa, located anterior to and below the elbow. What is it? a) A triangular region b) A circular region c) A rectangular region d) A square region [Ans. a] 9. Which artery originates from the brachial artery and travels down the lateral side of the fore arm in to the hand? a) The ulnar artery b) The superior artery c) Thoracic artery d) The radial artery [Ans. d] 10. The ulnar artery originates from the brachial artery anda) travels down the lateral side of the fore arm in to the hand

b) gives off a deep a palmer branch and then terminates in the superficial palmar arch c) Gives off a branch in the hand to from the superficial palmar arch. d) Terminates in the deep palmar arch of the hand by joining the deep branch of the ulnar artery [Ans. b] 11. Which information is correct for superficial palmar arch which continues into the hand and a branch of radial artery? a) consists of the deep palmar branch of the ulnar artery b) consists of the distal portion of the radial artery c) originates from the brachial artery d) consists of the distal portion of the ulnar artery [Ans. d] 12. The deep palmar arch which consists of the deep palmar branch of the ulnar artery and the deep palmer arch alsoa) Consists of the distal portion of the ulnar artery b) Consists of the distal portion of the radial artery c) It continues in to the hand and a branch of the radial artery. d) Originates from the brachial artery [Ans. b] 13. What are the name of the arteries which divide in to lateral and medial branches and are extending in to fingers/toes? a) The radial arteries b) The ulnar arteries c) The brachial arteries d) The digital arteries [Ans. d] 14. Which of the following information is not correct for the digital arteries? a) Arise from the palmar arches. b) Divide in to lateral and medial branches c) Arises from the brachial artery d) Extend in to finger/toes [Ans. c]

15. The ascending aorta has two branches, the right coronary artery and left coronary artery. From where the ascending aorta arise? a) Left ventricle b) Palmar arches c) Brachial artery d) Ulnar artery [Ans. a] 16. The ascending aorta arises from the left ventricle and it has two branches. What are the branches of ascending aorta? a) Radial and ulnar arteries b) The digital arteries c) Thoracic and left thoracic arteries d) Right and left coronary arteries [Ans. d] 17. The ascending aorta arises from the left ventricle. The ascending aorta has two branches and it formsa) The palmar arch b) The aortic arch c) The digital arteries d) Coronary arteries [Ans. b] 18. Which one is not one of the major visceral branches of the abdominal aorta feeds the stomach, liver, pancreas, duodenum etc? a) The celiac artery b) The renal artery c) The superior mesentic artery d) Coronary artery [Ans. d] 19. The celiac artery one of the visceral branches of the abdominal aorta, which feeds the stomach, liver, pancreas, duodenum anda) Spleen b) Intestine c) Cecum d) Ascending colon

[Ans. a] 20. The superior mesentic artery is commonly abbreviated as SMA. The superior mesentic artery is located approximately 1 cm distal to thea) Common hepatic artery b) The ulnar artery c) The celiac artery d) The radial artery [Ans. c] 21. Multiple renal arteries are not uncommon bilaterally. The renal artery which supplies blood to kidney, suprarenal glands anda) Spleen b) Intestine c) Duodenum d) Ureters [Ans. d] 22. At what distance above aortic bifurcation, the inferior mesenteric artery arises from the abdominal aorta and act as a collateral connection? a) 3-4 cm b) Approximately 3-4 cm c) 2-3 cm d) Approximately 2-3 cm [Ans. b] 23. There are four major visceral branches of abdominal aorta and three major parietal branches of abdominal aorta. Which one is the major parietal branch of the abdominal aorta? a) the inferior mesenteric artery b) the inferior phrenic artery c) The superior mesentic d) The renal artery [Ans. b] 24. The terminal branches of the abdominal aorta are right and left common iliac arteries where do the distal branches of the aorta carrying blood? a) Pelvis, abdominal wall and lower limbs b) Kidney, suprarenal glands and spleen c) Liver, duodenum and ureters

d) Pelvis, kidney and lower limbs [Ans. a] 25. The common iliac arteries are divide into the internal and external iliac arteries at the level of the lumbosacral junctiona) About 3 cm from their origin b) About 3 cm from the inguinal ligament on the lateral side c) About 5 cm from their origin d) About 5 cm from the inguinal ligament on the lateral side [Ans. c] 26. Which arteries have the branches that provide arterial inflow to regions like pelvic wall, gluteal muscle, pelvic viscera, thigh and perineum? a) The common iliac arteries b) The common femoral arteries c) The internal iliac arteries d) The external iliac arteries [Ans. c) The internal iliac arteries] 27. The external iliac artery when passes underneath the inguinal ligament, what is it become? a) The common femoral artery b) The common iliac artery c) The internal iliac artery d) Popliteal artery [Ans. a) The common femoral artery] 28. The popliteal artery is a discontinuation of thea) The common femoral artery b) The common iliac artery c) The celiac artery d) The superficial femoral artery [Ans. d] 29. What is the name of the artery that transverse the dorsum of the foot toward the base of the first toe? a) The distal popliteal artery b) The anterior tibial artery c) The common femoral artery

d) The common iliac artery [Ans. b] 30. The tibioperoneal trunk is the second branch of the distal popliteal artery. Ita) Passes superficial to the interosseous membrane b) Becomes the dorsalis pedis artery c) Penetrates in to the sole of foot d) Quickly gives rise to the posterior tibial and peroneal arteries [Ans. d ] 31. To supply the sole of foot the posterior tibial artery below the medial malleous divides intoa) Anterior and posterior tibial arteries b) Internal and external tibial arteries c) Medial and lateral tibial arteries d) Internal and lateral tibial arteries [Ans. c] 32. The peroneal artery at the distal end of the tibioperonal trunk, arises supply structures in the calcaneal region of the foot anda) Lateral side of the leg b) Medial side of the leg c) Anterior side of the leg d) Posterior side of the leg [Ans. a] 33. The planter arch consists of the deep planter artery and lateral planter artery anda) The medial planter artery b) The peroneal artery c) The dorsal metatarsal arteries d) The digital arteries [Ans. c] 34. All of the following information is correct for capillaries. Which of the information is not correct? a) They are more than a micrometer long b) They are vessels of the microcirculation c) Flow quality is steady

d) They are 8-10 microns in diameter [Ans. a] 35. What are considered to be resistance vessels help to regulate blood flow by contracting and releasing? a) Capillaries b) Capillary beds c) Arterioles d) Aorta [Ans. c] 36. The tunica intima consists of a surface layer of smooth endothelium over a base membrane and connective tissue, is thea) Outermost layer of the arterial wall b) Innermost layer of the arterial wall c) Intermediate layer of the arterial wall d) Intermediate layer of the capillary beds [Ans. b]

37. The tunica media is composed of smooth muscle and connective tissue and these components usually arranged in a a) Triangular pattern b) Square pattern c) Rectangular pattern d) Circular pattern [Ans. d] 38. Which layer usually consists the vasa vasorum, tiny vessels that carry blood to the walls of the larger arteries? a) The tunica externa b) The tunica media c) The tunica intima d) the capillary beds [Ans. a]

Ch-2 1. With every beat of heart, each one of the arterial tree oscillates what amount oof blood in aorta? a. 50 ml b. 60 ml c. 70 ml d. 80ml ans-c 2. In case of stroke volume, at the begining of cardiac contraction, the pressure in the left ventricles rises rapidly, quickly exceeding that in the aorta so that the aortic valve opens, a. blood is entered, blood pressure rises b. blood is ejected, blood pressure lowers c. blood is ejected, blood pressure rises d. blood is entered, blood pressure lowers ans-c 3. The arterial system isa. a singlebranched elastic conduit that carries blood away from the heart and outward to the most distant tissues b. a multibranched elastic conduit that carries blood to the heart and outward to the most distant tissues c. a singlebranched elastic conduit that carries blood to the heart and outward to the most distant tissues d. a multibranched elastic conduit that carries blood away from the heart and outward to the most distant tissues ans-d 4. As the arterial pressure wave moves distally-away from the heart and out toward the periphery, the propagation speed-the pulse wave velocity increases with growing stiffnessof the arterial walls.What factors of the pressure wave change as the wave move through the arterial system? a. the propagation speed and strength b. the propagation shape and strength c. the propagation speed, shape and strength d. the propagation speed and shape ans-c 5. What delivers an increased blood volume that supplies more nutrients? a. increased heart rate b. decreased heart rate c. normal heart rate d. normal and incresed heart rate ans-a 6. When the pressure waves move from the larger arteries through the high resistant vessels,capilliaries and then into the venous side, how does the mean pressure reacts? a. the mean pressure gradually increases b. the mean pressure gradually declines c. the mean pressure remains normal d. the mean pressure increases fast ans-b 7. What do the arterial pressure and total peripheral resistance do? a. determine the volume of plasma that enters it

b. determine the volume of blood that enters it c. determine the volume of plasma that leaves it d. determine the volume of blood that leaves it ans-d 8. Where is the greatest blood pressure? a. at the lever b. at the kidney c. at the stomach d. at the heart ans-d 9. What does the requirement(s) of any fluid medium between any two points? a. a route along with the fluid can flow b. a difference in energy levels between the two points c. a route along with the fluid can flow and a difference in energy levels between the two points d. a difference in pressure levels between the two points ans-c 10. Which one is the correct relationship? a. lower resistance=lower flow rate b. higher resistance= lower flow rate c. higher flow rate=higher resistance d. higher resistance=lower resistance ans-b 11. What is the main form of energy present in flowing blood? a. kinetic energy b. gravitational energy c. pressure energy d. chemical energy ans-c 12. Potential energy has several components. The dominant source is the pumping action of the heart muscle. The other one is a. peer pressure b. blood pressure c. parental pressure d. hydrostatic pressure ans-d 13. Kinetic energy is the ability of flowing blood to do work as a result of its velocity. It is a. proportional to the density of blood b. not completely compared to the pressure energy c. proportional to the density of blood and proportional to the square of the velocity d. proportional to the square of the velocity ans-c 14. How is the gravitional energy expressed? a. millimiteres of hydrogen b. millimiteres of mercury c. millimiteres of oxygen d. millimiteres of carbon dioxide ans-b 15. What introduce the gravitional energy of the fluid column? a. changes in the width b. changes in the height

c. changes in the square d. changes in the density ans-b 16. Gravitional energy is also known as hydrostatic pressure. In the ciculatory system,hydrostatic pressure is equivalent to a. weight of the column of blood extending from heart b. height of the column of blood extending from heart c. density of the column of blood extending from heart d. square of the column of blood extending from heart ans-a 17. For example, in a supine, medium sized patient in whom the arteries and veins are approximately the same levelas the heart. What is the difference in hydrostatc pressure effect on the arteries and veins? a. vast b. much more c. less d. negligible ans-d 18. An energy gradient is necessary for blood to move from one point to another. When will the movement occur? a. low pressure state to low pressure state b. high pressure state to high pressure state c. low pressure state to high pressure state d. high pressure state to low pressure state ans-d 19. At the time of the acceleration phase of pulse, how is the pressure? a. evenly accumulated b. oddly distributed c. evenly distributed d. oddly accumulated ans-c 20. What happens at the deceleration phase of the pulse (early systole to peak systole)? a. cardiac output increases to the point at which outflow through the high resistance peripheral vessels exceeds the volume ejected from heart b. cardiac output decreases to the point at which outflow through the low resistance peripheral vessels exceeds the volume ejected from heart c. cardiac output increases to the point at which outflowt hrough the low resistance peripheral vessels exceeds the volume ejected from heart d. cardiac output decreases to the point at which outflowt hrough the high resistance peripheral vessels exceeds the volume ejected from heart ans-d 21. Laminar flow is the type of flow thought to exist in many vessels. In this case, each very thin layer flows at a velolocity of, a. fastest at the vessel wall and slowest at the center of the vessel b. both fast at the vessel wall and at the center of the vessel c. both slow at the center of the vessel and at the vessel wall d. fastest at the center of the velssel and slowest at the vessel wall ans-d 22. In case if Laminar flow, what happens to the friction and energy losses? a. decrease to the extent that laminar flow is distributed b. remain the same to the extent that laminar flow is distributed

c. increase to the extent that laminar flow is distributed d. laminar flow has no relation with friction and energy loss ans-c 23. There are two forms of laminar flow. Parabolic flow and Plug flow.How is the velocity in Parabolic flow? a. gradually decreasing at the center of lumen b. same at the center of lumen and vessel wall c. gradually increasing at the vessel wall d. highest at the center of the lumen ans-d 24. The movement of blood through artery depends on a. the physical properties of the fluid b. the interaction between the conduit and fluid c. both the physical properties of the fluid and the interaction between the conduit and fluid d. neither the physical properties of the fluid nor the interaction between the conduit and fluid ans-c 25. What is the relationship between the conduit, fluid and pressure a. the longer the conduit the shorter the fluid is in contract and higher pressure required b. the longer the conduit the longer the fluid is in contract and higher pressure required c. the longer the conduit the longer the fluid is in contract and lower pressure required d. the longer the conduit the shorter the fluid is in contract and lower pressure required ans-b 26. Viscosity can be described as a chracter of fluid. The true relationship between the viscosity and velocity is a. increased viscosity=increased velocity b. decreased viscosity=decreased velocity c. increased viscosity=no change in velocity d. decreased viscosity=increased velocity ans-d 27. In the circulation system, energy is lost in the form of heat as the layers of the red blood cells rub against each other, creating friction. Friction is generateda. by the viscous properties of the fluid b. automatically c. by the force of blood d. by the solids on the fluid ans-a 28. Energy loss during blood flow occurs because of friction. In part, what determine the amount of friction and energy loss? a. the height of the vessels b. the width of the vessels c. the length of the vessels d. the dimensions of the vessels ans-d 29. In the micro circulation, the blood flow layers are relatively close to the vessel walls resulting in a a. blockage to the flow b. assistance to the flow c. resistance to the flow

d. smoothness to the flow ans-c 30. Due to the high viscosity in the circulatory system, what can be seen? a. high hematocrit b. more red blood cells c. more volume of plasma d. lower anemia ans-b 31. In the following equation, which symbol reflects the right abbreviation? R-8L/r4 a. r=the overall flow resistance b. L=vessel width c. =the viscosity of the fluid d. R=the radius of the vessel lumen ans-c 32. Energy loss in a fluid system can also be inertial in nature.Inertial losses are caused bya. changes in derection and velocity and increase with deviations in laminar flow b. changes in derection and/or velocity and increase with deviations in laminar flow c. changes in derection or velocity and increase with deviations in laminar flow d. changes in derection and/or velocity and decrease with deviations in laminar flow ans-b 33. Whose law defines the relationship between pressure, volume flow and resistance and helps to answer the question of how much fluid is moving through a vessel? a. Priestley b. Priestly c. Prusiner d. Poiseuille ans-d 34. Which characteristics of a vessel affects resistance more dramatically than either viscosity or vessel length? a. length b. width c. height d. diameter ans-d 35. which one is directly proportional to the to the volume flow and small changes may cause large change to the flow? a. length b. height c. radius d. width ans-c 36. According to the basic laws of fluid dynamics most notably law of conservation of mass, the relationship among velocity, volume flow and cross sectional area of the vessel isa. V=A/Q b. A=Q/v c. Q=V/A d. V=QA ans-b 37. In the cardiovascular system, why the changes in blood flow occurs? a. because of red blood cells

b. because of the changes in the radius of a vessel c. because of the changes in the radius of a vessel and the pressure energy gradient d. because of the pressure energy gradient ans-c 38. What is the Poiseuilles equation exactly? a. Q=[(P1-P2) 8L]/ r4 b. Q=[(P2-P1)r4]/8L c. Q=[(P1-P2) r4]/8L d. Q=[(P1-P2)r4]/8L ans-d 39. What is the abbreviated pressure-volume flow relationship? a. Q=R/P b. Q=P/R c. P=Q/R d. Q=PR ans-b 40. What is the Ohms law related to the flow of electricity? a. I=R/E b. I=ER c. E=I/R d. I=V/R ans-d 41. After the initial acceleration in systole, blood movement continues and develops into distinct streamline formations. What happens when the flow pattern becomes unstable? a. streamline accumulates and form big circular currents b. streamlines accumulate c. streamlines break up and form small circular currents d. streamlines form big circular currents ans-c 42. Who sought to determine how visvcosity, vessel radius and the pressure/volume relationship influence the stability of flow through a vessel a. Osborne Reynolds b. Hugh Watkins c. David Alter d. Martin Apple ans-a 43. The elements that affect the development of turbulentflow are expressed by a dimensionless number. The number is called= a. Watkins number b. Alters number c. Martins number d. Reynolds number ans-d 44. The factors that affect the development of turbulance are expressed by Reynolds number. What is the equation? a. Re-(Vq2)/r b. Re-(V 2r)/q c. Re-(Vq2r)/ d. Re- /(Vq2r) ans-c

45. Because the density and viscosity of the blood are fairly constant, the development of turbulence depends mainly on the size of the vessels and the velocity of flow. When the laminar flow tends to become distributed? a. When the Reynolds number exceeds 500 b. When the Reynolds number exceeds 1000 c. When the Reynolds number exceeds 2000 d. When the Reynolds number exceeds 3000 ans-c 46. Turbulent flow may cause vessel walls to vibrate, the harmonics of this vibration producea. vascular bleeding b. Aneurismal bruits c. arterial bruits d. vascular bruits ans-d 47. In case of pressure /velocity relationship, if gravitional energy remains constant, but kinetic energy increases, then what will happen to the potential energy? a. potential energy may decrease b. potential energy must decrease c. potential energy must increase d. potential energy will have no effect ans-b 48. Whose equation shows that the velocity and pressure are inversely related like where there is high velocity, there is low pressure, where there is low velocity, there is high pressure? a. Reynolds equation b. Boussineqs equation c. Bernouli equation d. Navier-Stokes equation ans-c 49. In the region proximal to the stenosis, how is the pressure energy and kinetic energy? a. the pressure energy is higher and the kinetic energy is lower b. the pressure energy is lower and the kinetic energy is higher c. both the pressure energy and the kinetic energy are higher d. both the pressure energy and the kinetic energy are lower ans-a 50. Distal to the stenosis(poststenosis), the kinetic energy decreases and the pressure energy increases. At this point, the total energy sum isa. highest b. lowest c. normal d. fluctuated ans-b 51. Pressure gradients varies between two points in a vessel. Flow separation within a vessel may be caused bya. changes in the geometry of the flow b. changes in the direction of the flow c. changes in the geometry of the vessel d. changes in the density of red blood cells ans-c

52. What kind of regions are left behind at the time of flow separation? a. regions of red blood cell b. regions of velocity c. regions of pressure d. regions of stagnant ans-d 53. In case of systole, because flow moves from higher to lower pressure, the direction of flow in the refgion of flow separation changes with respect to the transducer and causesa. no color change b. non visible color change c. visible color change d. the color into red ans-c 54. In case of diastole, when the flow at the vessel wall is stagnant, there is no movement of blood and causes a. visible color change b. non visible color change c. the color into red d. no color change ans-d 55. Steady flow is the result of a steady driving pressure. If there is no decreases in the pressure downstram then what will ahappen? a. there will be more flow away from the driving pressure b. there will be no flow away from the driving pressure c. the flow will remain the same as before d. the flow will increase suddenly ans-b 56. Where there is steady flow in a rigid tube, energy losses are mainly viscous. Which equation can describe this? a. Reynolds equation b. Boussineqs equation c. Bernoulis equation d. Poiseuilles equation ans-d 57. What flow reflect changes in both the driving pressure conditions and the response of the vascular system? a. Pulsatile b. Steady c. Diastolic d. Reverse ans-a 58. During the systole, which flow remains throughout the periphery? a. backward b. forward c. no flow d. normal flow ans-b 59. At the end of the systole, the aortic valve closes and what happens next? a. minimum ventricular contraction is obtained b. maximum ventricular contraction is fofeited c. maximum ventricular contraction is forfeited

d. maximum ventricular contraction is obtained ans-d 60. In which stage, the flow moves forward again as the reflective wave hits the proximal resistance of the next wave and reverses direction again? a. diastole b. early diastole c. systole d. early systole ans-b 61. How does the vessels recoil, convert potential energy into kinetic energy and maintain flow more distally? a. as the pressure wave moves slowly b. as the pressure wave moves very quickly c. as the pressure wave moves quickly d. as the pressure wave moves forward ans-c 62. If you drop a golf ball and there is no floor, it keeps moving downward and if you drop a golf ball onto a cement floor, it reverses direction. Whicj of the following statement goes with this example? a. flow always moves along the path of least assistance b. flow always moves along the path of most resistance c. flow always moves along the path of resistance d. flow always moves along the path of least resistance ans-d 63. Diastolic flow reversal is a hallmark of vessels that supplya. low resistance peripheral vascular beds b. high resistance vascular beds c. high resistance peripheral vascular beds d. high resistance peripheral beds ans-c 64. Vasodilation is produced by body heating, exercise and stenosis.When vasodilation occurs, what happens to the flow reversal? a. increases b. is present c. decreases or is absent d. is always absent ans-c 65. The flow of a continuous nature throughout systole and diastole feeding a dilatedvascular bed is known asa. low-resistance flow b. high-resistance flow c. high-assistance flow d. low-assistance flow ans-a 66. The internal carotid, vertebral, renal, celiac, splenic and hepatic arteries are characterized bya. low-resistance flow b. high-resistance flow c. high-assistance flow d. low-assistance flow ans-a

67. The external carotid, subclavian, aorta, iliac, externity arteries and fasting superior mesenteric arteries are characterized bya. low-resistance flow b. high-resistance flow c. high-assistance flow d. low-assistance flow ans-b 68. What are the reasons for the characteristic reversal of flow in a biphasic or triphasic high resistance disappears distal to a stenosis? a. decreased peripheral assistance as a result of relative ischemia b. increased peripheral resistance as a result of relative ischemia c. decreased peripheral resistance as a result of relative ischemia d. increased peripheral assistance as a result of relative ischemia ans-c 69. How is the pulsatility flow in response to vosoconstriction ? a. in medium and small size arteries of the limbs increases b. in minute arteries, arterioles and capillaries increases c. in medium, minute arteries and arterioles increases d. in small, medium and minute arteries increases ans-a 70. How is the pulsatility flow in response to vosodilation ? a. in medium and small size arteries of the limbs decreases b. in minute arteries, arterioles and capillaries decreases c. in medium, minute arteries and arterioles decreases d. in small, medium and minute arteries decreases ans-a 71. Compensatory responses of the microcirculation tend to maintain pressure and flow. When it is important to obtain information about pressure and flow patterns? a. at rest b. after the exercise c. at rest but not after exercise d. both at rest and after exercise ans-d 72. In an extremity at rest and in the presence of severestenosis or complete occlusion of the main artery, how is the blood flow? a. partial blood flow may be fairly normal b. partial blood flow may be abnormal c. total blood flow may be fairly normal d. total blood flow may be abnormal ans-c 73. What can an arterial obstruction do? a. decrease the volume flow b. forward the flow direction c. decrease velocity d. alter flow in nearby ans-d 74. Exercise should induce peripheral vasodilation in the microcirculation. As a result we can geta. both distal peripheral resistance and blood flow markedly increases b. distal peripheral resistance decreases and blood flow markedly increases c. distal peripheral resistance increases and blood flow markedly decreases

d. nearby peripheral resistance decreases and blood flow markedly increases ans-b 75. Vasoconstriction and vasodilation of the blood vessels within skeletal muscles are also influenced by sympathetic innervation fibers. The job isa. to regulate body control b. to regulate body resistance c. to regulate body temperature d. to maintain antibody ans-c 76. Autoregulation controls vasoconstriction and vasodilation which is accounted for the ability of most vascular bedsa. to maintain an increased level of blood flow b. to maintain a decreased level of blood flow c. to maintain a constant level of blood flow d. to maintain an increased level of plasma flow ans-c 77. A low resistance, monophasic Doppler flow signal may be present normally in an extremity artery after vigorous exercise because the exercise causes peripheral dilatation and reduced flow resistance. What decision can we adopt from this example? a. By increasing resistance in the working muscle, exercise normally decreases reflection of the Doppler flow signal in the exercising externity b. By decreasing resistance in the working muscle, exercise normally increases reflection of the Doppler flow signal in the exercising externity c. By decreasing resistance in the working muscle, exercise normally decreases reflection of the Doppler flow signal in the exercising externity d. By decreasing resistance in the working muscle, exercise normally shows constant reflection of the Doppler flow signal in the exercising externity ans-c 78. When a high resistance signal may occur? a. at increased vasoconstriction at the arteriolar level b. at normal vasoconstriction at the arteriolar level or from distal arterial obstruction c. at decreased vasoconstriction at the arteriolar level d. at normal vasoconstriction at the arteriolar level or from nearby arterial obstruction ans-b 79. What does the proper characterization of velocity waveforms require? a. an understanding of the normal flow characteristics of a particular artery b. an understanding of the psychologic status of the circulation c. an understanding of the normal flow characteristics of a particular artery but not the psychologic status of the circulation supplied by vessel d. an understanding of both the normal flow characteristics of a particular artery and the psychologic status of the circulation supplied by vessel ans-d 80. How one can examine the externity cooled or warmed? a. Flow to a cool, vasodilated externity will have pulsatile signals b. Flow to a cool, vasoconstricted externity will have pulsatile signals c. Flow to a warm, vasodilated externity will have pulsatile signals d. Flow to a warm, vasoconstricted externity will have steady signals ans-b 81. If good collateralization is present, proximal or distal Doppler velocity waveform qualitiesa. may be altered b. may not be altered

c. must be altered d. must not be altered ans-b 82. How is the distribution of frequencies of Laminar flow? a. even distribution of frequencies at diastole b. odd distribution of frequencies at systole c. even distribution of frequencies at systole d. odd distribution of frequencies at diastole ans-c 83. A critical, hemodynamically significant stenosis causes a major reduction in volume flow and pressure. What is the percentage of cross-sectional area of the arterial lumen reduction and a diameter reduction? a. 75% and 50% respectively b. 50% and 75% respectively c. 75% and 25% respectively d. 25% and 75% respectively ans-a 84. Diameter reduction is aa. one-dimensional measurement b. two-dimensional measurement c. three-dimensional measurement d. four-dimensional measurement ans-a 85. Area reduction is aa. one-dimensional measurement b. two-dimensional measurement c. three-dimensional measurement d. four-dimensional measurement ans-a 86. What happens in the critical stenosis? a. only pressure decrease b. only flow volume increase c. only pressure increase d. both pressure and flow volume decrease ans-d 87. The occurrence and degree of hemodynamic abnormality produced by a stenosis depend on many factors. One of thm isa. smoothness of surface b. depth of narrowing c. arteriovenous pressure gradient d. arterial resistance nearby to the stenosis ans-c 88. Critical arterial stenosis produces certain identifiable hemodynamic phenomena that are described in the literature as a. arterial profile b. stenosis profile c. collateral profile d. peripheral profile ans-b 89. The flow enters, passes through and/or exists the stenosis. As a result there is a/an a. decrease in Doppler shift frequencies but increase in velocities

b. increase in Doppler shift frequencies but increase in velocities c. increase in Doppler shift frequencies and in velocities d. decrease in Doppler shift frequencies and in velocities ans-c 90. When the poststenotic arterial lumen widens rather quickly, large flow separation patterns are observed at the walls as a result of velocity gradients. Who described this? a. Reynold b. Boussineq c. Bernoulli d. Navier ans-c 91. Why the energy is expected largely in the form of heat a. eddy currents work for and vortices work against the viscosity of blood b. vortices work for and eddy currents work against the viscosity of blood c. eddy currents and vortices work for the viscosity of blood d. eddy currents and vortices work against the viscosity of blood ans-d 92. Reduction in the diameter of a vessel increase the velocity of flow. The size of the vessel is inversely proportional to the velocity of blood flow. So we can form the equation likea. V=A/Q b. A=Q/V c. Q=V/A d. V=QA ans-b

Chap 3 1. Due to what disease the patient notes muscle fatigue with work and the discomfort is usually predictable ,occurring with the same amount of work and disappearing within minutes of activities cessationa) Chronic occlusive b) Claudication c) Acute arterial occlusion d) Ischemic rest pain [Ans. b] 2. If the patient complains of pain in a specific part of the leg after walking two city blocks. What note may include in the history of the patient? a) Block claudication b) Thigh claudication c) Calf claudication d) 2 block claudication [Ans. d] 3. Buttock claudication, which strongly suggests artoiliac disease. What can be suggested if the symptoms are unilateral? a) Distal iliac disease b) Common femoral disease c) Iliofemoral disease d) Popliteal disease [Ans. c] 4. If a patient feels pain at rest when the limb is not in a dependent position and the patient blood pressure is decreased, which one of the following is responsible for this situation? a) Buttock claudication b) Ischemic rest pain c) Acute arterial occlusion d) Block claudication [Ans. b] 5. Necrosis (tissue death), usually due to a deficient or absent blood supply. Necrosis is the most severe symptom of a) Arterial insufficiency b) Acute arterial occlusion

c) Ischemic rest pain d) Tissue loss [Ans. a] 6. Symptoms include the five Ps: pain, pallor, pulselessness, paresthesia, paralysis. Some include a sixth P for polar. Some even include a seventh P for purplish. Which one is represented by seventh P? a) Arterial insufficiency b) Ischemic rest pain c) Acute arterial occlusion d) Block claudication [Ans. c] 7. What may result from thrombus, embolism or trauma & is an emergency situation since the abrupt onset does not provide for the development of collateral channels? a) Arterial insufficiency b) Ischemic rest pain c) Acute arterial occlusion d) Block claudication [Ans. c] 8. For cold sensitivity symptoms include changes in skin color such as pallor (paleness), cyanosis (bluish discoloration) or rubor (dark red coloration) and the patient often experiencesa) Paresthesia and pain b) Paralysis and pain c) Paresthesia and paralysis d) Paralysis and pulselessness [Ans. a] 9. In what condition symptoms of intermittent ischemia of the fingers or toes occur in response to cold exposure? a) Mesenteric ischemia b) Renovascular hypertension c) Arterial insufficiency d) Raynauds phenomenon [Ans. d]

10. Raynauds phenomenon is a condition that exists when symptoms of intermittent ischemia of the fingers or toes occur in response to cold exposure as well asa) Physical stress b) emotional stress c) Physical pain d) Physical & mental stress [Ans. b] 11. What is more common form among diabetics and normally occurs at a younger age in human? a) Diabetics mellitus b) Medial calcification c) Atherosclerosis d) Diabetes [Ans. c] 12. What is the disease of the distal popliteal artery and tibial vessels that diabetics have a higher incidence? a) Occlusive b) Occlusion c) Claudication d) Arterial insufficiency [Ans. a] 13. There is a higher incidence of gangrenous changes and ultimately, amputations, poor sensation as a result of neuropathy leads to increases likelihood ofa) Hypertension b) Emotional stress c) Physical stress d) Trauma [Ans. d) trauma] 14. It remains unclear whether high blood pressure is a causative factor or enhances and complicates the development of the atherosclerotic process in case ofa) Trauma b) Hypertension c) Arterial insufficiency d) Occlusion [Ans. b) Hypertension]

15. What is associated with a greater incidence of coronary atherosclerosis and also increases an individuals susceptibility to peripheral and cerebrovascular involvement? a) Trauma b) Renovascular Hypertension c) Systemic Hypertension d) Hyperlipidemia [Ans. c) systemic Hypertension] 16. Although increased lipids may result from metabolic problems associated with heredity, a diet high in certain types of fat is associated with hyperlipidemia. As they are insoluble in water, elevated plasma lipids are closely associated with the development ofa) Occlusion b) Atherosclerosis c) Medial calcification d) Mesenteric ischemia [Ans. b] 17. Studies have demonstrated that the chemicals in cigarettes irritate the endothelial lining of the arteries in addition to causinga) Vasoconstriction b) Atherosclerosis c) Medial calcification d) Hyperlipidemia [Ans. a] 18. The term atherosclerosis is applied to a number of pathological conditions in which there is thickening, hardening and loss of elasticity of the a) Media layers of vessel b) Intima c) Visceral vessel d) Walls of the arteries [Ans. d] 19. There are so many risk factors that cause atherosclerosis such as hypertension, hyperlipidemia, family history, diabetes mellitus, sedentary lifestyle and smoking. What are the major factors among them? a) Hypertension, hyperlipidemia, family history

b) Smoking, hyperlipidemia, family history c) hyperlipidemia, family history, diabetes mellitus d) smoking, diabetes mellitus, sedentary lifestyle [Ans. b] 20. Atherosclerosis most often occurs at the carotid bifurcation, origins of brachiocephalic vessel, origins of the visceral vessels, the infrarenal aortoiliac system, superficial femoral artery at the abductor canal, the popliteal trifurcation anda) The subclavian artery b) The common femoral artery c) The common femoral bifurcation d) The common femoral trifurcation [Ans. c] 21. Leriche syndrome, caused by obstruction of the terminal aorta. It usually occurs in males and is characterized by fatigue in the hips, thighs or claves on exercising, often coldness of the lower limbs and absence of pulsation. Where does the absence of pulsation occur? a) Femoral arteries b) subclavian arteries c) Popliteal arteries d) brachial arteries [Ans. a] 22. Obstruction of a blood vessel by a foreign substances or blood clot, may be solid, liquid or gaseous and may arise from body or may enter from without is called a) Aneurysm b) Emboli c) Pseudo aneurysm d) Atherosclerosis [Ans. b] 23. Emboli move distally and become stuck in the vessels of the smallest caliber. Toe ischemia results, which often improves mainly as the result of blood flow from smaller a) Digital arteries b) Femoral arteries c) brachial arteries

d) Collateral arterial branches [Ans. d] 24. A true aneurysm is different from false aneurysm which does not contain all arterial wall layers. What is a true aneurysm? a) a dilatation of all Four layers of the arterial wall b) a dilatation of all Five layers of the arterial wall c) a dilatation of all Three layers of the arterial wall d) a dilatation of all Two layers of the arterial wall [Ans. c] 25. Arterial aneurysms can occur in nearly any artery of the body. What is the most common location for arterial aneurysms? a) Infrarenal aorta b) aortic arch c) carotid artery d) Thoracic aorta [Ans. a] 26. Patients with one aneurysm have a higher chance of having second aneurysm. Which of the following is not included as other location for second aneurysm? a) Carotid artery b) Renal artery c) Subclavian artery d) Splenic arteries [Ans. c] 27. The cause of aneurysm is unknown but may include poor arterial nutrition, congential defects, infection or trauma, iatrogenic injury and a) Occlusive b) atherosclerosis c) Medial calcification d) Hypertension [Ans. b] 28. Some terms that relate to aneurysm shape include focal aneurysm, fusiform aneurysm, saccular aneurysm and concentric aneurysm. What is a Fusiform aneurysm? a) Localized out-pouching of an artery

b) Localized out-pouching of a vessel c) Diffuse, circumferential dilatation of an artery d) Diffuse, circumferential dilatation of an arterial segment [Ans. d] 29. Any aneurismal formation has the propensity to form thrombotic material at the walls. The main complications of aneurysm include distal embolization of peripheral aneurysm and a) Rupture of aortic aneurysm b) circumferential dilatation of an arterial segment c) Localized out-pouching of an artery d) Embolization of pseudo aneurysm [Ans. a] 30. Some terms that relate to aneurysm shape include focal aneurysm, fusiform aneurysm, saccular aneurysm and concentric aneurysm. What is a Saccular aneurysm? a) Localized out-pouching of a vessel b) Diffuse, circumferential dilatation of an arterial segment c) Localized out-pouching of an artery d) Rupture of aortic aneurysm [Ans. c] 31. What occurs when a small tear of the intima allows blood to form a cavity between two wall layers and a new lumen, the false lumen is formed? a) Pseudo aneurysm b) Dissecting aneurysm c) Aortic aneurysm d) Peripheral aneurysm [Ans. b] 32. Two conditions must usually be met for dissecting aneurysm to form. Among the two the second condition is: development of an intimal tear through which blood leaks to media and first one is a) Strengthening of the media of the vessel b) Thickening of the media of the vessel c) Weakening of the media of the vessel d) Scratching of the media of the vessel [Ans. c]

33. In case of a dissecting aneurysm atherosclerosis is not generally considered to be a causative factor. Where does a dissection most often occur? a) Thoracic aorta b) Infrarenal aorta c) Subclavian artery d) Thoracic artery [Ans. a] 34. A pseudo aneurysm is essentially a pulsating hematoma. A hole in the arterial wall permits blood to escape under pressure, in to a contained area in the a) Media of the vessel b) Adjacent tissue c) Artery wall d) Thoracic aorta [Ans. b] 35. A hematoma forms in the tissue and if confined by the surrounding structures and if there is continuous blood flowing from the artery to the a) Pulsatile structure in the tissue b) Adjacent tissue c) Media of the vessel d) Nonthrombotic region of the hematoma [Ans. d] 36. A pseudo aneurysm is essentially a pulsating hematoma. To be considered a pseudo aneurysm, there must be a communication (channel) from the main artery to the a) Nonthrombotic region of the hematoma b) Media of the vessel c) Pulsatile structure in the tissue d) Adjacent tissue [Ans. c] 37. Arteritis inflammation of the arterial wall often results in thrombosis of the vessel and can affect tibial and peroneal arteries as well as the smaller and more distal arterioles and a) Media of the vessel b) Thoracic aorta c) Nutrient vessel

d) Nonthrombotic region of the hematoma [Ans. c] 38. Arteritis inflammation of the arterial wall often results in thrombosis of the vessel and can affect tibial and peroneal arteries. There are several types of arteritis. Which of the following is not one of them? a) Takayasus disease b) Occlusive disease c) Polyarteritis disease d) Buergrs disease [Ans. b] 39. Arteritis inflammation of the arterial wall. There are several types of arteritis. What is the most common form of arteritis among them? a) Thromboangiitis obliterans b) Polyarteritis disease c) Takayasus disease d) Occlusive disease [Ans. a] 40. Arteritis inflammation of the arterial wall often results in thrombosis of the vessel and can affect tibial and peroneal arteries. They have some characteristics. Which of the following is not one of the characteristics? a. Associated with heavy cigarette smoking b. Patients present with occlusions of the distal arteries c. Superficial thrombophlebitis is a primary result d. Most often associated with collagen vascular syndromes ans- c e) Arteritis inflammation of the arterial wall often results in thrombosis of the vessel. At early stage of the disease may occur rest pain and a. Atherosclerotic Occlusive b. Ischemic ulceration c. Superficial thrombophlebitis d. gangrene ans- b 41. Arteritis is associated with heavy cigarette smoking and occurs primarily in men younger than 40 years of age. Patients present with occlusions of thea. Digital arteries b. Carotid arteries c. Femoral arteries

d. Distal arteries ans- d 42. One of the several congenital anomalies of the arterial system, coarctation of the aorta is congenital narrowing or structure of the thoracic aorta, what may as well affect by this? a. Infrarenal aorta b. distal arteries c. abdominal aorta d. digital arteries ans- c 43. One of the several congenital anomalies of the arterial system, coarctation of the aorta is congenital narrowing or structure of the thoracic aorta. Clinical findings may include hypertension due to decreased kidney perfusion or manifestations of lower extremity ischemia. Which is not the example of these criteria? a. paralysis and trauma b. decreased pulses c. decreased segmental Doppler pressures d. decreased pulses and decreased segmental Doppler pressures ans- a 44. In dissection the media is weakened, the intima develops a tear through which blood leaks in to the a. true lumen b. arterial lumen c. false lumen d. main lumen ans- c 45. In dissection the media is weakened, the intima develops a tear through which blood leaks in to the false lumen that has developed between the intima and media. Flow velocities differ in each lumen. Dissection can affect the aorta and a. distal arteries b. peripheral arteries c. digital arteries d. Carotid arteries ans- b 46. What is divided in to two compartments by a thin membrane that plays the distinguishing feature of ultrasonographic? a. true lumen b. false lumen c. main lumen

d. arterial lumen ans- d 47. Dissection can affect the aorta. Aortic dissections. Which can also extend to the iliac arteries, may occur as a consequences of hypertension or a. severe chest trauma b. emotional stress c. physical stress d. hyperlipidemia ans- a 48. The complication is when the dissection enlarges, there is a risk of significant stenosis and/or occlusion of the a. brachial arteries b. digital arteries c. main artery d. carotid artery ans- c 49. Which one has the symptoms that include changes in skin color such as pallor (paleness), cyanosis (bluish discoloration), or rubor (dark red coloration) and the patient often suffers from paresthesia and pain? a. spastic Raynauds syndrome b. vasopastic disorders c. obstructive Raynauds syndrome d. ischemic ulceration ans- b 50. Raynauds phenomenon is a condition that exits when in response to cold as well as emotional stress fingers and toes shows symptom of a. spastic Raynauds syndrome b. intermittent ischemia c. vasopastic disorders d. ischemic ulceration ans- b 51. Primary Raynauds disease may be heredity and very common in young women. Which is not the alternative name of Primary Raynauds phenomenon? a. idiopathic Raynauds phenomenon b. spastic Raynauds syndrome c. intermittent ischemia d. obstructive Raynauds syndrome ans- d 52. Secondary Raynauds, also known as secondary Raynauds phenomenon. What may be the first manifestation of Secondary Raynauds?

a. intermittent ischemia, anatomic abnormality b. anatomic abnormality, vasospastic disorder c. collagen disease, buergers disease, anatomic abnormality d. collagen disease, intermittent ischemia, anatomic abnormality ans- c 53. Entrapment of the popliteal artery is the most written about entrapment syndrome. It is thought to be caused by compression of the popliteal artery by the medial head of the a. gastrocnemius muscle b. fibrous muscle c. gastrocnemius muscle and fibrous bands d. gastrocnemius muscle or fibrous muscle ans- a 54. Pallor means paleness. Pallor term is used when skin becomes pale. Which of the following is mainly the result of-Pallor or paleness of skin? a. reactive hyperemia b. deoxygenated hemoglobin c. arterial obstruction d. deficient blood supply ans- d 55. Rubor suggests damaged, dilated vessels or vessels dilated as a result of reactive hyperemia or infection. What is the meaning of rubor? a. paleness b. a dark reddish discoloration c. bluish discoloration d. purple patches ans- b 56. Cyanosis, a bluish discoloration of the skin and mucous membranes. What does the Cyanosis generally occur? a. concentration of deoxygenated hemoglobin b. deficient blood supply c. reactive hyperemia or infection d. dilated capillary and venue filling ans- a 57. When there are purple patches (similar to bruising) on the skin of the dorsum of the foot, usually the result of dilated capillary and venue filling is called a. pallor b. cyanosis c. livedo reticularis

d. rubor ans- c 58. It is essential to touch patients skin and feel the patients skin to determine the temperature of the skin. The patients skin should be a. normal b. warm c. cold d. warm or cold ans- b 59. What are the results of arterial insufficiency those are usually deep and regular in shape, often located over the tibial area? a. ulcerations b. lesions c. cyanosis d. venous ulcerations ans- a 60. It is important to elicit from the patient the length of time the ulceration has been present and also to examine and record observations of the a. foot and fingers b. fingers and toes c. foot and toes d. foot and hand ans- c 61. Gangrene is usually caused by deficient or absent of blood supply. What is the Gangrene? a. arterial insufficiency b. reactive hyperemia or infection c. deficient blood supply d. death of tissue ans- d 62. Loss of hair on the extremity may reflect a poor nutritional state caused by decreased circulation, although hair loss alone is poor indication of a. peripheral occlusive disease b. peripheral vascular occlusive disease c. vascular occlusive disease d. popliteal occlusive disease ans- b 63. The healthy flesh color branches in appearance as superficial vessels are constructed by manual pressure, normal skin color should return immediately upon the release of the pressure. When does Arterial perfusion decrease?

a. capillary refill time decrease b. capillary refill time remain constant c. capillary refill time increase d. capillary refill time reach at high ans- c 64. Elevating the extremity with impaired circulation produces a cadaveric pallor because of very poor arterial perfusion. With the extremity elevated only minimal arterial blood flow can make its way distally. Returning the extremity to a dependent position causes a slow return to normality followed by the a. bluish discoloration called cyanosis b. red discoloration called dependent rubor c. bluish discoloration called dependent cyanosis d. red discoloration called rubor ans- b 65. Returning the extremity to a dependent position causes a slow return to normality followed by the red discoloration. The ruborous coloration caused by the large amount of blood flowing in to small vasodilated a. superficial arteries b. carotid arteries c. digital arteries d. thoracic arteries ans- a 66. The rhythmic throbbing caused by the regular contraction and alternate expansion of an artery on time with the heartbeat usually signifies a. arterial insufficiency b. arterial sufficiency c. inadequate circulatory status d. adequate circulatory status ans- d 67. Grading pulses on scale of 0 to 4= is fairly standard. Always pulses palpated are compared on one side to the pulse at the same site on the other side. Which of the following grading is correct? a. 1+= weak, 4+=strong b. 2+=strong, 4+= standard c.3+= strong, 4+= bounding d. 3+= good, 4+=strong ans- c 68. What are easily palpated and their pulses quite bounding in response to the pressure of palpation if present? a. aneurysms

b. embolism c. atherosclerosis d. arteritis ans- a 69. Palpable pulses include the aorta, dorsal pedis, posterior tibial arteries etc. What is the name of the artery that cannot be palpated? a. femoral artery b. peroneal artery c. popliteal artery d. thoracic aorta ans- b 70. Normal flow patterns evident when listening through a stethoscope are often described as a lub-dub sound that corresponds with the closure of the a. pulmonary valves b. aortic valves c. ventricular valves d. artiventricular valves ans- d 71. What is abnormal low frequency sounds heard on auscultation, they can be caused by significant stenosis that sets up a vibratory response in the tissue distal to the stenosis? a. bruits b. elevation c. auscultation d. palpation ans- a. 72. Because bruits are low frequency, and depending on the examiner's hearing range, they may or may not always be heard. Bruits may be graded on the basis of their strength and duration. What are the grades of bruits? a. 1+=mild, 2+=good, 3+= strong b. . 1+=poor, 2+=strong, 3+= bounding c. 1+=mild, 2+=moderate, 3+= severe d. 1+=mild, 2+=strong, 3+= severe ans- c 73. The rhythmic throbbing caused by the regular contraction and alternate expansion of an artery on time with the heartbeat usually signifies arterial insufficiency. Which of the following may not indicate a - palpable "vibration" or "thrill" over a pulse site?

a. fistula b. aneurysms c. poststenotic turbulence d. patent dialysis graft. ans- b

Ch-4 1. During the psychologic studies,what kind of environment is essential to be maintained for the patient? a. normal b. cool c. warm d. changeable ans-b 2. What is it given to the patient whenever direct, indirect Doppler or imaging information is to be obtained? a. acoustic coupling gel b. a kind of antibiotic liquid c. special cream d. mixture of water and gel ans-a 3. Which one is not the capability among the following? a. helps to confirm the diagnosis of arterial occlusive disease b. integrate the severity of the occlusive process c. indicates the approximate location of the obstruction d. provides follow-up information ans-b 4. Which one is not the limitation among the following? a. Uncompensated congestive heart failure may result b. can not precisely localize the obstruction c. the test is technologist-dependent d. waveforms may not be affected by the waveforms ans-d 5. How the patient is positioned with the extremities at the same level as the heart? a. prone position b. supine position c. right side position d. left side position ans-b 6. At the time of evaluating extremities, the patients head can be slightly elevated.What is the position of the arms? a. on the belly b. on the chest c. at the sides d. at the sides wide apart ans-c 7. When a wave is reflected from a moving target, the frequency of the wave receives differ from that of the transmitted wave.What is the name of this difference? a. Doppler shift b. Doppler effect c. Doppler equation d. Doppler sign ans-a 8. Whenever there is a relative motion between the source and the receiver of the sound, then what is it called?

a. Doppler shift b. Doppler effect c. Doppler equation d. Doppler sign ans-b 9. Suppose an ambulace is running.The changing pitch of the ambulance siren,which is higher as the ambulance approaches and lower as the ambulance moves away.Which theory can be related with this example? a. Doppler shift b. Doppler effect c. Doppler equation d. Doppler sign ans-a 10. A continuous wave Doppler is used when the blood is moving target and the transducer is the stationary source.How many crystal(s) are there in a CW Doppler? a. one b. two c. three d. four ans-b 11. The Doppler probe (transducer) must be probed on which axisof the vessel? a. short b. long c. left d. right ans-b 12. Which angle of insonation is appropriate to the skin surface? a. 35-50 degrees b. 65-80 degrees c. 55-70 degrees d. 45-60 degrees ans-d 13. What kind of signal can mean that the probe angle is very acute to the vessel angle or it can indicate a significant arterial obstruction? a. a lower-pitched signal b. a higher-pitched signal c. a continuous signal d. a discrete signal ans-b 14. What kind of frequency meter is employed by Analog method to display the signals graphically on a strip-chart recorder? a. a zero-crossing frequency meter b. a single crossing frequency meter c. a double-crossing frequency meter d. a triple-crossing frequency meter ans-a 15. The circuitry counts every time the input signal crosses the baseline within a specific time span.Which one of the following is the right baseline? a. three b. two c. one

d. zero ans-d 16. The machine used to estimate the frequency of the reflected signal and displays it.What do the horizontal and vertical axis represent? a. the horizontal axis represents the amplitude of Doppler-shifted frequencies b. the vertical axis represents the time c. the vertical axis represents the amplitude of Doppler-shifted frequencies d. the vertical axis represents direct frequencies ans-c 17. What is the method that displays frequency on the vertical axis,time on the horizontal axis and the amplitude of backscattered signals at any given frequency and time? a. Auditory method b. Analog method c. Sinclair method d. Spectral analysis ans-d 18. What is applied to the site to be evaluated in Spectral analysis? a. acoustic gel b. a kind of antibiotic liquid c. special cream d. mixture of water and gel ans-a 19. What Doppler probe is utilized in the Spectral analysis? a. 4-6 MHz b. 6-8 MHz c. 8-10 MHz d. 10-12 MHz ans-c 20. In case of Spectral analysis,For the upper extremities,which Doppler velocity waveform is not recorded from the following arteries bilaterally? a. Axillary b. Brachial c. Radial d. Popliteal ans-d 21. In case of Spectral analysis,For the lower extremities,which Doppler velocity waveform is not recorded from the following arteries bilaterally? a. Common femoral b. Posterior tibial c. Dorsalis pedis d. Ulnar ans-d 22. Suppose an examiner is using a headset.Auditory signals are obtained.Which one of the following is the right signal? a. left earphone provides retrograde flow signals b. right earphone provides retrograde flow signals c. both the earphone provides retrograde signals d. both the earphone provides antegrade signals ans-a

23. Suppose an examiner is using a headset.Auditory signals are obtained.Which one of the following is the right signal? a. right earphone provides antegrade flow signals b. leftt earphone provides antegrade flow signals c. both earphone provides antegrade flow signals d. both earphone provides retrograde flow signals ans-a 24. Which one is not the potential sources of technical error when performing Doppler arterial survey? a. Improper probe position b. Excessive pressure on probe tip c. Adequate amount of gel d. Incorrect incident angle ans-c 25. In case of interpretation in qualitative way, normal signals have some characteristics excepta. triphasic with a rapid upstroke b. rapid downstroke c. a long peak below the baseline d. resumption of forward flow ans-c 26. In case of interpretation in qualitative way, abnormal signals have some characteristics excepta. monophasic b. pulsatile c. biphasic signals d. deterioration of the Doppler signal ans-b 27. What kind of effect is seen on the pulsatility of the arterial signal, causing it to assume the quality of low-resistance vessels by the vasodilation of the distal vessels ? a. it can increase the pulsatility of the arterial signal b. it can reduce the pulsatility of the arterial signal c. it helps to keep the pulsatility of the arterial signal remain same d. it has no effect on the pulsatility of the arterial signal ans-b 28. Post exercise waveforms normally maintain or augment preexercise waveforms with all of the waveform components usually depicted above the baseline.Abnormally the following changes can occur except one.Which one is it? a. slow upstroke with more rounded peak b. slow downstrike c. fast downstrike d. no reverse component ans-c 29. What is produced for blood flow to the muscles,which does cause an element of arterial vasodilation? a. supply b. demand c. normal flow d. vacancy ans-b

30. The inability to elict the Doppler signals may suggest occlusion,but the sensitivity to slow flow by the CW Doppler-which can not detect velocities of less thana. 6 cm/sec b. 7 cm/sec c. 8 cm/sec d. 9 cm/sec ans-a 31. The arteriovenous shunts in the skin of the fingertips cause the flow patterns in the hand to vary tremendously-Hemodynamics for Surgeons.Who is/are the author(s) of it? a. Swetnam and Subra b. Scott and Staal c. Strandness and Sumner d. Steere and Starzl ans-c 32. Regarding to the upper extremities,it is not uncommon to see continuous low-resistance Doppler signals in some arteries except one of a patient who is relaxed and warm.Which one is it? a. brachial b. fimoral c. radial d. ulnar ans-b 33. Suppose the recorder stylus is not recording any waveforms.Then you must check to make certain the proper test and probe have been selected.Which one is the right probe? a. 6 MHz b. 7 MHz c. 8 MHz d. 9 MHz ans-c 34. Suppose bands of noise are displayed on the tracing.Which one of the following is not a way to get rid of it? a. increasing the gain b. increasing the filter c. turning the system off and then on d. plugging the system into another outlet ans-a 35. Suppose no auditory signal is obtained,but there are recordable signals on the tracing.What should you do? a. Adjust the volume control b. plug out the headset connection c. increase the filter d. increase the gain ans-a 36. Suppose there is an auditory Doppler signal but no tracing.Which of the following may not happen? a. the recorder is off b. the recorder is in pause mode c. the recorder is in freeze mode d. the recorder is on ans-d

37. Pulsatility index provides a quantitative data, although it is independentent of the beamto-vessel angle when using handheld Doppler equipment.How is it determined? a. (Peak-to-Peak Frequency+Mean Frequency)/2 b. (Peak-to-Peak Frequency-Mean Frequency)/2 c. (Peak-to-Peak Frequency/Mean Frequency) d. (Peak-to-Peak Frequency x Mean Frequency) ans-c 38. In case of Pulsatility index,which value is normal for the common femoral artery? a. greater than 5.5 b. less than 5.5 c. greater than 6.5 d. less than 6.5 ans-a 39. In case of Pulsatility index,which value is normal for the popliteal artery? a. approximately 7.0 b. approximately 7.5 c. approximately 8.0 d. approximately 8.5 ans-c 40. In case of Pulsatility index,which value is normal for the artery in presence of the proximal occlusive disease? a. greater than 5.0 b. greater than 8.0 c. less than 8.0 d. less than 5.0 ans-d 41. In case of inverse damping factor,the ratio of the distal pulsatility index to the proximal pulsatility index of an arterial segment is counted.Which is the normal value for inverse damping factor? a. 0.8-1.0 b. 0.9-1.1 c. 1.0-1.2 d. 1.1-1.3 ans-b 42. By using acceleration time, how one can suggest the presence of significant iliac disease? a. acceleration time 145 b. acceleration time 143 c. acceleration time 133 d. acceleration time 123 ans-c 43. Systole should be simultaneously evident at a specific site bilaterally.A delay on one side may indicate a more proximal occlusive process.This description relates toa. Transit time b. Acceleration time c. Frequency time d. Pulsatility time ans-a

Ch5 1. Doppler segmental pressure provides objective baseline to follow the progression of the disease process or postoperative course. Which one of the followings presence and severity is being identified? a. chronic occlusive b. arterial insufficiency c. arterial occlusive disease d. occlusion disease ans- c 2. Limitations of Doppler segmental pressure are it cannot precisely localize the area of obstruction, although it can identify a general location. What cannot be discriminated by Doppler segmental? a. stenosis and occlusion b. common femoral disease and occlusion disease c. external iliac disease and stenosis d. stenosis and common femoral disease ans- a 3. Limitations of Doppler segmental pressure are it cannot precisely localize the area of obstruction, although it can identify a general location and difficult to discriminate between a. common femoral disease and external iliac disease b. common femoral disease and occlusion disease c. stenosis and common femoral disease d. external iliac disease and occlusion ans- a 4. Limitations of Doppler segmental pressure are it cannot precisely localize the area of obstruction, although it can identify a general location and may show falsely elevated Doppler pressure in those patients with renal disease and a. paralysis b. intermittent ischemia c. paresthesia d. diabetics ans- d 5. It is essential that the patient has rested at least 20 minutes prior to the Doppler segmental pressure test. When does it become essential? a. if the patient has diabetics b. if the patient has vascular disease c. if the patient has renal disease d. if the patient has chronic occlusive ans- b

6. It is essential that the patient has rested at least 20 minutes prior to the Doppler segmental pressure test. Just walking in to the test can reduce the amount of blood flow to the extremities if in fact the patient does have a. claudication b. block claudication c. vascular claudication d. 2 block claudication ans- c 7. The patient is positioned supine with extremities at the same level as the heart so that hydrostatic pressure cannot falsely elevate the blood pressure measurement. What is hydrostatic pressure? a. which would affect standing patient b. which would affect sitting patient c. which would affect patient having diabetics d. which would affect patient having vascular disease ans- b 8. The patient is positioned supine with extremities at the same level as the heart so that hydrostatic pressure cannot falsely elevate the blood pressure measurement. Which of the following is not appropriate position to facilitate the lower extremity evaluation? a. the patient head of the bed can be elevated slightly and patients head can rest on a pillow b. the patient hip is externally rotated with the knee slightly bent c. right or left lateral decubitus d. prone for access to the popliteal space ans- a 9. When a wave is reflected from a moving target the frequency of the wave received differs from that of the transmitted wave. What is the name of this difference? a. Doppler effect b. Doppler velocity waveform analysis c. Volume pulse waveforms d. Doppler shift ans- d 10. When a wave is reflected from a moving target the frequency of the wave received differs from that of the transmitted wave. Whenever there is relive motion between the source and the receiver of the sound, there is a. Doppler effect b. Doppler velocity waveform analysis c. Volume pulse waveforms

d. Doppler shift ans- a 11. Blood is the moving target and the transducer the stationary source. Depending on direction of flow relative to the Doppler beam, the reflected frequency is higher or lower than thea. Doppler velocity waveform b. Doppler shift c. continuous wave Doppler d. Volume pulse waveforms ans- b 12. The Doppler probe must be positioned on the long axis of the vessel. There is appropriate angle of insonation to the skin surface; this angle tends to work fairly well. What is the angle? a. 45-90 degrees b.60-90 degrees c. 45-60 degrees d. 90-120degrees ans- c 13. Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. When the blood pressure does artifactually lower and artifactually higher respectively? a. cuff is too large, cuff is too narrow b. cuff is too narrow, cuff is too large c. cuff is large, cuff is narrow d. cuff is narrow, cuff is large ans- a 14. Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. Bilateral brachial are obtained using blood pressure cuffsa. 12X14cm bladders b. 12X24cm bladders c. 12X40 cm bladders d. 12X40 mm bladders ans- c 15. Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. Bilateral brachial are obtained using blood pressure cuffs 12X40 cm bladders. What is being utilized? a. 10-12 MHz Doppler b. 8-10 MHz Doppler c. 6-8 MHz Doppler

d. 10-12 Hz Doppler ans- b 16. Cuff artifact resulting in inaccurate pressure measurement can occur if the cuff size is inappropriate for the size of the extremity. Appropriate sized blood pressure cuffs are utilized as four cuff techniques. What is not included in four cuff techniques? a. high thigh b. below knee c. low thigh d. at the toe ans- d 17. All cuffs should be placed straight on the extremity site and fit snugly so that bladder inflation quickly transmits the pressure in to the a. vessel b. muscle c. tissue d. blood ans- c 18. All cuffs should be placed straight on the extremity site and fit snugly so that bladder inflation quickly transmits the pressure in to the tissue. Where does a loose cuff create additional space? a. between skin and tissue b. between skin and bladder c. between skin and vessel d. between skin and veins ans- b 19. At what times the width of the pneumatic cuff should be at least greater than the diameter of the limb so that the artery under evaluation can be compressed when the bladder is inflated? a. 1.2 b. 2.2 c. 2 d. 2.2 ans- a 20. At what percent the width of the pneumatic cuff should be at least greater than the diameter of the limb so that the artery under evaluation can be compressed when the bladder is inflated? a. 20 b. 22 c. 12

d. 10 ans- a 21. The width of the pneumatic cuff should be at least 20% greater than the diameter of the limb so that the artery under evaluation can be compressed when the bladder is inflated. What must be compressed to avoid the falsely elevated pressure? a. bony structure b. bladder c. tissue d. artery ans- c 22. If the cuff bladder is too wide for the extremity segment being evaluated, what will be the blood pressure measurement? a. falsely high b. falsely elevated c. high d. falsely low ans- d 23. If the cuff bladder is too narrow for the extremity segment being evaluated, what will be the blood pressure measurement? a. falsely high b. falsely elevated c. low d. falsely low ans- b 24. The relationship between the size of the extremity and the size of the cuff bladder encircling the extremity is critical for measuring a. falsely elevated pressure b. normal blood pressure c. falsely low pressure d. accurate blood pressure ans- d 25. What blood pressure is expected when the narrow cuffs are purposely used on the thigh in order to obtain two separate blood pressure readings? a. falsely elevated blood pressure b. accurate blood pressure c. normal blood pressure d. falsely low pressure ans- a

26. Falsely elevated blood pressure is expected when the narrow cuffs are purposely used on the thigh in order to obtain two separate blood pressure readings. What will a narrow cuff secondary to body habitus produce? a. falsely low pressure b. falsely low pressure c. falsely elevated blood pressure d. falsely high blood pressure ans- c 27. The use of two thigh cuff is advantageous in that provides proximal and distal thigh pressure measurement. The disadvantage is that artifactually elevated pressures are obtained. What does it mean? a. the pressure at the low thigh level is normally 30 mmHg or higher than the highest brachial pressure b. the pressure at the high thigh level is normally 30 mmHg or higher than the highest brachial pressure c. the pressure at the high thigh level is normally 30 mHg or higher than the highest brachial pressure d. the pressure at the low thigh level is normally 30 mHg or higher than the highest brachial pressure ans- b 28. The bladder of the cuff should be placed over the artery. This is especially important when the bladder does not encircle the a. artery b. limb c. tissue d. vessel ans- b 29. Ideally, the bladder of the cuff should encircle the limbs circumference. Where should be the bladder of the cuff placed when the bladder does not encircle the limb as it is important? a. over artery b. over limb c. over vessel d. over thigh ans- a 30. The use of two thigh cuff is advantageous in that provides proximal and distal thigh pressure measurement. The disadvantage is that artifactually elevated pressures are obtained. Why the disadvantages occur? a. thigh cuff width is too much large for the usually large girth of the thigh b. thigh cuff width is too much narrow for the usually narrow girth of the thigh

c. thigh cuff width is too much large for the usually narrow girth of the thigh d. thigh cuff width is too much narrow for the usually large girth of the thigh ans- d 31. What is the technique that involves the use of one large cuff placed as high as possible on the thigh and satisfies the recommended width-girth relationship, it is so wide that one can fit on the thigh? a. the two cuff technique b. the three cuff technique c. the two thigh cuff technique d. one cuff technique ans- b 32. The three cuff technique involves the use of one large cuff placed as high as possible on the thigh and satisfies the recommended width-girth relationship, it is so wide that one can fit on the thigh. What is the advantage? a. falsely elevated pressure is identified b. provides proximal and distal thigh pressure measurement c. more accurate thigh pressure is obtained d. artifactually elevated pressures are obtained ans- c 33. The three cuff technique involves the use of one large cuff placed as high as possible on the thigh and satisfies the recommended width-girth relationship. Where do the remaining two cuffs in the three cuff technique applied? a. calf and toe b. calf and ankle c. knee and ankle d. calf and knee ans- b 34. Doppler signal are obtained and evaluated for the posterior tibial artery, dorsalis pedis artery. For which artery Doppler signal is obtained and evaluated if needed? a. peroneal artery b. popliteal artery c. renal artery d. femoral artery ans- a 35. A 45-60 degree angle of insonation to the vessel is optimal and necessary to obtain the clearest and best possible signal. What will be the angle of insonation behind the knee in relation to the skin surface because of vessel angle? a. 60 degrees b. 45 degrees

c. 90 degrees d. 180 degrees ans- c 36. What pressures are obtained bilaterally by using a handheld sphygmomanometer with manual inflation or a computerized system with automatic inflation and digital display? a. falsely elevated pressures b. accurate blood pressure c. two pedal Doppler pressures d. Segmental Doppler pressures ans- d 37. Usually the higher of the two pedal Doppler pressures is used to obtain the remainder of the certain pressure in the leg beginning with the calf level. What is that certain pressure? a. Segmental Doppler pressures b. falsely elevated pressures c. two pedal Doppler pressures d. falsely low pressure ans- a 38. To determine the measurements of pressures in calf or below knee the examiner use the higher of the posterior tibial artery pressures anda. popliteal artery pressures b. peroneal artery pressures c. dorsalis pedis artery pressures d. bladder calf pressures ans- c 39. It is important to start at the ankle level and then to move proximally at a time to eliminate the possibility of underestimating the measurement of a. segmental Doppler pressures b. systolic pressure c. the posterior tibial artery pressures d. dorsalis pedis artery pressures ans- b 40. The high-thigh cuff is inflated to above systole and then slowly deflated to determine the blood pressure. If the cuff is quickly deflated, immediately followed by inflation of the next cuff, there is not enough time for arterial blood to completely normalize in the leg. What would be the blood pressure like, obtained this way? a. falsely elevated pressure c. falsely lower than it should be

d. falsely higher ans- c 41. When a full extremity study is not required, the posterior tibial artery and dorsalis pedis artery are used for determining what? a. ankle pressure b. ankle/brachial pressure c. brachial pressure d. ankle and brachial pressure ans- a 42. Complete cessation of blood flow should be accomplished by inflating the cuff beyond the audible Doppler arterial signal and the cuff should be inflated a. 10-20 mmHg b. 20-40 mmHg c. 20-30 mmHg d. 20-40 mHg ans- c 43. In order to determine how high to take the inflation pressure, note the higher brachial systolic pressure and then increase inflation pressurea. 20-40 mmHg higher than it is b. 20-40 mHg higher than it is c. 20-30 mmHg higher than it is d. 20-30 mHg higher than it is ans- c 44. The higher brachial pressure is used because if there is a subclavian stenosis present unilaterally, with the affected side being lower there would be a systolic pressure difference. What would be the difference? a. 20-30 mmHg or greater b. 15-20 mHg or greater c. 20-30 mHg or greater d. 15-20 mmHg or greater ans- d 45. If pressure measurements need t O be repeated, the cuff should be fully deflated for about a minute prior to repeat so arterial flow stabilizes, what will happen otherwise? a. brachial blood pressure can be underestimated b. segmental pressure can be underestimated c. brachial blood pressure can be overestimated d. segmental pressure can be overestimated ans- b

45. Which pressure is recorded as the pressure at which the first audible Doppler arterial signal returns, similar to listening first audible sound when taking a brachial blood pressure with a stethoscope? a. segmental Doppler pressures b. brachial pressure c. the systolic pressure d. arterial pressure ans- c 46. To avoid unreliable results blood pressure and comments regarding difficulty with the study should be documented. What is the meaning of this line? a. to clearly discriminate a poor arterial signal from Doppler arterial signal b. to clearly discriminate a poor arterial signal from a venous signal c. to clearly discriminate a popliteal from proximal tibial disease d. f to clearly discriminate a falsely elevated pressure and falsely low pressure ans- b 47. The ankle/brachial index (ABI) is calculated by dividing the ankle pressure by the higher of the two brachial pressures. Which one is not included as additional terms for this index which utilize the same formula? a. ankle/leg index (ALI) b. ankle/arm pressure index (API) c. ankle/arm index (AAI) d. ankle/arm pressure index (API) or ankle/arm index (AAI) ans- a 48. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is considered to be the result of incompressible vessels, as are not reproducible? a. An ABI < 1.3-1.5 b. An ABI > 1.4-1.5 c. An ABI > 1.3-1.5 d. An ABI < 1.4-1.5 ans- C 49. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is indicated by ankle/brachial index (ABI) > 1.0? a. asymptomatic obstructive disease b. normal c. minimal arterial disease d. claudication ans- b 50. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is the finding if the ankle/brachial index (ABI) is 0.5-0.9?

a. claudication b. normal c. minimal arterial disease d. asymptomatic obstructive disease ans- a 51. Incompressible vessels have falsely elevated and therefore inaccurate pressures. What is the finding if the ankle/brachial index (ABI) > 0.9-1.0? a. claudication b. asymptomatic obstructive disease c. occlusive disease d. normal ans- b 52. Incompressible vessels have falsely elevated and therefore inaccurate pressures. An ABI of > 1.3-1.5 is considered to be the result of incompressible vessels, as are not reproducible (112 mmHg when repeated). What is the measurement of pressure of one time? a. 168 mmHg b. 148 mmHg c. 158 mmHg d. 1118 mmHg ans- c 53. From which highest pressure normally the ankle systolic pressure is the same as or greater than that pressure? a. falsely elevated pressures b. brachial blood pressure c. segmental Doppler pressures d. ankle/brachial pressure ans- b 54. The Doppler segmental pressure study usually not combined with a. Doppler velocity waveforms b. plethysmographic waveforms c. volume pulse waveforms d. Doppler volume waveforms ans- d 55. What is the range of ankle/brachial index (ABI) if the patient usually suffers from rest pain? a. 0.5-0.75 b. 0.25-0.5 c. 0.25-0.55

d. 0.5- 0.55 ans- b 56. It is better at predicting symptoms at rest if there are those who feel that an absolute ankle pressure which is less than 50 mmHg approximately rather than the ABI a. 0.5 b. 0.25 c. o.35-0.5 d. 0.05 ans- a 57. What is the value of ankle/brachial index that represents single segment involvement and that lesser values are more indicative of multiple lesions? a. ABI > 0.5 b. ABI 0.25 c. ABI 0.5 d. ABI > 0.25 ans- c 58. What would be suggested if a decrease pressure of > 30 mmHg between two consecutive levels? a. obstruction disease b. significant obstruction c. insignificant pressure d. insignificant obstruction ans- b 59. When do you can suggest that patient has obstructive disease at or above the level in the leg with lower pressure? a. A horizontal difference of 20-40 mmHg or more b. A vertical segmental pressure difference of 20-30 mmHg or more c. A horizontal difference of 20-30 mmHg or more d. A vertical segmental pressure differences of 20-40 mmHg or more ans- c 60. Horizontal pressures are less important when compared to vertical segmental pressure differences. When do horizontal pressure differences no longer valid? a. once obstructive disease has been detected b. once proximal disease has been detected c. once peroneal disease has been detected d. once popliteal disease has been detected ans- b 61. As limb girth increases from the ankle to the thigh, pressure measurement also increases. What is normally the high-thigh pressure in the average-size limb?

a. at least 30 mmHg greater than the highest brachial pressure. b. at least 30 mmHg greater than the brachial systolic pressure. c. at least 40 mmHg greater than the highest brachial pressure. d. at least 40 mmHg greater than the brachial systolic pressure. ans- a 62. As limb girth increases from the ankle to the thigh, pressure measurement also increases. The above knee and below knee systolic pressure should be the same as or a. greater than the highest brachial pressure. b. at least 30 mmHg greater than the brachial systolic pressure. c. greater than the brachial systolic pressure d. at least 30 mmHg greater than the highest brachial pressure ans- c 63. With the three cuff technique the large, single cuff segmental pressure is normally similar to the highest brachial pressure. Why does it happen? a. because it does not allow differentiation of proximal and distal thigh pressure b. because the cuff has wide girth c. because the single cuff has a smaller bladder d. because the single cuff has a longer bladder ans- d 64. Although wide-girth cuff usually yields a more accurate pressure, it does not allow differentiation of a. highest brachial pressure and systolic pressure b. proximal and distal thigh pressure c. systolic pressure and brachial systolic pressure d. proximal and systolic thigh pressure ans- b 65. What is the pressure level for foot ulcer healing when foot and toe ulcer fail to heal? a. 30 mmHg b. 20 mmHg c.30 mHg d. 20 mHg ans- a 66. For which of the following reasons resting value are compares to those after exercise (if no limitations pr contradictions exist) or after hyperemia ( an alternate means of stressing the peripheral circulatory system)? a. to determine the presence and absence of true claudication and pseudoclaudicaton b. to determine the presence and absence collaterals

c. to help differentiate between true claudication and collateral d. to help differentiate between pseudoclaudication and collateral ans- b 67. Which is the preferable test because it produces physiologic stress that reproduces a patients ischemic symptoms? a. reactive hyperemia testing b. Doppler segmental pressure lower extremities testing c. treadmill testing d. ischemic testing ans- c 68. Which of the followings are not contradictions and limitations of exercise testing? a. renal problems b. shortness of breath c. hypertension d. cardiac problems ans- a 69. How long the patient walks on a constant-treadmill at 12% elevation and 1.5 MPH, after resting values are obtained in exercise testing? a. maximum 7 minutes b. minimum 5 minutes c. minimum 7 minutes d. maximum 5 minutes ans- d 70. Some patients who complain of claudication have to stop walking because of conditions other than leg pain. What is not included as other condition? a. shortness of breath b. . hypertension c. thoracic problem d. cardiac problems ans- c 71. Postexcercise Doppler pressures are obtained from the higher brachial blood pressure. In exercise testing to capture the maximum pressure drop, where the pressure is first measured? a. contralateral ankle b. lower extremity ankle c. arm d. higher extremity ankle ans- b 72. How long a process can take to obtain postexcercise ABI immediately and then every two minutes until preexcercise pressures are once again attained?

a. 10-12 minutes b. 10 minutes c. 20-25 minutes d. 20 minutes ans- d 73. What can be suggested if ankle pressure that drop too low or unrecordable levels immediately after exercise and then increase to resulting levels in 2 to 6 minutes? a. obstruction at a single level b. significant obstruction c. multiple obstruction d. . obstruction at a lower extremity level ans- a 74. What can be suggested if ankle pressure that drop too low or unrecordable levels immediately after exercise and remain reduced or unrecordable for up to 12 minutes or more? a. obstruction at a single level b. obstruction at a lower extremity level c. multiple obstruction d. significant obstruction ans- c 75. What the name of the alternate method is for stressing the peripheral circulation that may indicate when the patient cannot walk long enough, uses a cane or walker, has pulmonary problems, has poor cardiac status or other situations? a. treadmill testing b. exercise testing c. reactive hyperemia testing d. Doppler segmental pressure lower extremities testing ans- c 76. If the patient has known severe arterial disease in one extremity and moderate arterial disease in the other. With walking, the extremity with the severe disease will force the patient to stop sooner, making it impossible to determine what the actual response would be in the other extremity. What test would be essential to perform to test both extremities for a truer comparison? a. exercise testing b. reactive hyperemia testing c. treadmill testing d. Doppler segmental pressure lower extremities testing ans- b

77. After treadmill exercise, ankle systolic pressures in normal limbs do not decrease. But what is the range of transient pressure decrease occurs at the ankles of normal limbs after reactive hyperemia? a. 17%-24% b. 7%-14% c. 27%-34% d. 17%-34% ans- d 78. Which testing is considered by many to be preferable test because it produces a physiological stress that produces a patients ischemic symptoms? a. treadmill testing b. reactive hyperemia testing c. Doppler segmental pressure lower extremities testing d. ischemic testing ans- a

Chap-6 1. Which one of the following is not the capability of Doppler segment pressures-upper extremities? a. Identifies the presence and severity of arterial occlusive disease. b. provides an objective baseline c. objectively evaluates the treatment plan d. results are usually differntiated ans-d 2. Which one of the following is not the limitation of Doppler segment pressures-upper extremities? a. may show falsely elevated Doppler pressures in patients b. patients with casts or extensive bandages that cant be removed c. this test can discriminate stenosis from occlusion d. waveforms may be affected by the ambient temperature ans-c 3. Which one of the following is not included in the patient positioning of Doppler segment pressures-upper extremities? a. the arms should be at the patients sides b. the patients head can be slightly elevated c. the patients leg should be folded d. the cuffs should be applied snugly over the muscular portion of the arm ans-c 4. When a wave is reflected from a moving target, the frequency of the wave receives differ from that of the transmitted wave.What is the name of this difference? a. Doppler shift b. Doppler effect c. Doppler equation d. Doppler sign ans-a 5. Whenever there is a relative motion between the source and the receiver of the sound, then what is it called? a. Doppler shift b. Doppler effect c. Doppler equation d. Doppler sign ans-b 6. Suppose an ambulace is running.The changing pitch of the ambulance siren,which is higher as the ambulance approaches and lower as the ambulance moves away.Which theory can be related with this example? a. Doppler shift b. Doppler effect c. Doppler equation d. Doppler sign ans-a 7. A continuous wave Doppler is used when the blood is moving target and the transducer is the stationary source.How many crystal(s) are there in a CW Doppler? a. one b. two c. three

d. four ans-b 8. The Doppler probe (transducer) must be probed on which axisof the vessel? a. short b. long c. left d. right ans-b 9. In case of the techniques of Doppler segment pressures-upper extremities,which size of cuff is placed snugly on the upper arm biliterally? a. 10x40 cm bladder b. 8x40 cm bladder c. 14x40 cm bladder d. 12x40 cm bladder ans-d 10. In case of the techniques of Doppler segment pressures-upper extremities,which size of cuff is placed snugly on the forearm biliterally? a. 8x40 cm bladder b. 10x40 cm bladder c. 12x40 cm bladder d. 14x40 cm bladder ans-b 11. A loose cuff creates space between the skin and the bladder, necessitating additional inflation and possibly, falsely elevated pressures.So in case of technique of Doppler segment pressures-upper extremities, how all the cuffs should be placed? a. bent b. horizontal c. vertical d. straight ans-d 12. In case of technique of Doppler segment pressures-upper extremities,what should be the width of pneumatic cuffs related to the diameter of the limb? a. at least 30% greater b. at least 40% smaller c. at least 20% greater d. at least 30% smaller ans-b 13. In case of technique of Doppler segment pressures-upper extremities,from where the upper arm pressure is obtained? a. bronchiole artery b. brachial artery c. radial artery d. ulnar artery ans-b 14. For the upper extremities, Doppler velocity waveforms are recorded from the following arteries bilaterally except one.Which one? a. Brachial b. Radial c. Clavian d. Ulnar ans-c

15. Suppose there is a 15-20 mmHg difference from one brachial pressure to the other.What would be the suggestion of the lower side to the subclavian artery and/or the vessel under the cuff? a. a greater than 30% diameter reduction b. a greater than 40% diameter reduction c. a greater than 50% diameter reduction d. a greater than 60% diameter reduction ans-c

16. What is the limit of reduction in blood pressure normally between the upper arm and the forearm ? a. 15-20 mmHg b. 20-25 mmHg c. 25-30 mmHg d. 35-40 mmHg ans-a 17. What should be the radial and ulnar artery pressures of each other? a. within 20-25 mmHg b. within 15-20 mmHg c. within 10-15 mmHg d. within 5-10 mmHg ans-d 18. Radial and ulnar artery pressures should be within 5-10 mmHg of each other.The vessel with the lower pressure may be obstructed if there is a difference ofa. 10 mmHg b. 20 mmHg c. 30 mmHg d. 40 mmHg ans-b 19. In case of Allen test, which of the following is not the capability of this process? a. determines hand viability if the radial artery is to be removed for use b. Evaluates patency of the wrist arteries c. Evaluates patency of the palmar arch d. the skin over the palm can be stretched ans-d 20. In case of Allen test, which of the following is not the limitation of this process? a. may compress the radial or ulnar arteries b. may cause compression of the small vessels c. relative pollar can occur d. may determine hand viability ans-d 21. While the technologists continues to manually compress the artery in Standard Allen Test, the patient is asked to clench the hand into a tight fist for about what time? a. 30 seconds b. 45 seconds c. 1 minute d. 2 minutes ans-c 22. Waveforms can be obtained both prior to and during the radial artery compression maneuver when a photoplethysmographic (PPG) sensor is affixed toa. 1-2 fingers b. 2-3 fingers c. 3-4 fingers d. 4-5 fingers ans-b 23. Which one of the following is not true about the photoplethysmographic (PPG) sensor? a. a photoplethysmographic (PPG) sensor is affixed to 3-4 fingers b. PPG waveforms are obtained as the Digital Pressures and Plethysmography c. PPG sensor is affixed to the digit using double stick tape

d. the equipment is set to PPF function(AC mode) ans-a 24. At what speed the strip-chart analog recoeder of photoplethysmographic (PPG) sensor is set if only monitoring is required? a. 2 mm/sec b. 3 mm/sec c. 4 mm/sec d. 5 mm/sec ans-d 25. At what speed the strip-chart analog recorder of photoplethysmographic (PPG) sensor is set if waveform quality assessment is required? a. 20 mm/sec b. 25 mm/sec c. 30 mm/sec d. 35 mm/sec ans-b 26. In standard Allen Test,what is indicated by the reappearence of the normal skin color when the hand is relaxed? a. the palmar arch is not patient b. the radial artery continues to be automatically compressed c. the ulnar artery is providing inflow d. the ulnar artery is providing outflow ans-c 27. In standard Allen Test, if the hand does not return to its normal color during relaxation,what does it mean except one? a. an obstruction of distal ulnar artery b. making the hand ischemic c. an obstruction of distal palmar arch d. the palmar arch receives adequate blood supply ans-d 28. It is possible to use a continuous-wave Doppler probe instead of a photoplethysmographic (PPG) sensor to obtain waveforms.But what is the difficulty? a. ability to hold the probe steady b. the size of the digital artery is big c. ability to hold the probe steady on the very small digital artery d. inability to hold the probe steady ans-d

Ch 7 1. Which test is helps to determine healing potential of a wound or ulcer by amputation level? a. laser Doppler b. reactive hyperemia testing c. treadmill testing d. exercise testing ans- a 2. Laser Doppler helps to determine healing potential of a wound or ulcer. Which of the followings make the laser Doppler testing difficult? a. skin must be ulcerated b. patient is supine with head in a pillow c. inability of the patient to rest quitely d. patient positioned comfortably ans- c 3. What is routinely used for the transcutaneous measurement of the movement or flow of blood? a. Doppler shift b. laser Doppler c. exercise testing d. Doppler principle ans- d 4. The laser Doppler is used to assess the characteristics of the microvascular blood volume in the a. superficial layers of the tissue b. capillary beds of the skin c. deep arteries d. veins ans- b 5. What is the name of the system that can be used to measure blood flow velocities in deep arteries and veins? a. optical system b. light wave length c. ultrasound-based system d. longer wavelengths system ans- c 6. What are immediately scattered in random directions by both cell types (moving red blood cells are Doppler-shifted in frequency but stationary cells are not)? a. photons

b. protons c. ultrasound wavelengths d. optical waves ans- a 7. A portion of the scattered laser light is collected by a receiving optical fiber and returned to a photo detector. The photo detector converts this optical signal to determine microvascular blood volume into a. energy b. ultrasound wavelength c. electronic signal d. short wavelength ans- c 8. In laser Doppler testing skin perfusion pressure (SSP) mode is activated. What is the measurement of the pressure to inflate the cuff? a. 40 mmHg b. 100 mmHg c. 65 mmHg d. 20 mmHg ans- b 9. In laser Doppler test the pressure is held for 10 seconds, waiting for the volume indicator drop below 0.1%. If it does not, the transducer is inflated another a. 40 mmHg b. 100 mmHg c. 65 mmHg d. 20 mmHg ans- d 10. What angle the patients leg is elevated and holding it there until the volume drops below 0.1? a. 60 degrees above horizontally b. 60 degrees below horizontally c. 60 degrees above vertically d. 60 degrees below vertically ans- a 11. When the patients skin perfusion pressure (SSP) is obtained? a. once the volume is >0.1 b. once the volume is <0.1 c. once the volume is >0.01 d. once the volume is<0.01 ans- b

12. In laser Doppler testing the examiner sees a steady baseline, which is followed by a doubling or more of the graphs pressure scale. What is indicated by this? a. patients falsely elevated pressure b. Patients falsely low pressure c. patients actual pressure d. patients falsely higher pressure ans- c 13. What can be indicated by skin perfusion pressure (SSP) >30 mmHg in case of laser Doppler testing? a. less likely to heal b. likely to heal c. unlikely to heal d. no ulcer ans- b 14. What can be indicated by skin perfusion pressure (SSP) <30 mmHg in case of laser Doppler testing? a. less likely to heal b. likely to heal c. unlikely to heal d. no ulcer ans- a

Chap8 1. What are the limitations of Penile Pressures and Waveforms except one ? a. hihjly anxious or antagonistic patients are difficult to study b. only duplex and color flow imaging provide data c. may indicate pelvic steal,arterial vasospasm or ipsilateral arterial disease d. patient may be unable to undergo the injection acomponent ans-c 2. In case of duplex /color flow imaging evaluation, what Doppler probe can be utilized and Doppler waveforms and pressures are obtained? a. 6-8 MHz b. 8-10 MHz c. 10-12 MHz d. 12-14 MHz ans-b 3. What kind of imaging and Doppler spectral analysis with or without color flow imaging are included in duplex scanning? a. A-mode b. B-mode c. C-mode d. D-mode ans-b 4. Appropriately sized blood pressure cuffs are placed on the upper arms, ankles and proximal shaft of the penis.Penile cuff sizes area. 2 x 12 cm b. 2.5 x 12.5 cm c. 3 x 13 cm d. 2 x 9 cm ans-b 5. Penile pressures are obtained with some end-point detectors. Which of the following is not one of them? a. strain gauge b. plethysmography c. continuous wave d. pulse volume plethysmography ans-b 6. Penile/brachial index(PBI) is calculated using the higher brachial pressure.What is the normal Penile/brachial index(PBI)? a. 0.75 or greater b. 0.65 or greater c. 0.55 or greater d. 0.45 or greater ans-a 7. Penile/brachial index(PBI) is calculated using the higher brachial pressure.What is the marginal Penile/brachial index(PBI)? a. 0.35-0.44 b. 0.45-0.54 c. 0.55-0.64 d. 0.65-0.74 ans-d

8. Penile/brachial index(PBI) is calculated using the higher brachial pressure.What is the abnormal Penile/brachial index(PBI)? a. less than 0.45 b. less than 0.55 c. less than 0.65 d. less than 0.75 ans-c 9. The penile/brachial index least expected in a young adult male with normal sexual response would be anything less thana. 0.55 b. 0.65 c. 0.70 d. 0.75 ans-b 10. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is not normal? a. sharp b. systolic peak c. prominenet dictoric wave d. downslope is bowed away ans-d 11. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is not mildly abnormal? a. sharp peak b. absent dictoric wave c. systolic peak d. downslope is bowed away from baseline ans-c 12. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is not moderately abnormal? a. sharp peak b. flattened systolic peak c. upslope and downslope time decreased d. dictoric wave absent ans-a 13. Plethysmographic waveforms are evaluated in penile/brachial index.Which one of the following is the sign of severely abnormal? a. sharp b. systolic peak c. prominenet dictoric wave d.pulse wave has low amplitude ans-d 14. According to the penile pressures and waveforms, in most cases informed consent is obtained from the patient. What kind of transducer is selected in this case? a. 6 or 9 MHz b. 7 or 10 MHz c. 6 or 10 MHz d. 8 or 11 MHz ans-b

15. Repeat measurements are obtained postinjection.Protocol varies in the literature regarding how soon the postinjection velocities and cavernous artery dimensions are measured.What is the time that multiple measurements may be obtained at various increments after the injection? a. upto 6 minutes b. upto 5 minutes c. upto 4 minutes d. upto 3 minutes ans-a 16. Peak systolic and end diastolic measurements are obtained from the proximal cavernous arteries before full erection is achievedTo obtain the highest velocity recordings how many measurements may be required? a. only one b. no measurement c. several d. maximum two ans-c 17. At what time the dimensions of the cavernous arteries are measured in an A/P transverse view? a. during diastole b. during systole c. during erection d. any time ans-b 18. It is important for the patient to instruct about priapism.He must contact his urologist if a rigid erection is maintained for a period of time after injection.What is the time period? a. 1 hours b. 2 hours c. 3 hours d. 4 hours ans-c 19. Which of the following is the right interpretation about the preinjection and the postinjection? a. preinjection has a low resistance quality b. both of them have the same resistance quality c. preinjection has a high resistance quality d. postinjection has a high resistance quality ans-c 20. There are various schools of thought concerning the importance of peak systolic and end diastolic velocities.The general normal measurement isa. 10 cm/sec b. 20 cm/sec c. 30 cm/sec d. 40 cm/sec ans-c 21. There are various schools of thought concerning the importance of peak systolic and end diastolic velocities.The general marginal measurement isa. 55-59 cm/sec b. 45-49 cm/sec c. 35-39 cm/sec

d. 25-29 cm/sec ans-d 22. There are various schools of thought concerning the importance of peak systolic and end diastolic velocities.The general reduced measurement isa. < 15 cm/sec b. < 25 cm/sec c. < 35 cm/sec d. < 45 cm/sec ans-b 23. Postinjection,the deep dorsal venous flow velocities should not increase.What is the normal measurement? a. < 1 cm/sec b. < 2 cm/sec c. < 3 cm/sec d. < 4 cm/sec ans-c 24. Postinjection,the deep dorsal venous flow velocities should not increase.What is the moderately increased measurement? a. 10-20 cm/sec b. 20-30 cm/sec c. 30-40 cm/sec d. 40-50 cm/sec ans-a 25. Postinjection,the deep dorsal venous flow velocities should not increase.What is the markedly increased measurement? a. > 10 cm/sec b. > 20 cm/sec c. > 30 cm/sec d. > 40 cm/sec ans-b 26. It has been suggested that an increase in postinjection may indicate a venous leak, which could contribute to the erectile dysfunction. What is the measure? a. > 3 cm/sec b. > 4 cm/sec c. > 5 cm/sec d. > 6 cm/sec ans-b 27. A varicocele is an enlargement of the veins of the spermatic cord. A condition which occurs most often in a particular age of people. What is the general period? a. very young like boy b. adolescent c. middle age d. old age ans-b 28. A varicocele is an enlargement of the veins of the spermatic cord. A condition which occurs most often in young men and adolescents. In which side it is most common? a. front side b. back side c. left side d. right side ans-c

29. A varicocele is an enlargement of the veins of the spermatic cord. What kind of transducer is been used to determine the presence of varicocele? a. 5 MHz transducer b. 10 MHz transducer c. 15 MHz transducer d. 20 MHz transducer ans-b

Ch 9 1. Which one of the followings helps to differentiate true arterial claudication from nonvascular sources? a. Doppler segmental pressure b. plethysmography in combination with Doppler segmental pressure c. plethysmography in combination with Doppler shift d. plethysmography ans- b 2. One of the limitations of plethysmography is- cannot be specific to a single vessel. What is the reason of this limitation? a. because it may be difficult to discriminate between major arteries and collateral branches b. because of obesity that makes difficult to perform volume and strain gauge c. because it measures volume changes in a large segment of a limb. d. because it combined with Doppler segmental pressure ans- c 3. Which of the followings is not included in the terms that are used to describe volume plethysmography? a. true plethysmography b. pulse volume recordings plethysmography c. air plethysmography d. pneumo plethysmography ans- b 4. Which of the followings is not included in the terms that are used to describe volume plethysmographic waveforms? a. pulse volume recordings b. volume pulse recordings c. pulse contour recordings d. pulse speed recordings ans- d 5. Pneumatic cuffs are placed around specific levels of the extremities or digits. What is the range of pressure of air which is sequentially introduced in to the cuff depending on the site and level of the cuff? a. up to 10-65 mmHg b. up to 10-25 mmHg c. up to 10-55 mmHg d. up to 10-75 mmHg ans- a 6. There is momentary increases in the limb segment volume occur during systole, when arterial flow peaks. What are the areas through which arterial flow moves

underneath the cuff? a. arteries, vessels, branches and limbs b. arteries, limb, skin and collateral branches c. arteries, branches, small vessels and collateral branches d. arteries, vessels and branches ans- c 7. The pulsatile pressure changes occurring inside the air-filled bladder are converted by pressure transducer into a. ultrasound waveform b. analog waveform c. optical waveform d. volume plethysmographic waveforms ans- b 8. Due to what disease the arterial flow decreases underneath the cuff and because arterial flow decreases the waveform changes in appearance? a. occlusive disease b. obstructive disease c. arterial disease d. vascular disease ans- b 9. Which one of the followings is not a part of a photoplethysmography? a. thermometer b. transducer c. amplifier d. strip-chart recorder ans- a 10. Photoplethysmography is not a true plethysmography, although it is still considered plethysmographic technique. In what name PPG records the rapid changes in blood content of the skin? a. pulse waveform b. volume plethysmographic waveforms c. pulsatile waveform d. analog waveform ans- c 11. Photoplethysmography (PPG) sends infrared light directed into the underlying tissue with a light emitting diode, and the adjacent photodetector (photocell) receives the backscattered infrared light and measures the reflection of light. Why is PPG use infrared light? a. because measurements made in the infrared range have a constant but minimal attenuation

b. because the tissue and the blood in the cutaneous vessels attenuates a portion of it c. because measurements made in the infrared range have a constant but minimal reflection d. because measurements made in the infrared range have a constant but maximum attenuation ans- a 12. What is utilizing a mercury-filled silicone-like tube that makes contact with copper electrodes at both end and it is wrapped around the limb part being evaluated with just enough stretch to ensure good contact? a. Photoplethysmography b. volume plethysmography c. strain gauge plethysmography d. displacement plethysmography ans- c 13. The length of the extremity strain gauge is approximately 1-3 cm shorter than the circumference of the extremity. With digits, the gauge is approximately a. 0.3 cm shorter b. 0.5 cm shorter c. 0.2 cm shorter d. 0.7 cm shorter ans- b 14. During volume plethysmography appropriately sized pneumatic cuffs are applied snugly to the thigh, calf and ankle bilaterally. What are the cuff sizes? a. 4cuff versus 3 cuff b. 3 cuff versus 6 cuff c. 4 cuff versus 5 cuff d. 3 cuff versus 4 cuff ans- d 15. In case of volume plethysmography if during the recording of the waveforms the stylus pen is not centered rather located at either the top or bottom of chart paper, what should you done to center the stylus pen? a. activate self-calibrates b. activate the re-set control c. activate central button d. start the procedure again ans- b 16. In volume plethysmography an appropriate amount of air is used to inflate cuff pressure to predetermined levels. From where does the examiner begin with? a. upper part of the extremity and moves distally

b. lower part of the extremity and moves horizontally c. upper part of the extremity and moves proximally d. lower part of the extremity and moves distally ans- a 17. In volume plethysmography an appropriate amount of air is used to inflate cuff pressure to predetermined levels. How many pulse cycles are recorded at each level? a. two b. four c. three d. six ans- c 18. During volume plethysmography, if the cuff is applied too loosely, it will take much more air to inflate the cuff bladder to the predetermined amount. What can happen by doing this? a. can intensify the waveform b. can attenuate the waveform c. can expand the waveform d. can alternate the waveform ans- b 19. Appropriately sized strain gauges are applied to various levels of the extremity with careful attention to extremity positioning and gauge application. Which of the followings is not included in these levels? a. high and low thigh b. below calf c. ankle d. arm ans- d 20. Photoplethysmography (PPG) is most often applied to the evaluation of a. digital arterial disease b. penile pressure c. obstruction disease d. arterial disease ans- a 21. There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which of the criteria is not described by anyone? a. qualitative criteria for the waveforms b. quantative criteria for the waveforms c. criteria of a semi quantative nature

d. criteria that considers both contour and amplitude of the pulse waveforms ans- b 22. There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as normal? a. sharp peak, absent dicrotic reflective wave b. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic wave c. sharp systolic peak with prominent dicrotic wave d. absent or low-amplitude pulse wave with equal upslope and downslope time ans- c 23. There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as moderately abnormal? a. wave sharp peak, absent dicrotic reflective b. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic wave c. absent or low-amplitude pulse wave with equal upslope and downslope time d. sharp systolic peak with prominent dicrotic wave ans- b 24. There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as mildly abnormal? a. sharp systolic peak with prominent dicrotic wave b. absent or low-amplitude pulse wave with equal upslope and downslope time c. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic wave d. wave sharp peak, absent dicrotic reflective ans- d 25. There are different schools of thought concerning the interpretation of arterial plethysmographic waveforms. Which one of the following criteria considers as severely abnormal? a. wave sharp peak, absent dicrotic reflective b. sharp systolic peak with prominent dicrotic wave c. absent or low-amplitude pulse wave with equal upslope and downslope time d. flattened systolic peak, up-close and dpwnslope time decreased and nearly equal, absent dicrotic wave ans- c 26. How moderately or severely abnormal volume plethysmographic waveforms always reflect the significant disease proximal to the level of the tracing?

a. hemodynamically b. dynamically c. semi-dynamically d. non-dynamically ans- a 27. In case of volume plethysmographic waveforms if amplitude is reduced but there are no changes in the contour of the waveform, what would be the findings? a. insignificant unless it is unilateral b. significant unless it is bilateral c. significant unless it is unilateral d. insignificant unless it is bilateral ans- c 28. What is the key reason for combining Doppler pressure with plethysmography technique? a. if amplitude is reduced but there are no changes in the contour of the waveform b. reveal the difference between a normal waveform and a hyperemic waveform c. to obtain a waveform of fair quality d. to obtain a waveform of fair quality but an abnormal Doppler segmental pressure at the same time ans- d 29. Which of the plethysmographic waveforms reveal the difference between a normal waveform and a hyperemic waveform that is affected collateralization? a. volume plethysmographic waveforms b. comparative plethysmographic waveforms c. strain gauge plethysmographic waveforms d. photoplethysmographic waveforms ans- b 30. What would be the problem if the patients arterial studies require AC mode and venous studies need the DC mode during plethysmography? a. the machine is not in the correct mode b. too much stylus movement c. recorder stylus cannot be centered d. there is no tracing at all ans- c 31. What would be the action if the recorder stylus is stuck at the bottom or top of the paper (machine is not in the correct mode) during plethysmography? a. activate the reset control b. reattach the PPG or strain gauge c. confirm that the machine is in the right mode

d. ascertain that the correct mode has been selected ans- a 32. What would be the action if an acceptable waveform cannot be recorded which means too much stylus movement during plethysmography? a. activate the reset control b. the machine is not in the correct mode c. there is no tracing at all d. reattach the PPG or strain gauge ans- d 33. What would be happen if the correct mode has been selected, the correct test name has been entered and the proper paper has been correctly installed during plethysmography? a. ascertain that the correct mode has been selected b. confirm that the machine is in the right mode c. there is no tracing at all d. activate the reset control ans- c 34. Which plethysmography consists of water-filled, watertight container in which the body part is immerses and the water temperature must remain constant? a. volume plethysmography b. displacement plethysmography c. strain gauge plethysmography d. photoplethysmography ans- b 35. Which of the following plethysmography refers to transient changes in limb volume related to pulse-by-pulse activity of the left ventricle, the body part expanding when arterial inflow exceeds venous outflow? a. displacement plethysmography b. volume plethysmography c. pulse plethysmography d. strain gauge plethysmography ans- c

36.

If your hand is inside a loose-fitting surgical rubber glove, a certain pressure exerted by surrounding fluid that keeps the glove in close contact with the skin. What is the name of that pressure? a. systolic pressure b. hydrostatic pressure c. increased blood pressure d. falsely elevated pressure ans- b

Chap10

1. In case of pressures and plethysmography, which one of the following is not the capabilities ? a. helps to detect the presence of arterial disease b. differrentiates temporary arterial obstruction from vasospasm c. assess effects of treatment d. helps to determine the presence/absence of sympathetic activity ans- b 2. Vasoconstriction greatly affects the quality of the results.Before testing the patient, the examiner should ask some important questions.Which of the following excludes from these questions? a. Has the patient just come in from cold weather? b. Has the patient been smoking? c. Is the patient nervous? d. Where does he live? ans- d 3. Which one of the following is not the limitations of the Vasoconstriction? a. incorrectly applied photocell to the skin b. poor positioning of the gauge c. differentiation of fixed arterial obstruction d. extensive bandages ans- c 4. In case of patients positioning, for the evaluation of toes, the patient should be supine.Patients head can be elevateda. 5-10 degrees b. 10-15 degrees c. 10-20 degrees d. 15-20 degrees ans- c 5. An appropriately sized cuff, the width of which should be at least 1.2 times that of the toe, is applied to the base of the toe.What is the measurement of the cuff that is used for the fingers? a. 1.5-2.0 cm

b. 2.0-2.5 cm c. 2.5-3.0 cm d. 3.0-3.5 cm ans- b 6. An appropriately sized cuff, the width of which should be at least 1.2 times that of the toe, is applied to the base of the toe.What is the measurement of the cuff that is used for the great toe? a. 1.5-2.0 cm b. 2.0-2.5 cm c. 2.5-3.0 cm d. 3.0-3.5 cm ans-c 7. There is no specific manual calibration done for volume or photoplethysmography prior to usage, but what is required by strain gauge eqipment? a. auto calibration by the doctor b. manual calibration by the doctor c. auto calibration by the technologist d. manual calibration by the technologist ans- d 8. What does the plethysmography measure? a. all volume changes b. all flow changes c. all pressure changes d. all red blood cell changes ans- a 9. While the pulsations are being recorded,the examiner inflates the cuff to superstolic pressure, at which point there should be no pulsations.What is the measurement? a. 5-10 mmHg higher than ankle pressure b. 10-20 mmHg higher than ankle pressure c. 20-30 mmHg higher than ankle pressure d. 30-35 mmHg higher than ankle pressure ans- c 10. When a brachial blood pressure is taken while a stethoscope is positioned over the brachial artery, the arm cuff is normally inflated to about-

a. 100 mmHg b. 150 mmHg c. 200 mmHg d. 250 mmHg ans- c 11. In case of the technique for fingers, what is the size of the cuff is usually used for the fingers? a. 1.5-2.0 cm b. 2.0-2.5 cm c. 2.5-3.0 cm d. 3.0-3.5 cm ans- b 12. In case of the technique for fingers(without cold stress), what is the width of the cuff is usually used for the toes? a. 2.4-3.0 cm b. 2.0-2.6 cm c. 3.0-3.6 cm d. 1.4-2.0 cm ans- a 13. The fingers are long enough.So how many cuffs can be applied to obtain two levels of volume plethysmographic waveforms? a. one b. two c. three d. four ans- b 14. In case of the technique for fingers(with cold stress),after resting study is performed how long the feet or hands are immersed in cold water if the patient can tolerate it? a. two minutes b. three minutes c. four minutes d. five minutes ans- a

15. In case of normal plethysmographic waveform qualities, which of the following is not suitable? a. sharp upstroke during peak systole b. prolonged downstroke c. reflected wave approximately half way down d. amplitude is greater in toe than fingers ans- d 16. In case of abnormal obstructive waveform qualities, which of the following is not suitable? a. waveform is present with functional obstructive disease b. slow upslope to a rounded peak c. amplitude is greater in fingers than toe d. downslope that blows away from baseline ans- c 17. In case of abnormal peaked waveform qualities, which of the following is not suitable? a. upslope is slower than normal b. sharp, anactoric notch is present c. Dictoric notch located high on the downslope d. has no characteristics of normal and obstructive waveform ans- d 18. In case of systolicpressure measurements, what is the measurement of finger/brachial indices that characterize normal upper extremitydigits? a. 0.6-0.7 b. 0.7-0.8 c. 0.8-0.9 d. 0.9-1.0 ans- c 19. In case of systolicpressure measurements,what percentage of normal values exceed an index of 0.79? a. 60% b. 70% c. 80% d. 90% ans- d

20. In case of systolicpressure measurements,what index value is exceeded by 90% of normal values? a. 0.69 b. 0.79 c. 0.89 d. 0.99 ans- b 21. In case of systolicpressure measurements, the presence of artifactually high ankle pressures from arterial calcinosis usually negates a toe/ankle pressure index.According to the literature,normal toe pressures vary froma. 30%-40% b. 50%-70% c. 60%-80% d. 70%-90% ans- c

Ch 11 1. Which technique helps to determine wound healing and amputation level and reflects the tissue oxygen tension that depends on the balance between oxygen supply and consumption? a. laser Doppler b. transcutaneous oximetry c. Doppler shift d. plethysmography in combination with Doppler segmental pressure ans- b 2. Transcutaneous oximetry (tc PO2) helps to determine wound healing and amputation level. Which of the followings is not a limitation of transcutaneous oximetry (tc PO2)? a. inability to keep the electrode fairly flat on the skin surface b. inability of a patient to lie quietly as long as 20 minutes c. reflects tissue oxygen tension d. electrode cannot be placed on skin that is not intact ans- c 3. During Transcutaneous oximetry (tc PO2) patient should be warm and quiet. What should be the ambient room temperature? a. should not exceed 20 degrees C b. 20 degrees C c. more or less 20 degrees C d. should not exceed 20 degrees C ans- d 4. Transcutaneous oximetry (tc PO2) reflects tissue PO2, which depends on a balance between oxygen consumption and oxygen supply. When does PO2 can be measured to within 1-2 % of its true value on the surface of the skin? a. if a patient lie quietly as long as 20 minutes b. if a correctly calibrated electrode is used c. if electrode fairly flat on the skin surface d. if the skin is intact ans- b 5. During Transcutaneous oximetry (tc PO2) the electrode houses heating element that heats the skin to a temperature of 44-45 degrees C, increasing blood flow and a. melting a lipid layer in the fatty tissue b. decreases the PO2 near 0 on the surface of the skin c. raises oxygen content d. moving it to capillaries ans- a

6. What is measured by a sensor in the electrode During Transcutaneous oximetry (tc PO2)? a. PO2 on the surface of the skin b. blood flow c. how much oxygen comes through the skin d. oxygen content ans- b 7. What is located between a membrane which is attached to the electrode and the skin surface in case of transcutaneous oximetry (tc PO2)? a. sensor b. a self-adhesive molded plastic fixation ring c. electrolyte solution d. oxygen surface ans- c 8. The electrode/sensor is gently placed on the skin and turned securely in to the fixation ring. Why is it important that the electrode be as flat as possible against the skin? a. the electrode houses heating element that heats the skin b. so that the electrolyte solution covers the skin inside the fixation ring. c. so that the blood pressure increases d. decreases the PO2 near 0 on the surface of the skin ans- b 9. After the required manual calibration, within what time PO2 readings are recorded after stabilization, depending on the particular equipment used? a. 15-20 minutes b. 20 minutes c. 20-25 minutes d. 25 minutes ans- a 10. The electrode is applied near a wound to determine the probability of healing or at the anticipated level of amputation. Where should not be electrode applied to determine healing potential in toes? a. 5 cm from the toes b. 10 cm below the patella c. 10 cm from the toes d. 10 cm above the patella ans- c 11. Where the sensor of the electrode should not be placed during transcutaneous oximetry (tcPO2)? a. skin close to the bone

b. intact skin c. edematous skin d. ulcers ans- b 12. What is the PO2 level during transcutaneous oximetry (tc PO2) to perform transcutaneous oximetry with oxygen challenge? a. less than normal only b. greater than poor c. greater than normal and poor d. less than normal and poor ans- d 13. Which of the followings is not one of the steps of transcutaneous oximetry with oxygen challenge? a. electrodes are applied to the chest and to the site of interest b. a few drops of electrolyte solution are put inside the plastic ring c. oxygen per masked is administered to the patient d. PO2 values are obtained ans- b 14. What should be the measurement of increase of oxygen challenge if the PO2 level is normal (60-80mmHg)? a. 10-20 mmHg b. 30-40 mmHg c. 20-30 mmHg d. 10-30 mmHg ans- a 15. In case of poor PO2, oxygen challenge would not increase this value to normal; there may be a slight increase or none at all. What is the value of poor PO2? a. 10-20 mmHg b. 30-40 mmHg c. 10-15 mmHg d. 15-20 mmHg ans- c 16. What can be suggested if a patient has a poor PO2 reading below the knee but a better one above the knee? a. above-knee amputation are less likely to heal b. below-knee amputation are less likely to heal c. above-knee amputation are more likely to heal d. below-knee amputation are more likely to heal ans- c

17. What can be suggested if a patient has a poor PO2 reading at the site of a wound or arterial ulceration? a. wound less likely to heal b. wound will not heal c. wound more likely to heal d. ulcer less likely to heal ans- b 18. If a patients PO2 falls in between normal and poor, oxygen challenge is the appropriate next step. If a patients initial reading is 20 mmHg, what is possible to happen following oxygen challenge? a. it could decrease to 10 mmHg b. it could increase to 30 mmHg c. it could decrease than 20 mmHg d. it could increase to 30 mmHg ans- d 19. If a patients PO2 falls in between normal and poor, oxygen challenge is the appropriate next step. After oxygen challenge the chest electrode should always a. remain constant b. increase c. decrease d. same as before ans- b 20. There are many factors that affect the measured tcPO2 value, which of the following two are the most important factors? a. arterial PO2 and capillary temperature b. skin composition and blood flow c. arterial PO2 and skin blood flow d. . skin composition and capillary temperature ans- c 21. In case of which disease a low tcPO2 can be interpreted as reduced arterial PO2? a. artery disease b. cardiac disease c. pulmonary disease d. cardiopulmonary disease ans- d

Chap12

1. Which one of the following is not the capabilities of duplex scanning and color flow imaging of the upper extremities? a. localize arterial stenosis b. determine the presence or absence of aneutysm c. detect arterivenous fistulas d. IV site imaging is present ans-d 2. Which oneghi of the following is not the limitation of duplex scanning and color flow imaging of the upper extremeties? a. presence of dressings,skin staples,sutures or open wounds b. evaluation of hemodialysis access graft c. presence of IV site d. diagnosis of Raynouds syndrome ans-b 3. Which one of the following is not included in the positioning of the patient of duplex scanning and color flow imaging of the upper extremeties? a. patient is supine with small pillow under the head b. extremity is positioned close to the examiner c. the arm is positioned at approximately a 80 degree angle from body d. the patient should be kept in pledge position ans-c 4. In the technique, the neck vessels are identified,with attention given to the innominate artery on the right.Which common carotid artery arises from the arotic arch? a. left b. right c. front d. back ans-a 5. Duplex scanning (with or without color flow imaging) is performed at an order.Which of the following is the right order? a. subclavian> brachial>radial> axillary>ulnar>palmar b. subclavian>ulnar >axillary>brachial>radial >palmar

c. subclavian>axillary>brachial>radial>ulnar>palmar d. subclavian>ulnar>axillary>brachial>radial> palmar ans-c 6. In case of duplex scanning and color flow imaging of the upper extremeties, how the hemodialysis grafts are evaluated? a. identify and evaluate outflow artery b. identify and evaluate inflow artery c. identify and evaluate arterial anastomosis d. identify and evaluate body of the graft ans-a 7. In case of duplex scanning and color flow imaging of the upper extremeties, how the hemodialysis grafts are evaluated? a. if color flow imaging is available,observe the image b. observe the aneurysm c. identify and evaluate venous anastomosis d. identify and evaluate inflow vein ans-d 8. For stenosis, there are no criteria for classifying upper extremity disease as there are for the lower extremities.Besides peak systolic velocities vary widely with changes in a. body temperature b. skin temperature c. blood temperature d. plasma temperature ans-b 9. Interpretation of duplex and color flow findings is similar to that for other arterial systems.If there is a hemodynamically significant stenosis present, what happens to the stenosis profisle? a. must exist b. should exist c. may not exist d. must not exist ans-b 10. For the occlusion, it is not uncommon for nerves,tendons, and veins to be mistaken for an occluded artery.What can be the effect of warming the extremity?

a. can decrease possibility of false-negative information b. can decrease possibility of positive information c. can decrease possibility of false-positive information d. can increase possibility of false-positive information ans-c 11. In case of hemodialysis access graft findings,which one of the following should not be identified and documented as to location,extent and type? a. puncture sites b. thrombus c. aneurysmal fixation d. perigraft fluid ans-c 12. A low peak systolic velocity associated with poor-quality Doppler signals obtained throughout the access graft could suggest ana. arterial inflow problem b. arterial outflow problem c. arterial inflow solution d. arterial outflow solution ans-a 13. Occlusion of a fistula or graft obviously prevents successful dialysis.Oftentimes,the dialysis nurse will have to trouble accessing the fistula or graft.What is it referred for the patient? a. to continue b. to test again c. duplex evaluation d. to start over the process ans-c 14. Volume flow measurement is a method to evaluate dialysis access function.Which of the following is not true about volume flow measurement? a. it can be quite variable b. it gives exact measurement c. it depends on several factors d. the evaluation may not be true ans-b

15. In case of other hemodynamic complications, large blood volumes are shunted from the artery to the low-resistance venous circulation.What can cause the congestive heart failure? a. decreased arterial return b. increased arterial return c. decreased venous return d. increased venous return ans-d 16. What kind syndrome there can be whereby the distal arterial (high-pressure) blood flow is reversed into the low resistance (low-pressure) venous circulation? a. Steal syndrome b. Sterotonin syndrome c. Straight back syndrome d. Barlow syndrome ans-a 17. In case of other hemodynamic complications, which of the following is not the symptom of steal syndrome? a. distal to the shunt b. pallor c. coolness of skin d. increased pulses ans-d 18. For brachial artery reactivity testing, the patient should be fasting,relaxed and supine.Reactive hyperemia is induced by inflating a cuff on the forearm(or the upper arm) to a. 150 mmHg b. 200 mmHg c. 250 mmHg d. 300 mmHg ans-c 19. For brachial artery reactivity testing, the patient should be fasting,relaxed and supine.What is the time limit for reactivating hyperemia which is induced by inflating a cuff on the forearm(or the upper arm) to 250 mmHg? a. 3-3.5 minutes

b. 3.5-4 minutes c. 4-4.5 minutes d. 4.5-5 minutes ans-d 20. In case of brachial artery reactivity testing, what is the rate of increasing of the diameter of a brachial artery that has a healthy endothelium when the cuff is on the upper arm? a. by 5% b. by 10% c. by 15% d. by 7% ans-b 21. In case of brachial artery reactivity testing, what is the rate of increasing of the diameter of a brachial artery that has a healthy endothelium when the cuff is on the forearm? a. at least 4% b. at least 5% c. at least 6% d. at least 7% ans-c

Ch 13 1. Which of the followings presence or absence is not determined by using duplex scanning and color flow imaging? a. greater than 50% diameter reduction of stenosis b. arterial disease c. aneurysms d. greater than 50% diameter reduction of occlusions ans- b 2. What can be localized by using duplex scanning and color flow imaging of the lower extremities? a. level of obstruction b. tissue oxygen tension c. stenotic lesion d. arterial stenosis ans- c 3. Which one of the followings is not one of the limitations that could stop duplex scanning and color flow imaging technique from being performed? a. incisional tenderness,hematoms b. presence of IV site c. presence of dressing, skin staples or open wounds d. obesity ans- b 4. Which of the following positioning is not appropriate for patient to perform duplex scanning and color flow imaging of the lower extremities technique? a. the patients hip is minimally rotated externally, with his or her knee slightly flexed b. the patient is supine with pillow under the head c. the patients hip is minimally rotated externally with knee slightly bent d. the extremity to be examined is positioned as close as possible to the examiner ans- c 5. Why prone positioning of the patient is necessary during performing duplex scanning and color flow imaging of the lower extremities technique? a. to access the popliteal artery b. to access the peroneal artery c. to access the pulmonary space d. to access the femoral artery ans- a 6. The simplified explanation of the Doppler equation that follows serves as a reminder of the importance of understanding each component as well as the

significance of utilizing an appropriate Doppler angle. This is not applicable to a. abdominal vessels b. arteries c. tissue d. peripheral vessel ans- c 7. What is the Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference? a. f= Fo V/c Cos b. f=2Fo V Cos /c c. Fo= 2f Cos /c d. f = 2Fo c Cos /V ans- b 8. What is the meaning of f in Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference? a. carrier frequency b. frequency c. speed of ultrasound in tissue d. Doppler frequency shift ans- d 9. What is the meaning of Fo in Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference? a. frequency b. Doppler frequency shift c. carrier frequency d. velocity ans- c 10. What is the meaning of c in Doppler equation in case of duplex scanning and color flow imaging technique depending on the reference? a. frequency b. carrier frequency c. Doppler frequency shift d. speed of ultrasound in tissue ans- d 11. What must be known to calculate velocity in Doppler equation for duplex scanning and color flow imaging technique? a. speed of ultrasound in tissue b. Doppler frequency shift c. carrier frequency

d. angle between the ultrasound beam and the blood flow ans- b 12. Which of the following is not one of the terms that are used to represent Fo in Doppler equation for duplex scanning and color flow imaging technique? a. transducer b. carrier frequency c. frequency shift d. stationary source ans- c 13. Which of the following is represented by Fo in Doppler equation for duplex scanning and color flow imaging technique? a. round trip of the ultrasound b. speed of ultrasound in tissue c. frequency shift d. receiver ans- a 14. To what the Doppler frequency shift in Doppler equation for duplex scanning and color flow imaging technique is proportional? a. round trip of the ultrasound b. variables in the numerators c. speed of ultrasound in tissue d. carrier frequency ans- b 15. What is the variation of the Doppler equation in duplex system to calculate velocity in case of duplex scanning and color flow imaging of the lower extremities? a. V=Fo Cos / c f b. V= c f/Fo Cos c. V= 2Fo Cos / c f d. V=c f/2Fo Cos ans- d 16. What is the source of error for calculating velocity from the variation of the Doppler equation in duplex system? a. Doppler frequency shift b. Doppler angle c. speed of ultrasound d. carrier frequency ans- b 17. To what velocity (V) in the variation of the Doppler equation in duplex system is directly proportional?

a. f and Fo b. Fo and Cos c. c and f d. c and Cos ans- c 18. To what velocity (V) in the variation of the Doppler equation in duplex system is inversely proportional? a. Fo and Cos b. c and Cos c. f and Fo d. c and f ans- a 19. What should the Doppler angle be when acquiring velocity information in vascular ultrasound? a. 90 degrees b. 45 degrees c. 120 degrees d. 60 degrees ans- d 20. What is well known to prevent usage of 60 degrees Doppler angle for acquiring velocity information in vascular ultrasound and likely to produce Doppler angles of much less than 60 degrees? a. aortoiliac duplex b. vessel curvature c. stationary source d. systolic velocity ans- b 21. Which of the following vessels are not scanned by the examiner with 7 or 5 MHz linear array transducer using duplex ultrasonography with or without color imaging? a. distal external iliac artery b. proximal-distal artery c. ulnar artery d. common femoral artery ans- c 22. The arteries are scanned by the examiner with 7 or 5 MHz linear array transducer using duplex ultrasonography. What can you assume if the artery is assessed in gray scale? a. normal b. can be normal or abnormal

c. plaque d. nothing ans- c 23. Peak systolic is measured in each major vessel. What is the meaning of Doppler signals is characterized as monophasic? a. normal b. abnormal c. can be normal or abnormal d. nothing ans- b 24. Peak systolic is measured in each major vessel. What is the meaning of Doppler signals is characterized as triphasic? a. normal b. abnormal c. can be normal or abnormal d. nothing ans- a 25. Which of the following is not obtained when a greater than 50% diameter reduction is suspected on the basis of peak systolic velocity and the color flow and/or gray scale image? a. poststenotic signals b. prestenotic peak systolic velocity c. systolic velocity in the stenotic segment d. duplex color flow image with spectral waveforms ans- d 26. There many types of grafts. Gore-Tex is an example of which type of grafts? a. in situ vein grafts b. reversed saphenous vein graft c. synthetic grafts d. in situ bypass grafts ans- c 27. Which of the following sites are not imaged in gray scale and color for synthetic bypass grafts and not obtain peak systolic velocities? a. proximal anastomosis b. anterior tibial artery c. mid graft d. distal native artery ans- b 28. For vein grafts, all of the aforementioned sites are examined. In addition, the length of the graft is carefully assessed and check for the presence of patent

branches that could possibly not form a. AV fistulas b. stenosis c. valve cusp sites d. anastomosis ans- d 29. Why it is helpful to know what type of bypass graft was implanted and where the bypass graft was anastomosed proximally and distally? a. for future follow up b. to decrease the frustration level of the technologist/sonographer c. to harvest the saphenous vein d. to assess the length of the graft ans- b 30. Normal Doppler signals are triphasic. Biphasic signals can be significant although some patients will normally have biphasic flow signals without any evidence of significant a. stenosis b. occlusive disease c. arterial disease d. cardiac disease ans- c 31. The prestenotic peak systolic velocity is compared to the stenotic peak systolic velocity and a ratio is calculated. What is suggested by an increase in velocity greater than 100%? a. a greater than 75% diameter increase b. a greater than 50% diameter reduction c. a greater than 75% diameter reduction d. a greater than 50% diameter increase ans- b 32. The prestenotic peak systolic velocity is compared to the stenotic peak systolic velocity and a ratio is calculated. What is suggested by a prestenotic to stenotic PSV ratio greater than 4:1? a. a greater than 50% diameter reduction b. increase in velocity greater than 100% c. a greater than 50% diameter increase d. a greater than 75% diameter reduction ans- d 33. The prestenotic peak systolic velocity is compared to the stenotic peak systolic velocity and a ratio is calculated. What is suggested by a stenotic PSV greater than 400 cm/sec?

a. increase in velocity greater than 100% b. a greater than 50% diameter reduction c. a greater than 75% diameter reduction d. a prestenotic to stenotic PSV ratio greater than 4:1 ans- c 34. In where significant stenosis and occlusions commonly do occur at the level of the adductor canal or Hunters canal? a. distal superficial femoral artery and proximal popliteal artery b. proximal native artery and distal native artery c. deep femoral artery and common femoral artery d. anterior tibial artery and posterior tibial artery ans- a The most important e l e m e n t in the serial assessment of bypass grafts is the comparison of the current study to previous studies. Observe for significant changes. Which of the followings is not fall in to the significant changes? a. A decrease in ABI of greater than 0.15* b. a stenotic PSV greater than 400 cm/sec c. A decrease of 30 cm/sec PSV in any graft segment d. A change in quality ans- b 35. What will be affected by discrepancies in size (vessel diameter) between the graft and the native artery-as well as variations within the vein graft? a. stenotic peak systolic velocity b. velocity of blood flow c. velocity of ultrasound d. prestenotic peak systolic velocity ans- b 36. Postoperative complications of a vein bypass graft Include arteriovenous fistula a n d an intact valve cusp. What can a arteriovenous fistula do? a. produce stenosis b. produce occlusion c. siphon off graft blood volume d. increase in velocity greater than 100% ans- c 37. What is the accepted criterion for the ultrasonographic diagnosis of an aneurysm? a. increase in diameter 50% b. less than the native artery c. increase in diameter 75%

d. greater than popliteal artery ans- a 38. Pseudoaneurysm can also occur in native arteries subsequent to a catheter procedure. Which is not a catheter procedure a. angiography b. heart catheterization c. trauma d. ultrasonography ans- d 39. Which of the followings is not a major intraoperative application of duplex scanning and color flow imaging? a. to identify and evaluate any suspicious turbulent areas in the vein bypass graft b. check the patency of the anastomotic sites c. to identify and evaluate any suspicious occlusion in the vein bypass graft d. to identify and evaluate any suspicious stenotic areas in the valve sites ans- c 40. No matter which kind of vein graft has been placed the entire length of the graft must be assessed. What is important for in situ graft during evaluation? a. the anastomotic sites must be carefully evaluated b. to observe for branches that may not have been ligated c. to check the patency of the anastomotic sites d. to identify and evaluate any suspicious turbulent areas in the vein bypass graft ans- b

Chap14 1. In which part the duplex scanning and color flow imaging of the abdominal vessels is needed to determine the presence/absence of significant stenosis,follow up bypass grafts and evaluate aneurysms? a. renal artery b. liver c. aortoiliac vessels d. kidney ans-c 2. In which part the duplex scanning and color flow imaging of the abdominal vessels is needed to determine the presence/absence of significant stenosis,which may account for or cause mesenteric bowel ischemia? a. mesenteric arteries b. liver c. aortoiliac vessels d. renal artery ans-a 3. Which one of the following is not the limitation of duplex scanning and color flow imaging of the abdominal vessels? a. bowel gas b. previous abdominal surgery c. nonfasting patient d. regular breath and respiration ans-d 4. Which one of the following is the right patient positioning of duplex scanning and color flow imaging of the abdominal vessels? a. LLD for access to the left flank b. LLD for access to the right flank c. RLD for access to the right flank d. supine,with head elevation of 45 degree ans-b 5. What kind of transducer and duplex ultrasonography with or without color flow imaging is used for general remarks by the examiner who begins scanning for the vessels of interest? a. 2.25 MHz transducer b. 4.25 MHz transducer c. 6.25 MHz transducer d. 4 MHz transducer ans-a 6. What kind of transducer and duplex ultrasonography with or without color flow imaging is used for children or thin elderly by the examiner who begins scanning for the vessels of interest? a. 2.25 MHz transducer b. 3 MHz transducer c. 4 MHz transducer d. 7 MHz transducer ans-d 7. Combining longitudinal and transverse approaches,and other approaches,as necessary,the examiner evaluates the gray scale and color flow patterns,observing for

aneurysm,plaque and other pathologies and findings.The transverse approach includesa. 30 degree view b. 45 degree view c. 60 degree view d. 90 degree view ans-d 8. Using longitudinal approach in order to accurately and appropriately set the Doppler angle,the examiner also assesses the Doppler waveform qualities,peak systolic velocity and when appropriate, the end diastolic velocity of the arteries under examination.What is the Doppler angle? a. 600 b. 500 c. 400 d. 300 ans-a 9. In case of aneurysm of aortoiliac arteries,for the aorta,what is the qualified dialation of designation as an aneurysm? a. 1 cm b. 2 cm c. 3 cm d. 4 cm ans-c 10. For the aorta, a dilation of greater than 3 cm qualifies for designation as an aneurysm.In general, what percentage of increase in diameter qualifies an artery as aneurysmal? a. 20% or more b. 30% or more c. 40% or more d. 50% or more ans-d 11. It is helpful to know that many of the patients undergoing this study present with hypertension(controlled or not well controlled) and that many of these hypertensive patients havea. Heart attack b. Cerebral hemorrhage c. renovascular hypertension d. Stroke ans-c 12. In case of renal artery and kidney-technique,the aorta is evaluated proximally as needed.How the peak systolic velocity of the aorta is obtained? a. proximal to the inferior mesenteric artery b. distal to the inferior mesenteric artery c. proximal to the superior mesenteric artery d. distal to the superior mesenteric artery ans-d 13. In case of renal artery and kidney-technique,using a transverse approach,the examiner locates the renal arteries.What is a good landmark for identifying the left renal artery? a. left brachial vein b. left renal vein c. left axillary vein d. left femoral vein ans-b

14. The renal arteries and kidney arteries(i.e., segmental,interlobar) are normally characterized by their low-resistance .Which of the following artery is not included with normally low-resistance flow patterns? a. celiac artery b. hepatic artery c. splenic artery d. common carotid artery ans-d 15. In case of renal artery and kidney-technique,how the renal-to-aortic ratio(RAR) is calculated? a. (Renal artery PSV/Aortic PSV) b. (Renal artery PSV+Aortic PSV)/2 c. (Renal artery PSV-Aortic PSV)/2 d. (Renal artery PSVxAortic PSV) ans-a 16. The renal-to-aortic ratio(RAR) is calculated by dividing the highest peak systolic velocity of the renal artery by the peak systolic velocity of the aorta.What is the normal interpretation? a. < 2.5 b. < 3.5 c. < 4.5 d. < 5.5 ans-b 17. The renal-to-aortic ratio(RAR) is calculated by dividing the highest peak systolic velocity of the renal artery by the peak systolic velocity of the aorta.What is the abnormal interpretation? a. 2.5 b. 3.5 c. 4.5 d. 5.5 ans-b 18. The renal-to-aortic ratio(RAR) is calculated by dividing the highest peak systolic velocity of the renal artery by the peak systolic velocity of the aorta.What is indicated by the abnormal interpretation? a. 40% or greater diameter reduction b. 50% or greater diameter reduction c. 60% or greater diameter reduction d. 70% or greater diameter reduction ans-c 19. The RAR may not be accurate in the presence of an aortic aneurysm or when the peak systolic velocities af the aorta area. < 20 cm/sec b. < 30 cm/sec c. < 40 cm/sec d. < 50 cm/sec ans-c 20. The RAR may not be accurate in the presence of an aortic aneurysm or when the peak systolic velocities af the aorta area. > 60-70 cm/sec b. > 70-80 cm/sec c. > 80-90 cm/sec

d. > 90-100 cm/sec ans-d 21. The RAR may not be accurate in the presence of an aortic aneurysm or when the peak systolic velocities af the aorta are < 40 cm/sec or > 90-100 cm/sec.In either scenario,what is the peak systolic velocities along with poststenotic turbulence is considered by some to be abnormal? a. 90-100 cm/sec b. 140-1600 cm/sec c. 160-180 cm/sec d. 180-200 cm/sec ans-d 22. The kidney is examined for morphologic abnormalities (cyst,cortex thinning,other defects).What is the range of normal pole-to-pole measurements of length? a. 8-10 cm b. 10-12 cm c. 12-14 cm d. 11-13 cm ans-b 23. The arteries of the kidney (i.e.,segmental,interlobar,arcuate) are normally characterized by their low resistance.Ratios such as end diastolic ratio(EDR)-also known as the parenchymal resistance ratio(PRR) can be applied to determine if flow resistance has increased.How is it measured? a. (End diastolic velocity-Peak diastolic velocity)/2 b. (End diastolic velocity/Peak diastolic velocity)x0.5 c. (End diastolic velocity+Peak diastolic velocity)/2 d. (End diastolic velocity/Peak diastolic velocity) ans-d 24. The arteries of the kidney (i.e.,segmental,interlobar,arcuate) are normally characterized by their low resistance.Ratios such as end diastolic ratio(EDR)-also known as the parenchymal resistance ratio(PRR) can be applied to determine if flow resistance has increased.What is the normal measurement? a. > 0.2 b. > 0.3 c. > 0.4 d. > 0.5 ans-a 25. The arteries of the kidney (i.e.,segmental,interlobar,arcuate) are normally characterized by their low resistance.Ratios such as end diastolic ratio(EDR)-also known as the parenchymal resistance ratio(PRR) can be applied to determine if flow resistance has increased.What is the abnormal measurement? a. < 0.2 b. < 0.3 c. < 0.4 d. < 0.5 ans-a 26. For the lesser degree, to determine whether resistance is increasing in the kidney (specially the transplanted kidney) is Pourcelots ratio/resistivity index(RI).How is it calculated? a. (PSV+EDV)PSV b. (PSV-EDV)PSV c. (PSV-EDV)/PSV

d. (PSV+EDV)/PSV ans-c 27. For the lesser degree, to determine whether resistance is increasing in the kidney (specially the transplanted kidney) is Pourcelots ratio/resistivity index(RI).What is the normal range? a. < 0.5 b. < 0.6 c. < 0.7 d. < 0.8 ans-c 28. For the lesser degree, to determine whether resistance is increasing in the kidney (specially the transplanted kidney) is Pourcelots ratio/resistivity index(RI).What is the abnormal range? a. 0.7 b. 0.8 c. 0.9 d. 0.10 ans-a 29. Suppose, we get from Doppler findings:PSV=60,EDV=15 and End diastolic ratio=0.25.What is the resistivity index(RI)? a. 0.55 b. 0.65 c. 0.75 d. 0.85 ans-c 30. The renal resistanceindex value(RRIV) uses the peak systolic velocity and the end diastolic velocity obtained from the kidneys segmental arteries.What is the value of lower resistance which is associated with improvement in both blood pressure and renal function after the correction of renal artery stenosis? a. < 80 b. < 70 c. < 60 d. < 50 ans-a 31. The renal resistanceindex value(RRIV) uses the peak systolic velocity and the end diastolic velocity obtained from the kidneys segmental arteries.How RRIV is calculated? a. (1-EDV/PSV)x100 b. (EDV/PSV-1)x100 c. (1-EDV)/PSVx100 d. (1+EDV/PSV)x100 ans-a 32. The acceleration time is the time interval from the onset of the systole to the initial peak and is reported in milliseconds(msec).A proximal stenosis of 60% diameter reduction is most likely to produce an AT ofa. 70 msec b. 80 msec c. 90 msec d. 100 msec ans-d 33. The acceleration index describes the slope of the Doppler velocity waveform.It is calculated as the change in velocity between the onset of systole and the systolic peak

divided by the AT.What is the unit of measure for AI? a. cm/sec b. cm/sec2 c. cm2/sec d. cm2/sec2 ans-b 34. The acceleration index describes the slope of the Doppler velocity waveform.It is calculated as the change in velocity between the onset of systole and the systolic peak divided by the AT.How a positive result is defined? a. 291 cm/sec2 b. 270 cm/sec2 c. 245 cm/sec2 d. 279 cm/sec2 ans-a 35. Suppose a patient has come who present with a history of dull,achy or crampy abdominal pain 15-30 minutes after meals ma suffer from mesenteric ischemia.It is also known as mesenteric angina.After fasting study, the patient is given high calorie liquid meal.When the study is repeated again? a. 10-20 minutes after the meal b. 20-30 minutes after the meal c. 30-40 minutes after the meal d. 15-35 minutes after the meal ans-b 36. In case of mesenteric arteries interpretation,at which range the published variances of peak systolic velocity in the celiac artery vary with end diastolic velocities of 55 cm/sec? a. 80 to 160 cm/sec b. 50 to 100 cm/sec c. 50 to 160 cm/sec d. 40 to 120 cm/sec ans-c 37. In case of mesenteric arteries interpretation, the published variances of peak systolic velocity in the celiac artery vary from 50 to 160 cm/sec with end diastolic velocities ofa. 55 cm/sec b. 45 cm/sec c. 35 cm/sec d. 25 cm/sec ans-a 38. In case of mesenteric arteries interpretation, the published variances of peak systolic velocity in the celiac artery vary from 50 to 160 cm/sec with end diastolic velocities of 55 cm/sec.What is the abnormal fasting peak systolic velocity at 70-99% diameter reduction? a. 125 cm/sec b. 150 cm/sec c. 175 cm/sec d. 200 cm/sec ans-d 39. In case of mesenteric arteries interpretation, the published variances of peak systolic velocity in the celiac artery vary from 50 to 160 cm/sec with end diastolic velocities of 55 cm/sec.An abnormal fasting peak systolic velocity of 200cm/sec is predictive of a a. 40-69% diameter reduction

b. 50-79% diameter reduction c. 60-89% diameter reduction d. 70-99% diameter reduction ans-d 40. In case of mesenteric arteries interpretation,at which range the published variances of peak systolic velocity in the superior mesenteric artery (SMA) vary? a. 90-137 cm/sec b. 100-157 cm/sec c. 110-177 cm/sec d. 120-177 cm/sec ans-c 41. In case of mesenteric arteries interpretation, published variances of peak systolic velocity in the superior mesenteric artery (SMA) vary from 110-177 cm/sec.What is the meaasurement of abnormal fasting peak systolic velocities of a 70-99% diameter reduction? a. 225 cm/sec b. 250 cm/sec c. 275 cm/sec d. 295 cm/sec ans-c 42. In case of mesenteric arteries interpretation, published variances of peak systolic velocity in the superior mesenteric artery (SMA) vary from 110-177 cm/sec.What is the range of diameter reduction at abnormal fasting peak systolic velocities of 275 cm/sec? a. 40-69% diameter reduction b. 50-79% diameter reduction c. 60-89% diameter reduction d. 70-99% diameter reduction ans-d 43. In case of mesenteric arteries interpretation,additional criteria utilizing the SMA end diastolic velocities has also been validated.What is the best indicator of severe stenosis in the fasting SMA? a. EDV of > 45 cm/sec b. EDV of > 35 cm/sec c. EDV of > 25 cm/sec d. EDV of > 15 cm/sec ans-a 44. In case of mesenteric arteries interpretation,additional criteria utilizing the SMA end diastolic velocities has also been validated.In a particular case,an EDV of > 45 cm/sec is the best indicator of severe stenosis in the fasting SMA.Also used along with other useful thresholds in identifying patients with severe stenosis:the absence of a triphasic SMA waveform and fasting PSV ofa. > 100 cm/sec b. > 200 cm/sec c. > 300 cm/sec d. > 400 cm/sec ans-c 45. The celiac artery branches into the hepatic and splenic arteries.The liver and spleen have fixed metabolic requirements and are not likely to be influenced by the postprandial state.What are normally evident in these vessels at all times? a. high peak systolic and end diastolic velocities

b. low peak systolic and end diastolic velocities c. high peak systolic and reverse diastolic velocities d. low peak systolic and reverse diastolic velocities ans-a 46. Because of the small caliber, it is quite difficult to locate the inferior mesenteric artery(IMA),which branches off the distal aorta.Easy detection and ultrasonographic dominance of the inferior mesenteric artery may suggest occlusion of thea. Internal iliac artery b. Popliteal artery c. Peroneal artery d. superior mesenteric artery ans-d 47. Studies indicate that duples evaluation of the mesenteric arteries suggests chronic mesenteric ischemia when there are abnormal findings for at least two of the three mesenteric vessels.Which of the following is not one of them? a. celiac arteries b. superior mesenteric arteries c. splenic arteries d. inferior mesenteric arteries ans-c 48. Liver transplantation is becoming a more frequently utilized procedure to treat patients with end-stage liver disease.What kind of transducer is used in the pre and post operative assessment of these patients? a. 1 or 2 MHz transducer b. 2 or 4 MHz transducer c. 3 or 5 MHz transducer d. 6 or 8 MHz transducer ans-c 49. Liver transplantation is becoming a more frequently utilized procedure to treat patients with end-stage liver disease.Which of the following is not included for the preoperative duplex evaluation of candidates for liver transplantation? a. portal vein b. splenic vein c. hepatic vein d. renal vein ans-d 50. Postoperatively,duplex ultrasonography is used to document patency of portal vein,splenic vein,superior mesenteric vein,hepatic veins,inferior vena cava, and hepatic artery,as well as portal vein flow direction and vessel size.What is the ideal vein size? a. 0.5-1.0 cm b. 1-1.5 cm c. 1.5-2 cm d. 0.5-1.5 cm ans-b 51. Posroperative complications include allograft rejection,pseudoaneurysm,hepatic infraction and thrombosis of the portal vein,inferior vena cava, and/or hepatic artery.The hepatic artery inflow becomes crucial to the viability of thea. liver b. kidney c. appendix

d. heart ans-a 52. The location of the hepatic artery provides a challenge to obtaining a proper Doppler angle.If the Doppler angle is high, no flow may be detected because of the poor or nonexistent Doppler shift.What is the hogh range? a. 50-60 degrees b. 60-70 degrees c. 70-80 degrees d. 80-90 degrees ans-d 53. In case of renal transplant(Allograft),what kind of transducer is used for duplex evaluation ? a. 3 MHz b. 5 MHz c. 7 MHz d. 9 MHz ans-b 54. Which of the following is not the technique of renal transplant-allograft? a. duplex evaluation b. longitudinal and transverse approaches c. B-mode observation d. preoperative followup ans- d 55. In case of renal transplant(Allograft),which of the following is not the B-mode sign of rejection? a. increased renal transplant size b. decreased renal transplant size c. increased cortical echogenicity d. hypeochoic regions in the parenchyma ans-b 56. With respect to the other vascular complications suplex scanning also has diagnostic value.Its applications include the following excepta. renal artery stenosis b. renal vein thrombosis c. arterivenous thrombosis d. pseudoaneurysm ans-c

Ch 15 1. The deep superior epigastric artery is the terminal branch of the internal mammary artery. What is the diameter at its origin? a. about 0.6 mm b. about 1.6 mm c. about o.6 cm d. about 1.6 cm ans- b 2. The deep superior epigastric artery is the terminal branch of the internal mammary artery. From where does the deep superior epigastric artery arise? a. internal iliac artery in the lower abdomen b. external iliac artery in the lower abdomen c. internal mammary artery d. internal iliac artery in the upper abdomen ans- b 3. Smaller branches of mammary and iliac arteries anastomose in a region known as the watershed area. Where does this watershed area located? a. between the internal and external iliac arteries in the lower abdomen b. between the internal and external mammary arteries c. between the superior and inferior epigastric arteries d. between internal and external iliac arteries in the upper abdomen ans- c 4. What is used for the transverse rectus abdominis myocutaneous (TRAM) flap in autogenous breast reconstruction? a. the muscle with best arterial blood supply b. the muscle with subcutaneous fat c. the muscle with overlying skin d. rectus abdominis muscle ans- a 5. What type of linear array transducer is used for preoperative epigastric artery mapping technique? a. a 5 MHz linear array b. a 5.5 MHz linear array c. a 7.5 MHz linear array d. a 6.5 MHz linear array ans- c 6. What type of phase array transducer is used for preoperative epigastric artery mapping technique? a. a 5.5 MHz phase array b. a 7.5 MHz phase array

c. a 8.5 MHz phase array d. a 5 MHz phase array ans- d 7. What kind of Doppler is not used to identify location and obtain velocities of the epigastric arteries and their preferators? a. power Doppler b. laser Doppler c. low flow setting Doppler d. color flow Doppler ans- b 8. How deep the epigastric arteries that are located below the skin surface? a. 4-5 cm b. 4 cm c. 3-4 cm d. 1 cm ans- c 9. The epigastric arteries are approximately 3-4 cm below the skin surface. What is the diameter of the preferators? a. less than 1 cm b. less than 3cm c. less than 3 mm d. less than 1 mm ans- d 10. Which of the following is not responsible for limiting the success of preoperative epigastric artery mapping technique? a. scarring b. presence of dressing, skin staples c. depth d. effect of radiation treatment ans- b 11. From where the internal mammary artery also known as the thoracic artery does arise? a. arch of the s superficial artery b. arch of the common femoral artery c. arch of the subclavian artery d. arch of the carotid artery ans- c 12. Sonographically, the internal mammary artery appears as a tubular structure and it is characterized by low-resistance flow. What is the diameter of that tubular structure?

a. 2 mm b. 1 mm c. 1 cm d. 2 cm ans- a 13. From where radial artery does originate which travels down the lateral side of the forearm in to the hand? a. subclavian artery b. brachial artery c. thoracic artery d. carotid artery ans- b 14. What is used evaluate the brachial, ulnar and radial arteries for gray-scale and Doppler flow qualities in preoperative radial artery mapping technique? a. color flow Doppler b. laser Doppler c. duplex ultrasonography d. ultrasonography ans- c 15. What kind of abnormalities are not generally observed in case of preoperative radial artery mapping technique a. increased PSVs b. abnormal Doppler quality c. calcification of the artery wall d. abnormal effect of radiation treatment ans- d 16. Preoperative vein mapping may be performed in the upper and/or lower extremities. In the lower extremity, what kinds of veins are mapped to assess their acceptability for use in grafting procedures? a. cephalic veins b. saphenous veins c. basilica veins d. pulmonary veins ans- b 17. In case of preoperative vein mapping in the upper extremities the entire length of the vein is evaluated at increments for compressibility, diameter and continuity. Which are the increments typically? a. high, mid, distal thigh b. knee and below knee c. wrist

d. ankle ans- c 18. Preoperative vein mapping may be performed in the upper and/or lower extremities. In the upper extremity, what kinds of veins are mapped to assess their acceptability for use in grafting procedures? a. pulmonary veins b. great saphenous veins c. small saphenous veins d. cephalic veins ans- d 19. In case of preoperative vein mapping in the upper extremities proximal tourniquet often assists with a. expansion of the vein size b. vein wall compressibility c. coaptation of vein wall d. vein wall thickening ans- a 20. Which of the followings can be included as abnormal findings during Preoperative vein mapping in the upper extremity? a. inadequate diameter b. excessive vein wall thickening c. the basic vein is larger d.incompressibility ans- c

Ch 16 1. Arteriovenous fistulae can be congenital or traumatic. Between which two they set up an abnormal connection and causing rather marked anatomic and hemodynamic changes? a. high pressure venous system and low pressure arterial system b. low pressure venous system and high pressure arterial system c. low pressure proximal arterial system and low pressure distal arterial system d. high pressure proximal arterial system and low pressure distal arterial system ans- b 2. When fistula is located close to the heart, the potential for cardiac failure increases. Which of the followings more likely to cause if fistulae is located peripherally? a. trauma b. congestive heart failure c. muscle necrosis d. ischemia ans- d 3. An arteriovenous fistulas diameter and length predict the resistance it offers. What may be involved by an arteriovenous fistula? a. high pressure arterial system and low pressure venous system b. arterial system and venous system c. proximal arteries and distal arteries d. high pressure proximal arterial system and low pressure distal arterial system ans- c 4. By which of the following flow through the fistula (connection between the artery and the vein) is not usually characterized? a. the flow pattern is often bidirectional b. elevated peak c. phasicity is present d. diastolic velocities associated with spectral broadening ans- c 5. Venous flow approaching the AVF has somewhat elevated velocities. Phasicity is present, but the venous signal has somewhat increased pulsatility. Why venous signal has somewhat increased pulsatility? a. because of the mixed arterial and venous flow b. because of the connection with artery via AVF c. because diastolic velocities associated with spectral broadening d. because a large, chronic fistula tends to elevate venous pressure ans- b

6. Venous flow moving away from the AVF has elevated velocities throughout. Phasicity is present, as well as increased pulsatility. Why pulsatility is increased? a. because of the mixed arterial and venous flow b. because a large, chronic fistula tends to elevate venous pressure c. because of the connection with artery via AVF d. because diastolic velocities associated with spectral broadening ans- a 7. What are caused by swelling within the osteofascial compartments of the leg or arm? a. popliteal artery entrapment syndromes b. arteriovenous fistulae c. compartment syndromes d. cystic adventitial disease ans- c 8. Which of the following is not responsible for causing compartment syndromes which most commonly occur following revascularization to correct prolonged ischemia? a. embolic b. occlusion of the vessel c. bleeding within a compartment d. traumatic ans-b 9. Which one of the followings is a late sign of compartment syndromes which is found after clinical findings? a. loss of pulses b. paresthesias c. weakness of involved muscle d. tension of the compartment ans- a 10. Following repair of an occluded or traumatized tibial artery, swelling may become evident. Because the compartment is bound by bone, fascia, and interosseous membrane, outward swelling is impossible. Swelling therefore may compress tibial arteries and what is not caused because of this? a. necrosis of the muscles and severe pain b. occlusion of the vessel c. foot drop d. neurological changes ans- b 11. Which one of the followings is appropriate treatment for compartment syndromes by swelling within the osteofascial compartments of the leg or arm?

a. surgical treatment b. endaterectomy c. sympathectomy d.fasciotomy ans- d 12. With cystic adventitial disease process cystic fluid accumulates in the wall of the peripheral artery. What can be caused by this? a. loss of pulses b. narrowing of the vessel c. foot drop d. necrosis of the muscles ans- b 13. The etiology of cystic adventitial disease most common in males. What is age range of these males? a. 35-40 years b. young c. 40-50 years d. old ans- c 14. Deviating medially around a normally positioned gastrocnemius muscle or the medial head of the gastrocnemius muscle may have an abnormal location. What is caused by this? a. cystic adventitial disease b. popliteal artery entrapment syndromes c. compartment syndromes d. thoracic outlet syndromes ans- b 15. Popliteal artery entrapment syndromes are most commonly found in males. What is age range of these males? a. 35-40 years b. old c. 40-50 years d. young ans- d 16. Young male complains of pain in the calf muscle following exercise. The vascular laboratory findings reveal normal pressures, pulses and plethysmographic waveforms at rest, but appreciably abnormal decrease during active planter flexion or passive dorsiflexion of the foot. From what disease patient is suffering? a. cystic adventitial disease b. arteriovenous fistulae

c. popliteal artery entrapment syndromes d. compartment syndromes ans- c 17. What occurs when there is neurovascular bundle compression by the shoulder structures (cervical rib, costoclavicular, and scalene muscle)? a. thoracic outlet syndrome b. popliteal artery entrapment syndromes c. compartment syndromes d. arterial compartment syndromes ans- a 18. What techniques are utilized to detect arterial changes of a patient suffering from thoracic outlet syndrome? a. arteriography b. angiography c. ultrasonography d. plethysmographic ans- d 19. Patients shoulders back with the head turned sharply toward the arm being tested; then turned sharply away from the arm being tested. what is the name of this position? a. causative position b. Adson maneuver positioning c. Fowlers position d. prone position ans- b 20. Which one of the followings is appropriate treatment for thoracic outlet syndrome which occurs when there is neurovascular bundle compression by the shoulder structures? a. surgical treatment b. endaterectomy c. sympathectomy d.fasciotomy ans- a 21. Which of the followings is a clinical presentation of trauma which can cause arterial injuries? a. necrosis of the muscles and severe pain b. occlusion of the vessels c. long bone fractures that secondarily injure vessels d. compression of the popliteal artery ans- c

Ch 17 1. Which one of the followings are not most commonly employed types of arteriography technique? a. intraarterial injection b. computed tomography c. intravenous digital technology d. a rapid film changer technique ans- c 2. Which artery are the most commonly used and the safest approach for arteriography technique? a. axillary artery b. common femoral artery c. superficial artery d. brachial artery ans- b 3. In arteriography technique once the catheter is positioned properly, a liquid contrast agent is injected and flows with the moving blood. Which of the followings can be imaged in such situation? a. arterial wall b. small vessel c. arterial lumen d. collateral vessels ans- c 4. In arteriography technique following removal of the catheter, pressure is applied to the puncture site and patient is positioned for 6-8 hours of bed rest. How patient is positioned? a. prone b. lateral recumbent c. fowlers position d. supine ans- d 5. By what percentage the diameter of the arterial lumen is decreased by a hemodynamically significant stenosis for many large muscular arteries? a. 75% b. 50% c. 25% d. 60% ans- b 6. Atherosclerotic plaque appears as irregular or smooth negative images on arteriogram wherever the plaque displaces the contrast media. Which of the

followings is not the common location for Atherosclerotic plaque? a. aortic arch b. adductor canal c. brachial artery d. femoral artery ans- b 7. In which location aneurysms are not most commonly develop? a. axillary artery b. femoral artery c. infrarenal aorta d. popliteal artery ans- a 8. What may develop along the dilated wall of the aneurysmal artery, creating the appearance of a straight tube on arteriography? a. tortuosity of the vessel b. occlusion c. thrombus d. vasospasm ans- c 9. What is appears as severe narrowing of the arterial lumen, usually without occlusion? a. thrombus b. vasospasm c. aneurysms d. fibromuscular dysplasia ans- b 10. Which are caused by medial hyperplasia and which create the appearance of a string of beads? a. aneurysms b. thrombus c. vasospasm d. fibromuscular dysplasia ans- d 11. There are few limitations of arteriography technique. One of them is it may not be possible to perform arteriography on a paitient who isa. paitient in kidney failure b. paitient of high blood pressure c. allergic to contrast agent d. claustrophobia ans- c

12. Which the followings are not one of the complications that could arise during arteriography technique? a. pseudoaneurysms b. kidney failure c. local arterial occlusion d. puncture site hematoma ans- b 13. Which technique is capable of distinguishing flood flow from soft tissue without the use of contrast agent? a. magnetic resonance imaging and angiography b. ultrasound c. MRI d. computed tomography ans- a 14. Which disease can be evaluated by magnetic resonance imaging (MRI) and angiography (MRA)? a. abdominal aortic disease b. popliteal arterial disease c. occlusion disease d. peripheral arterial disease ans- d 15. What may be overestimated because of nonlaminar or slow flow states, which can result in the loss of the magnetic signals? a. pulses b. blood pressure c. stenoses d. obstruction ans- c 16. It is difficult to undergo the magnetic resonance imaging (MRI) and angiography (MRA) with paitient who has a. allergy to contrast agent b. claustrophobia c. high blood pressure d. occlusion ans- b 17. Which one uses ionizing radiation to obtain cross-sectional images of the aorta and other body structures and can be performed with or without the use of contrast agent? a. magnetic resonance imaging and angiography b. MRI

c. ultrasound d. computed tomography ans- d 18. Which of the following technique have to be used to evaluate aneurysms in patient and determine the size of the aneurysms? a. CT b. MRI c. MRA d. Ultrasound ans- a 19. Which one of the followings cannot be evaluated by the computed tomography (CT) technology? a. hemorrhage b. stenoses c. arteriovenous malformation d. cerebral infractions ans- b 20. Surgical treatment is to operate depends on the extent and severity of interest. What are removed by surgical therapy named endarterectomy? a. aneurysms b. arteriovenous malformation c. atherosclerotic materials d. cerebral infractions ans- c 21. Surgical treatment is to operate depends on the extent and severity of interest. Which surgical treatment is used to provide an alternate pathway for distal blood flow? a. sympathectomy b. endarterectomy c. fasciotomy d. bypass grafts ans- d 22. Which of following vein is not used in surgical therapy, bypass grafts which provide an alternate pathway for distal blood flow? a. axilliary vein b. saphenous vein c. in-situ vein d. cephalic vein ans- a

23. Surgical treatment is to operate depends on the extent and severity of interest. One of them is bypass graft. Which one of the following is not a common bypass grafts? a. femoral to popliteal b. aorta to bifemoral c. aorta to axillary d. femoral to femoral ans- c 24. What is used to dilate precisely that segment of a vessel that contains a focal atherosclerotic lesion? a. stents and stents graft b. percutaneous transluminal angioplasty c. embolectomy d. atherectomy ans- b 25. What kind of catheter is used in percutaneous transluminal angioplasty technology? a. balloon-tipped catheter b. Foley catheter c. peripheral venous catheter d. a very thin catheter ans- a 26. Balloon angioplasty cannot be applied to all vessels or all types of lesions. In which vessels balloon angioplasty cannot be applied? a. popliteal arteries b. femoral arteries c. peroneal arteries d. iliac arteries ans- c 27. Which particular sent has been used to repair specific types of aneurysms disease, especially in the aorta? a. balloon expandable b. covered stent c. thermal expanding d. self-expanding ans- b 28. A particular sent has been used to repair specific types of aneurysms disease, especially in the aorta. Which of the followings is not a type of aortic sent graft? a. tube grafts b. aortoiliac grafts

c. bifurcated grafts d. self expanding grafts ans- d 29. Which are most often used to repair aneurysms disease of the aorta and also to treat stenosis and maintain patency of vessels? a. bypass grafts b. endarterectomy c. stent grafts d. medical therapy ans- c 30. Which may identify the complications of endovascular aortic stents including endoleak, graft stenosis or thrombosis, dissection, problems at the attachment sites resulting in migration and twisting of the limbs of a bifurcated graft? a. magnetic resonance imaging and angiography b. duplex ultrasound c. computed tomography d. ultrasonography ans- b 31. Which of the following is a minimally invasive endovascular procedure that may be used in some patients who are not candidates for traditional surgical or endovascular treatment? a. balloon angioplasty b. stent placement c. subintimal angioplasty d. angiography ans- c 32. Which technology is routinely performed for post interventional evaluation of aortic stent grafts? a. computed tomography angiography b. magnetic resonance imaging and angiography c. computed tomography d. duplex ultrasound ans- a 33. Which of the following noninvasive technique is used to evaluate stents (for iliac, renal, femoral arteries) or stents grafts (for aortic aneurysm)? a. computed tomography angiography b. duplex imaging c. ultrasonography d. computed tomography ans- b

34. The stent graft is used to repair an abnormal aortic aneurysm. A successful procedure should reduce the size of the aneurismal sac. If blood flow is observed in the sac, or if the size of the sac fails to diminish or grows larger, there could be an endoleak. These leaks are divided into five types. Which of the following leak is Type III? a. branch leaks b. attachment endoleaks at proximal and distal attachment sites c. modular connect endoleak d. transgraft endoleaks ans- c 35. All leaks are confirmed with spectral Doppler. What kinds of leaks have reproducible arterial waveforms that differ from the graft flow waveforms? a. branch leaks b. attachment endoleaks c. transgraft endoleaks d. true leaks ans- d 36. Which of the following technology is used to extract embolus from the affected arterial segment? a. angioplasty b. duplex ultrasound c. thrombectonomy d. atherectomy ans- c 37. What is an alternative percutaneous transluminal angioplasty that cuts through or pulverizes the plaque with a rotational device at the end of the catheter? a. balloon angioplasty b. atherectomy c. subintimal angioplasty d. thrombectonomy ans- b 38. Vascular duplex ultrasound is also used to assess patency of the vessel following peripheral endovascular procedures. Protocols vary with regard to frequency of this post procedure evaluation, depending of on the method endovascular intervention. Which of the following is not a method endovascular intervention? a. percutaneous transluminal angioplasty b. atherectomy c. endarterectomy d. stent ans- c

39. Which of the following is not a one of the important factors in determining whether a pseudoaneurysm is an appropriate candidate for ultrasound-guided compression? a. pseudoaneursym spontaneously thromboses b. the size of the pseudoaneurysm c. ability to uniformly and appropriately compress the neck d. the location of the pseudoaneurysm ans- a 40. What is important to do during the pseudoaneursym treatment procedure to determine whether the compressions are working? a. to firmly compress the transducer against the skin b. closing off the neck of the aneurysm for ten minutes c. to observe the duplex or color flow image d. to observe the native vessels and aneurysm ans- c 41. Which system is needed to be observed as it is an important component of overall pseudoaneursym treatment to make certain patency is maintained during the compression maneuver? a. vascular system b. deep venous system c. arterial system d. carotid system ans- b 42. Thrombonin injection is a promising alternative to manual compression techniques in most cases. Which of the followings is not a adverse effect of thrombin to patient? a. allergic to drugs b. clotting mechanism c. anaohylaxis d. microemobolization of pulverized particles ans- d 43. What other option you should chose if the pseudoaneurysm is too large to be repaired by manual compression of the neck a. thrombonin injection b. medical therapy c. surgical treatment d. do nothing ans- c

Ch 18 1. The internal carotid artery originates from common carotid artery and then travels in to the base of the skull. What is the name of the first major branch of internal carotid artery? a. anterior cerebral artery b. anterior choroidal artery c. ophthalmic artery d. posterior communicating artery ans- c 2. Which arteries are given off before the internal carotid artery finally divides into the middle cerebral artery and anterior cerebral artery? a. ophthalmic artery and anterior choroidal artery b. anterior choroidal artery and posterior communicating artery c. ophthalmic artery and posterior auricular artery d. anterior choroidal artery and occipital artery ans- b 3. Which of the following distributes blood to the anterior brain, the eyes, the forehead and the nose? a. the common carotid artery b. the internal carotid artery c. anterior cerebral artery d. the external carotid artery ans- b 4. The external carotid artery originates from common carotid artery and gives off eight branches. Which of the following is the branch of external artery? a. anterior choroidal artery b. ophthalmic artery c. anterior cerebral artery d. posterior auricular artery ans- d 5. Which of the following supplies blood to the neck, face and scalp all of which are high-resistance vascular beds? a. the internal carotid artery b. the common carotid artery c. the external carotid artery d. ascending pharyngeal artery ans- c 6. The external carotid artery originates from common carotid artery and gives off eight branches. What is the name of the first major branch of external carotid artery?

a. superior thyroid artery b. facial artery c. ophthalmic artery d. ascending pharyngeal artery ans- a 7. The right and left vertebral arteries are asymmetrical in size with right usually smaller than left. From where do they originate? a. the common carotid artery b. the subclavian artery c. aortic arch d. brachiocephalic artery ans- b 8. What is formed by the union of the right and left vertebral arteries after they enter the skull through the foramen magnum? a. posterior cerebral arteries b. posterior communicating artery c. the basilar artery d. the circle of Willis ans- c 9. Which of the following provides an important collateral pathway that maintains blood flow to the brain in cases of stenosis or occlusion? a. posterior cerebral arteries b. the circle of Willis c. posterior communicating artery d. the basilar artery ans- b 10. Which of the following vessels is not included as the major branch of the ophthalmic artery? a. the frontal artery b. the supraorbital artery c. the nasal artery d. superior thyroid artery ans- c 11. The supraorbital artery arises from the ophthalmic artery and travels interiorly and superiorly to the globe. Through branches of which artery the supraorbital artery joins the external artery? a. facial artery b. superficial temporary artery c. superior thyroid artery

d. maxillary artery ans- b 12. Which of the followings is appropriate intracranial-extracranial anastomosis for the internal carotid artery and the external carotid artery connections? a. the occipital arteries and the atlantic arteries b. the deep cervical and ascending cervical branches c. anterior cerebral artery and superior thyroid artery d. ophthalmic and orbital arteries ans- d 13. Which of the following branches of the cerebral arteries are connected by leptomeningeal collaterals from the meningeal border-zone network? a. chorodial branches b. occipital cortical branches c. terminal cortical branches d. central branches ans- c 14. Poiseuilles law describes flow through a rigid tube as being parabolic or laminar. Which of the following is the equation of Poiseuilles law? a. Q=(P)r4/8L b. Q=(P)r/L c. P=(Q)r4/8L d. P=(Q)r/L ans- a 15. Poiseuilles law describes flow through a rigid tube as being parabolic or laminar. To what the quantity of flow is inversely proportional to in Poiseuilles law? a. pressure gradient across a arterial system b. measurement of radius c. the size of the vessel d. viscosity of the fluid ans- d 16. Poiseuilles law describes flow through a rigid tube as being parabolic or laminar. To what the quantity of flow is directly proportional to in Poiseuilles law? a. viscosity of the fluid b. pressure gradient across a arterial system c. length of the vessel d. viscosity of the blood ans- b 17. The blood must change direction as the flow stream narrows at the stenosis and enlarges as it exits the stenosis. Velocity increase through a stenosis sincea. velocity and area are directly proportional

b. velocity and radius are directly proportional c. velocity and area are inversely proportional d. velocity and radius are inversely proportional ans- c

Ch 19 1. Which of the following is a fleeting neurologic dysfunction without lasting effects and its symptoms usually lasts for a few minutes to a few hours but never more than 24 hours? a. cerebrovascular accident b. reversible ischemic neurologic deficit c. transient ischemic attack d. vertebrobasilar insufficiency ans- c 2. Which of the following symptoms occur in patients when they are suffering from vertebrobasilar insufficiency? a. motor dysfunction of an arm b. paresthesia c. speech impairment d. monovascular visual disturbances ans- b 3. Which one of the following produces a permanent neurological deficit? a. TIA b. VBI c. CVA d. RIND ans- c 4. Which one may be a causative factor in the development of atherosclerosis or may enhance the development of the atherosclerotic process? a. smoking b. hyperlipidemia c. trauma d. Hypertension ans- d 5. The two most common mechanisms of cerebrovascular insufficiency are ischemia and hemorrhage. Due to what hemorrhage can occur? a. stenosis b. ruptured aneurysm c. thromboembolic event d. embolism ans- b 6. The two most common mechanisms of cerebrovascular insufficiency are ischemia and hemorrhage. Which one is not a leading cause of ischemia? a. atherothromboembotic pathologies b. lacunar strokes

c. ruptured aneurysm d. cardiogenic pathology ans- c 7. Which one of the following is a thin layer of lipid material on the intimal layer of the artery? a. a fibrous plaque b. a fatty streak c. a complicated lesion d. an ulcerative lesion ans- b 8. Which one is an accumulation of lipids that is covered by more lipid material, collagen and elastic fiber deposits? a. a fibrous plaque b. a fatty streak c. a complicated lesion d. an ulcerative lesion ans- a 9. A fibrous plaque is an accumulation of lipids, which fibrous plaque contains fibrous tissue, more collagen, calcium and cellular debris? a. an ulcerative lesion b. embolism c. a fatty streak d. a complicated lesion ans- d 10. What is the name of the fibrous plaque that is characterized by the deterioration of the normally smooth surface of the fibrous cap? a. a complicated lesion b a fatty streak. c. an ulcerative lesion d. embolism ans- c 11. What is a piece of thrombus that moves through the circulatory system until it lodges in a distant blood vessel, resulting in complete or partial obstruction of the vessel? a. aneurysm b. embolism c. thrombosis d. a fibrous plaque ans- b

12. The aggregation of blood factors is compressed primarily of platelets trapped within a network of fibrin. What is the name of this aggregation which is one of the most common causes of stroke? a. embolism b. aneurysm c. thrombosis d. atherosclerosis ans- c 13. Which of the following is an abnormal, localized dilation of a blood vessel due to congenital defects or weakness of the vessel wall and may be caused by trauma or infection? a. aneurysm b. thrombosis c. atherosclerosis d. embolism ans- a 14. Arteritis is an inflammation of an artery. Takayasus arteritis a chronic inflammation that results in narrowing of the arteries. What are involved by typeII lesion? a. pulmonary vessels b. thoracic and abdominal aorta c. aortic arch and its branches d. superficial temporal arteries and its branches ans- b 15. What may be caused by the inflammation of the distal superficial temporal artery and its branches known as temporal arteritis? a. trauma b. infection c.severe headache d. atherosclerosis ans- c 16. What s function as a chemoreceptor sensitive to changes in the oxygen tension of the blood and signals necessary changes in respiratory activities? a. thrombosis b. carotid body tumor c. fibromuscular dysplasia d. aneurysm ans- b 17. Tumors are highly vascular structures that develop between the internal and external carotid arteries. What usually feds them?

a. the common carotid artery b. the aortic arch c. the internal carotid artery d. the external carotid artery ans- d 18. What is most commonly caused by trauma that results in a sudden tear in the intimal wall and creates a false lumen? a. carotid body tumor b. fibromuscular dysplasia c. dissection d. neointimal hyperplasia ans- c 19. Fibromuscular dysplasia most commonly caused by dysplasia of the media along with over growth of collagen. Where does dysplasia occur? a. origin of the vessels b. mid to distal segment of vessel c. vessel wall d. proximal to distal segment of vessel ans-b 20. What is a response to vascular injury, which may be result of vascular reconstruction such as carotid ebdarterectomy? a. dissection b. fibromuscular dysplasia c. carotid body tumor d. neointimal hyperplasia ans- d 21. Traumatic damage to vessels and surrounding tissue can produce variety of conditions. Which of the following is not caused due to traumatic damage? a. fibromuscular dysplasia b. occlusion c. dissection d. pseudoaneurysm ans- a 22. Normally anterior vessels internal carotid, anterior cerebral, middle cerebral and anterior communicating arteries- supply blood to the brains cerebral hemispheres. Neurological deficits may be attributing to problems with anterior circulation. Which of the following can be included as problems of anterior circulation? a. diplopia b. bilateral paresthesia

c. dysphasia d. vertigo ans- c 23. What cause behavioral abnormalities which frequently accompany ischemia of the temporal lobe? a. the ipsilateral carotid artery b. infraction of the right middle cerebral artery c. a lesion in the left middle cerebral artery d. an stroke affecting cerebral cortex ans- b 24. Which of the following cause dysphasia (impaired speech) and aphasia (inability to speak) in a right handed person? a. a lesion in the left middle cerebral artery b. infraction of the right middle cerebral artery c. an stroke affecting cerebral cortex d. a lesion in the right middle cerebral artery ans- a 25. Normally posterior vessels- vertebral, basilar, posterior cerebral and posterior communicating arteries supply blood to the brain stem, cerebellum, and occipital lobe of brain. Symptoms of brain ischemia may be attributable to the problems of the posterior circulation. Which of the following can be included as problems of posterior circulation? a. dysphasia b. unilateral paresthesia c. bilateral anesthesia d. amaurosis fugax ans- c 26. Which of the following is a frequently seen sign and symptoms of affected artery named vertebrobasilar artery? a. dysphasia b. dysphagia c. paralysis d. dyslexia ans- b 27. Which of the following are a frequently seen sign and symptoms of affected artery named anterior cerebral artery? a. confusional state b. ipsilateral amaurosis fugax c. poor coordination

d. impaired motor and sensory function ans- d 28. Which of the following are not a frequently seen sign and symptoms of affected artery named middle cerebral artery? a. behavioral changes b. dyslexia c. agitated delirium d. dysarthria ans- b

Ch 20 1. Which examination can detect hemodynamically significant lesion of the internal carotid artery by evaluating the flow to some of its terminal branches around the eye? a. laser Doppler b. periorbital Doppler c. Doppler segmental pressure d. Doppler shift ans- b 2. What is the frequency of Doppler that is used by an examiner to locate the frontal artery at the inner canthus of the eye? a. 9-10 MHz b. 8-10 Hz c. 8-10 MHz d. 9-10 Hz ans- c 3. A series of compression maneuvers are performed to detect the presence of abnormal collateral channels that suggests disease. In which of the following artery these compression maneuvers are not performed both ipsilaterally and contralaterally? a. superficial carotid artery b. thoracic artery c. facial artery d. infraorbital artery ans- b 4. In which of the following situation it can be interpreted that it is normal in case of periorbital Doppler examination? a. compression of the facial, superficial temporal and infraorbital arteries should not diminish b. ipsilateral compression of common carotid artery should diminish in the frontal artery c. antegrate flow should be evident in the frontal artery d. diminish or reverse flow during compression of facial, superficial temporal and infraorbital arteries ans- d

Ch 21 1. Which of the following detects hemodynamically significant lesions of the internal carotid artery by evaluating flow in one of its terminal branches? a. periorbital Doppler examination b. plethysmography c. oculopneumoplethysmography d. magnetic resonance imaging and angiography ans- c 2. Which technology cannot differentiate occlusion from a tight stenosis and also incapable of determining the ocular systolic pressure in patient with severe headache? a. periorbital Doppler examination b. oculopneumoplethysmography c. duplex scanning d. plethysmography ans- b 3. Which of the following technique is a technique that records changes in volume and the fluctuations in volume are related to changes in blood flow during systole or diastole such as when arterial inflow exceeds venous outflow? a. intravenous digital technology b. angioplasty c. oculopneumoplethysmography d. plethysmography ans- d 4. A through patient history must be obtained to rule out the contradictions to perform plethysmography test. Which of the followings is not considered as contradiction to perform this test? a. a past spontaneous renal detachment b. allergies to local anesthesia c. conjunctivitis d. unstable glaucoma ans- c 5. What measurement of vacuum maybe required to occlude inflow in a patient with systemic systolic pressure of <140 mmHg? a. 300 mmHg b. 500 mmHg c. 600 mmHg d. 200 mmHg ans- a

6. What is the maximum vacuum requirement to occlude inflow in a patient with systemic systolic pressure of >140 mmHg? a. 300 mmHg b. 500 mmHg c. 600 mmHg d. 200 mmHg ans- b 7. When a maximum vacuum of 500 mmHg is usually required to occlude inflow in a patient during plethysmography test? a. systemic systolic pressure of <140 mmHg b. systemic systolic pressure of 140 mmHg c. systemic systolic pressure of >140 mmHg d. systemic systolic pressure of 140 mmHg ans- c 8. The examiner must never compress both common carotid arteries simultaneously. Why the compression is never performed in the area of the carotid sinus? a. increase blood pressure b. loss of pulses c. alter heart rate d. occlusion of vessels ans- c 9. The first phase consists of 3-5 second compression while the OPG maintains an intraocular pressure. What is the measurement of intraocular pressure that is maintained by OPG? a. 300 mmHg b. 60 mmHg c. 500mmHg d. 110 mmHg ans- b 10. The second phase is only performed if pulsations are noted during the first phase consists of 15 seconds compression while the OPG decreases intraocular pressure. What is the measurement of intraocular pressure that is decreased by OPG? a. 300 mmHg b. 60 mmHg c. 500mmHg d. 110 mmHg ans- d

11. In what measurement ophthalmic systolic pressure should not differ to interpret normal in case of oculopneumoplethysmography (OPG)? a. 5 mmHg b. <5 mmHg c. 5 mmHg d. >5 mmHg ans- a 12. A normal ratio of ophthalmic systemic pressure should exit during oculopneumoplethysmography (OPG). Which one is correct for normal ratio of ophthalmic systemic pressure? a. OSP 39 brachial systolic pressure (BSP 0.429 b. OSP 39 brachial systolic pressure (BSP) 0.429 c. OSP 39 brachial systolic pressure (BSP) 0.430 d. OSP 39 brachial systolic pressure (BSP 0.430 ans- c 13. If the OSP are greater than 140 mmHg, the examiner measures the amplitude of the first pulse. What should be the difference in amplitude of the tracings? a. >2 mm b. <2 mm c. 10 mm d. <10 mm ans- b 14. OSP differ by 5 mmHg have an abnormal ratio of ophthalmic to systemic pressure. Which of the following is correct form of an abnormal ratio of ophthalmic to systemic pressure? a. OSP 39 brachial systolic pressure (BSP 0.430 b. OSP 39 brachial systolic pressure (BSP) 0.429 c. . OSP 39 brachial systolic pressure (BSP) 0.430 d. OSP 39 brachial systolic pressure (BSP 0.429 ans- d 15. If the OSPs exceed 140 mmHg, the examiner measures the amplitude of the first pulse. What is the difference of amplitude that considered as abnormal? a. 2 mm b. 2mm c. >2 mm d. <2 mm ans- c

Ch 22 1. What is an accurate means of localizing the presence of arterial disease in the extracranial carotid arteries and can differentiate an occlusion from a tight stenosis? a. oculopneumoplethysmography b. MR angiography c. computed tomology d. Duplex scanning ans- d 2. Which of the following factors do not affect adversely to perform duplex ultrasonography? a. patient movement b. the size of the contour in the neck c. stress d. the presence of dressing ans- c 3. Which of the following is responsible for both overestimating and underestimating disease by duplex ultrasonography? a. artifact is mistaken as plaque b. an inappropriate Doppler angle c. a high bifurcation precludes through evaluation of the internal carotid artery d. hyperemia ans- b 4. What combines physiologic information based on Doppler-shifted frequencies with the anatomic in formation of real time, high resolution, B-mode ultrasonographic imaging? a. color flow imaging b. continuous wave Doppler c. duplex ultrasound d. color Doppler ans- c 5. Which of the following technology has limited use in carotid evaluation and may be the only means available to accurately display very high velocities such as severely elevated peak systolic velocities in some cases? a. continuous wave Doppler b. duplex ultrasound c. pulsed Doppler ultrasound d. color Doppler ans- a

6. Reproducible and consistent velocity measurements require an angle. What is the value of this required angle? a. zero (0) degrees b.60 degrees c. 45-60 degrees d. 0- 60 degrees ans- c 7. What is a method of displaying the variety of frequencies of the flowing blood during systole and diastole? a. color Doppler b. continuous wave Doppler c. spectral analysis d. color flow imaging ans- c 8. Color flow Doppler information is displayed on the image after it is evaluated for its frequency content and its face. What frequency content is determined? a. intensity of the signals b. the hue or shade of the color c. error production d. direction toward and away from the transducer ans- b 9. Which of the following transducer is not used for performing duplex scanning in a patient? a. 7 MHz transducer b. 10 MHz transducer c. 7.5 MHz transducer d. 5 MHz transducer ans- a 10. The sample volume of the pulsed Doppler is usually kept as small as possible. What is the sample volume of the pulsed Doppler? a. 0.5-1 mm b. 1-1.5 mm c. 0.5-1 cm d. 1-1.5 cm ans- b 11. Reproducible and consistent velocity measurements require an angle. Which of the following angle of insonation provides the greatest Doppler shift but not used in clinical application? a. zero (0) degrees b.60 degrees

c. 45-60 degrees d. 0- 60 degrees ans- a 12. In which of the following situation it can be interpretated that B-mode is normal in case of duplex scanning technology? a. low-mid level echoes of similar appearance b. thrombosis c. A solid color should be evident in the vessel walls d. calcification ans- c 13. What is the name of the low- medium-level echoes (heterogeneous) indicating soft and dense areas? a. fibrous plaque b. complex plaque c. fatty streaks d. calcification ans- b 14. Which of the following is characterized as very bright and highly reflective echoes? a. fibrous plaque b. complex plaque c. fatty streaks d. calcification ans- d 15. In spectral analysis, the band evident along the top of the waveform during systole may fill in the spectral window. This vertical thickening is considered spectral broadening and is consistent with a. percentage stenosis b. multiple frequencies c. velocities d. phases ans- b 16. An occlusion of which artery is usually consistent with the loss of a diastolic component in the ipsilateral common carotid artery? a. the internal carotid artery b. posterior auricular artery c. the external carotid artery d. anterior cerebral artery ans- a

17. What is the diameter of stenosis if peak systolic frequency is <4khz and peak systolic velocity is <125 cm/sec? a. 16-49% b. 1-15% c. 50-79% d. 80-99% ans- b 18. What is the diameter of stenosis if peak systolic frequency is >4 kHz, peak systolic velocity is >125 cm/sec, end diastolic velocity is <140, and end diastolic frequency is <4 kHz? a. 16-49% b. 1-15% c. 50-79% d. 80-99% ans- c 19. What is the diameter of stenosis if peak systolic frequency is >4 kHz, peak systolic velocity is >125 cm/sec, end diastolic velocity is >140, and end diastolic frequency is >4 kHz? a. 80-99% b. 16-49% b. 1-15% c. 50-79% ans- a 20. What is the diameter of stenosis if peak systolic frequency, peak systolic velocity, end diastolic velocity and end diastolic frequency are absent? a. occluded b. 1-15% c. normal d. 80-99% ans- a 21. Two important clinical trials evaluating the efficiency of carotid endarterectomy established therapeutic benefit for asymptomatic patients and for symptomatic patient. Which of the following is the Asymptomatic Carotid Atherosclerosis Study, ACAS)? a. PSV of 290 cm/sec and EDV of 80 cm/sec is consistent with 60% diameter reduction to external carotid artery b. ICA PSV/CCA PSV ratio 4 is consistent with 60% diameter reduction to external carotid artery c. PSV of 290 cm/sec and EDV of 80 cm/sec is consistent with 60% diameter reduction to internal carotid artery

d. ICA PSV/CCA PSV ratio 4 is consistent with 60% diameter reduction to internal carotid artery ans- c 22. Two important clinical trials evaluating the efficiency of carotid endarterectomy established therapeutic benefit for asymptomatic patients and for symptomatic patient. Which of the following is the North American Symptomatic Carotid Endarterectomy Trial (NASCET)? a. PSV of 290 cm/sec and EDV of 80 cm/sec is consistent with 60% diameter reduction to internal carotid artery b. ICA PSV/CCA PSV ratio 4 is consistent with 60% diameter reduction to external carotid artery c. PSV of 290 cm/sec and EDV of 80 cm/sec is consistent with 60% diameter reduction to external carotid artery d. ICA PSV/CCA PSV ratio 4 is consistent with 60% diameter reduction to internal carotid artery ans- d 23. The key to successful physician interpretation of carotid duplex exams is the use of consistent protocols and application of validated diagnostic criteria. For what percentage of stenosis Doppler is not accurate for subcategorizing? a. >50% b. 50% c. <50% d. 50% ans- c 24. What is the percentage of diameter reduction if , peak systolic velocity is <125, end diastolic velocity is <40 and ICA/CCA ratio <2? a. <50% b. 50-69% c. 10% d. 70-99% ans- a 25. What is the percentage of diameter reduction if , peak systolic velocity is >230, end diastolic velocity is >100 and ICA/CCA ratio >4? a. >10% b. 70-99%. c. <50% d. 50-69% ans- b 26. What is the percentage of diameter reduction if , peak systolic velocity is 125230, end diastolic velocity is 40-100 and ICA/CCA ratio 2-4?

a.10-50% b. 70-99%. c. <50% d. 50-69% ans- d

Ch 23 1. What is capable of detecting intracranial stenoses and occlusions and can evaluate the onset, severity and time course of vasoconstriction caused by subarachnoid hemorrhage? a. periorbital Doppler b. transcarnial Doppler c. laser Doppler d. power Doppler ans- b 2. What is the frequency of the Doppler that is used in transcarnial Doppler system with spectrum analyzer? a. 4 MHz b. 7.5 MHz c. 5 MHz d. 2 MHz ans- d 3. What is the value of assumed angle of insonation that is used in transcarnial Doppler system? a. zero (0) degrees b. 60 degrees c. 45-60 degrees d. 0-60 degrees ans- a 4. What is used to evaluate the status of the carotid arteries before common carotid artery compression or oscillation maneuvers are performed? a. ultrasound waveforms b. duplex ultrasonography c. MR angiography d. computed tomology ans- b 5. What is the name of the accurate vessel if the depth of sample is 55-65, direction of the blood flow is bidirectional and velocity of the blood flow is 55+/-12 cm/sec? a. posterior cerebral artery b. anterior cerebral artery c. terminal internal carotid artery d. middle cerebral artery ans- c 6. What is the name of the accurate vessel if the depth of sample is 60-70, direction of the blood flow is antegrade and velocity of the blood flow is 39+/-10 cm/sec? a. anterior cerebral artery

b. posterior cerebral artery c. terminal internal carotid artery d. ophthalmic artery ans- b 7. What is the name of the accurate vessel if the depth of sample is 60-90, direction of the blood flow is retrograde and velocity of the blood flow is 38+/-1o cm/sec at right and left of midline? a. ophthalmic artery b. internal carotid artery c. vertebral artery d. basilar artery ans- c 8. Which of the following is the accurate vessel if the depth of sample is 60-80, direction of the blood flow is parasellar and velocity of the blood flow is 47+/-14 cm/sec and its angle varies? a. ophthalmic artery b. internal carotid artery c. vertebral artery d. basilar artery ans- c 9. What is the name of the accurate vessel if the depth of sample is 40-60, direction of the blood flow is antegrade and velocity of the blood flow is 21+/-5 cm/sec? a. ophthalmic artery b. middle cerebral artery c. posterior cerebral artery d. vertebral artery ans- a 10. Which of the following is the accurate vessel if the depth of sample is 60-80, direction of the blood flow is retrograde and velocity of the blood flow is 55+/-11 cm/sec and the approach is transforamenal? a. basilar artery b. anterior cerebral artery c. middle cerebral artery d. vertebral artery ans- b 11. What occurs when there is antegrade flow in the ipsilateral ophthalmic artery and can be attributed to flow from the contralateral interior cerebral artery via the anterior communicating artery? a. external to internal collateralization b. internal to external collateralization

c. crossover collateralization d. posterior to anterior collateralization ans- c 12. Posterior to anterior collateralization is evident when flow velocities in the ipsilateral posterior cerebral artery exceeds those of the ipsilateral middle cerebral artery by a. >150 b. >125 c. <125 d. <150 ans- b 13. The diagnosis of vasospasm is most accurate in the middle cerebral artery. Serial recordings of middle cerebral arterial flow pattern are necessary to document the increase in velocities associated with a vasospasm. What are the values of normal velocities? a. <150 b. >125 c. <120 d. <125 ans- c

Ch 24 1. Normally in case of subclavian steal condition brachial blood pressure is greater from one side to other. What is the measurement of brachial blood pressure difference? a. 10-15 mmHg b. 15-20 mmHg c. 25-30 mmHg d. 20-25 mmHg ans- b 2. Which of the following of surgical treatment is used to treat the subclavian steal condition? a. stent graft b. sympathectomy c. endaterectomy d. steroid therapy ans- c 3. Temporal arteritis is the inflammation of distal segment of the superficial temporal artery. What is the appropriate treatment for temporal arteritis? a. stent graft b. bypass graft c. endaterectomy d. steroid therapy ans- d

Ch 25 1. Which of the following uses real-time digital video processing to detect small amounts of the contrast medium that has been injected to artery? a. A rapid film changer technique b. digital subtraction angiography c. magnetic resonance angiography d. computed tomography ans- b 2. Which of the following equation is used in percentage stenosis calculationdiameter reduction? a. [1-(d2/D2)]100 b. (d/D)100 c. [1-(d/D)]100 d. [1-( D2/ d)]100 ans- c 3. Which of the following equation is correct to determine percentage stenosis calculation- area reduction? a. [1-( D2/ d)]100 b. [1-(d/D)]100 c. (d/D)100 d. [1-(d2/D2)]100 ans- d 4. In cases of symmetrical lesions, what is considered to be homodynamically significant? a. 75% area reduction=50% diameter reduction b. 75% diameter reduction=50% area reduction c. 50% area reduction=75% diameter reduction d. 25% diameter reduction=50% area reduction ans- a 5. Suppose there is a symmetrical lesion where D= 6 mm and d= 2 mm. what is percentage of diameter reduction? a. 89 b. 71 c. 67 d. 45 ans- c 6. Suppose there is a symmetrical lesion where D= 6 mm and d= 2 mm. determine the area reduction. a. 67 b. 89

c. 92 d. 83 ans- b 7. Which of the following technology provides high quality images of blood flow without x-ray and required the use of contrast agent? a. magnetic resonance imaging b. duplex ultrasonography c. magnetic resonance angiography d. color flow imaging ans- c 8. Which of the following used to evaluate the presence and absence of cerebral infarctions, tumors, masses, or anatomic variation? a. computed tomography angiography b. magnetic resonance angiography c. digital subtraction angiography d. computed tomography ans- d 9. Which of the following is the pharmacologic treatment for occlusive disease which decreases platelet aggregation? a. stent b. aspirin c. the cessation of smoking d. bypass graft ans- b 10. Which of the following is the appropriate surgical treatment for a patient who is suffering from stenosis? a. endaterectomy b. bypass graft c. sympathectomy d. angioplasty ans- a

Chap26 1. For the lower extremity veins,the paired proneal veins empty the lateral region of the leg and carry blood cephalad into the tibioperoneal trunk.The paired deep veins of the calf follow the arteriees and what are they called? a. pulmonary veins b. superior veins c. jugular veins d. corresponding veins ans-d 2. The paired anterior tibial veins empty the front of the leg.From which of the following veins the anterior tibial and tibioperoneal trunk veins join just below the knee? a. coronary vein b. renal vein c. popliteal vein d. radial vein ans-c 3. Large mascular veins empty the soleal muscles into the posterior tibial and peroneal veins and the gastrocnemius muscle into thea. coronary vein b. renal vein c. popliteal vein d. radial vein ans-c 4. The popliteal vein becomes the femoral vein at the adductor canal or Hunters canal.What vein is formed by the confluence of the femoral vein and deep femoral /profunda femoris vein? a. common femoral vein b. radial vein c. ulnar vein d. brachial vein ans-a 5. For the lower extremity veins,what becomes the external iliac vein just above the inguinal ligament? a. common femoral vein b. radial vein c. ulnar vein d. brachial vein ans-a 6. For the lower extremity veins,at what level of the lumbar vertebra the confluence of the common iliac veins form the inferior vena cava and continues to the right atrium of the heart? a. 3rd b. 4td c. 5th d. 6thd ans-c 7. Which vein is the longest vein in the body originating on the dorsum of the foot and traveling medially to the saphenofemoral junction in the groin just below the inguinal ligament?

a. popliteal vein b. saphenous vein c. ulnar vein d. jugular vein ans-b 8. In case of the lower extremity veins, which of the following veins forms communication between the superficial and deep systems? a. coronary veins b. mesenteric veins c. perforating veins d. jugular veins ans-c 9. In case of perforating veins how many valve(s) is/are there in each perforating veins? a. one b. two c. three d. four ans-a 10. In case of perforating veins, how many important perforators do the posterior tibial veins have near the medial malleolus? a. one b. two c. three d. four ans-b 11. In case of perforating veins, the posterior communicating branch of the great saphenous vein in the medial lower calf is connected to a a. first preforator b. second preforator c. third preforator d. fourth preforator ans-c 12. Which of the following vein represents a superficial connection of the three ankle perforating veins-an anatomic fact of the major importance in the development of a venous stasis ulcer? a. splenic vein b. axillary vein c. hepatic vein d. posterior arch vein ans-d 13. In the brain,venous sinuses are spaces between the dura mater and periosteum that receive venous rerturn.Where do they eventually terminate? a. internal jugular veins b. renal veins c. mesenteric veins d. hepatic veins ans-a 14. In thee lower extremities,the venous sinuses are dialeted channels located in the calf muscles that allow venous blood to accumulate and then to drain into the peroneal veins anda. common iliac vein

b. pulmonary veins c. subclavian veins d. posterior tibial veins ans-d 15. For the upper extremity veins,the paired radial veins travel along the lateral aspect of the forearm.The paired deep veins of the arm and forearm collow the arteries and what are they called? a. pulmonary veins b. superior veins c. jugular veins d. corresponding veins ans-d 16. In case of upper extremity veins,which of the following veins travel along the medical aspect of the forearm? a. paired ulner veins b. popliteal veins c. femoral veins d. hepatic veins ans-a 17. In case of upper extremity veins,which of the following veins become the axillary vein usually near the armpit or axilla? a. common femoral vein b. radial vein c. ulnar vein d. brachial vein ans-d 18. In case of upper extremity veins,which of the following veins become subclavian vein when it is joined by the cephalic vein usually near the lateral boeder of the first rib? a. splenic vein b. axillary vein c. hepatic vein d. posterior arch vein ans-b 19. In case of upper extremity veins,which of the following vein joins the internal jugular to form the brachiocephalic or innominate vein? a. common iliac vein b. pulmonary vein c. subclavian vein d. posterior tibial vein ans-c 20. For the superficial veins,which of the following vein is formed by the digital veins on the lateral aspect of the forearm and arm with the basilic vein on the medial aspect? a. splenic vein b. axillary vein c. hepatic vein d. cephalic vein ans-d 21. In case of the superficial veins,the cephalic vein travels literally up athe arm and at its confluence with the axillary vein, becomes thea. common iliac vein b. pulmonary vein

c. subclavian vein d. posterior tibial vein ans-c 22. In case of the superficial veins,the basilic vein ascends medially up the arm,becoming the axillary vein where it joins thea. common femoral vein b. radial vein c. ulnar vein d. brachial vein ans-d 23. For the abdominal veins,the portal system drains blood from the abdominal part of the digestive tract, i.e., the pancreas,spleen,gall bladder and mesentery and carries it into thea. femoral vein b. iliac vein c. jugular vein d. portal vein ans-d 24. For the structural and functional anatomy of veins, which of the following is the inner, single layer of endothelial cells? a. tunica adventitia b. tunica media c. tunica intima d. tunica albuginea ans-c 25. For the structural and functional anatomy of veins, which of the following is the middle,thicker layer of smooth muscles and collagenous fiber? a. tunica adventitia b. tunica media c. tunica intima d. tunica albuginea ans-b 26. For the structural and functional anatomy of veins, which of the following is the outer, thin, fibrous layer surrounding elastic tissue? a. tunica adventitia b. tunica media c. tunica intima d. tunica albuginea ans-a 27. For the structural and functional anatomy of veins, how many valves are there in the great saphenous vein? a. approximately 8 b. approximately 10 c. approximately 12 d. approximately 14 ans-c 28. For the structural and functional anatomy of veins, how many valves are there in the small saphenous vein? a. 2-12 b. 2-8 c. 4-10

d. 6-12 ans-d 29. For the structural and functional anatomy of veins, how many valve(s) is/are there in each perforators ? a. 1 b. 2 c. 3 d. 4 ans-a 30. For the structural and functional anatomy of veins, how many valves are there in each infrapopliteal (deep) veins? a. 2-12 b. 2-8 c. 4-10 d. 7-12 ans-d 31. For the structural and functional anatomy of veins, how many valves are there in each popliteal and femoral veins? a. 1-3 b. 2-4 c. 3-5 d. 4-6 ans-a 32. For the structural and functional anatomy of veins,what is the percentage of containing valves of external iliac vein? a. 20% b. 15% c. 12% d. 10% ans-c 33. For the structural and functional anatomy of veins, how many valve(s) is/are there in common femoral vein? a. 1 b. 2 c. 3 d. variable ans-a 34. For the structural and functional anatomy of veins, how many valve(s) is/are there in internal jugular vein? a. 4 b. 3 c. 2 d. 1 ans-d 35. For the structural and functional anatomy of veins, how many valve(s) is/are there in axillary vein? a. four b. three c. two d. one ans-d

36. For the structural and functional anatomy of veins, how many valve(s) is/are there in cephalic vein? a. 7-12 b. 1-3 c. variable d. 1 ans-c 37. For the structural and functional anatomy of veins, how many valve(s) is/are there in basilic vein? a. 1 b. variable c. 6-12 d. 1-3 ans-b 38. In case of the structural and functional anatomy of veins,Which of the following is the vein with valves? a. soleal sinuses b. innominate veins c. axillary veins d. subclavian veins ans-c 39. In case of the structural and functional anatomy of veins,Which of the following is the vein without valves? a. cephalic vein b. superior vena cava c. internal jugular vein d. saphenous vein ans-b

Chap27 1. Because the veins are seldom completely full of blood as well as the arteries are,their flattened shape offers a great deal of flow resistance.On the other hand,because the fully distended cross-sectional area of a vein is abouta. two to three times b. three to four times c. four to five times d. two to five times ans-b 2. Hydrostatic pressure is equivalent to the weight of a column of blood extending from the heart to the level where the pressure is being measured.What is the formula? a. HP=pgh b. HP=pg/h c. HP=p/gh d. HP=h/pg ans-a 3. Hydrostatic pressure is equivalent to the weight of a column of blood extending from the heart to the level where the pressure is being measured.Which one of the following is the hydrostatic pressure in the supine individual? a. 0 mmHg b. 25 mmHg c. 50 mmHg d. 100 mmHg ans-a 4. Hydrostatic pressure is equivalent to the weight of a column of blood extending from the heart to the level where the pressure is being measured.Which one of the following is the hydrostatic pressure when the individual stands? a. 0 mmHg b. 25 mmHg c. 50 mmHg d. 100 mmHg ans-d 5. In case of pressure/volume relationships, by which of the following pressure, the shape of the veins is determined? a. intraluminal pressure b. interstitial pressure c. transmural pressure d. hydrostatic pressure ans-c 6. For the effects of muscles pump mechanism,the contraction of leg muscles squeezes the veins and propels the blood toward the heart.If the venous valves are competentthe blood will travel in only one direction.What happens to the normal pattern of blood flow? a. decreases venous pressure, pooling and venous return b. decreases venous pressure and pooling and increases venous return c. increases venous pressure and pooling and decreases venous return d. increases venous pressure pooling and venous return ans-b 7. Which of the following is not the symptom during the valsalva maneuver? a. intrahoracic pressure increases

b. intraabdominal pressure increases c. all venous return is halted d. increase in volume of bloodreturning to heart ans-d

Chap28 1. In the past,the clinical diagnosis of acute deep venous thrombosis(DVT) based on the patients medical history and physical exam was considered notoriously unreliable.Which of the following is not the most common findings? a. Swelling b. pressure c. pain d. redness of erythema ans-b 2. Differential diagnosis in patients with a clinically suspected with deep venous thrombosis includes the following except onea. heat failure b. complications of chronic venous insufficiency c. extrinsic compression d. swelling ans-d 3. Differential diagnosis in patients with a clinically suspected with deep venous thrombosis includes the following except onea. muscle strain b. heaviness c. direct injury to the leg d. muscle tear ans-b 4. Differential diagnosis in patients with a clinically suspected with deep venous thrombosis includes the following except onea. Bakers cyst b. cellulitis c. ulcerations d. lymphangitis ans-c 5. Which of the following may not have been possessed by patients with chronicvenous disease? a. varicosities b. swelling c. heaviness d. cellulitis ans-d 6. In case of risk factors and contributing diseases, the development of venous thrombosis is based on how many factors known as Virchows triad? a. two b. three c. four d. five ans-b 7. In case of risk factors and contributing diseases,which of the following is not the example of venous stasis? a. hypotension b. pregnancy c. obsity

d. cancer ans-d 8. In case of risk factors and contributing diseases,which of the following is not included in the examples of surgery? a. patient is immobile b. calf muscle pump activated c. mechanical ventilation may alter pressure gradients d. injury to endothelium ans-b 9. In case of risk factors and contributing diseases,which of the following is not included in the examples of hypercoagulability? a. pregnancy b. hormone replacement therapy c. paraplegia d. cancer ans-c 10. In case of the mechanisms of thrombosis, Paget-Schroetter syndrome, also known as stress or effort thrombosis, usually involves thrombosis of the subclavian ora. axillary vein b. brachial vein c. coronary vein d. pulmonary vein ans-a 11. In some cases, the artery causes enough compression to thicken the vein well as well as alter flow to the point of thrombosis.Which of the following vein by the right common iliac artery is the May-Thurner syndrome? a. left common iliac vein b. femoral vein c. splenic vein d. redial vein ans-a 12. In case of valvular incompetence, valves no longer maintain undirectional movement of the blood. What do the incompetence venous valves do from the following except one? a. allow blood to travel antegrade b. decreasing pressure c. creating venous hypertension d. allow blood to travel retrograde ans-b 13. In case of congenital disease, which of the following is not an example of congenital venous disease that patients may also have? a. avalvular vein(s) b. incompetent valves c. valve containing vein d. arteriovenous malformations ans-c 14. The elevated pressure in the portal vein is often the result of an obstruction of blood flow.Although it is related to some form of advanced chronic liver disease such as cirrhosis, it can also be caused by severe congestive heart failure or a proximal venous occlusion of, for examplea. jugular vein b. renal vein

c. hepatic vein d. femoral vein ans-c 15. Which of the following is not the characteristics of venous ulcer? a. brawny discoloration b. lipodermatosclerosis c. varicosities d. loss of hair ans-d 16. Which of the following is not the characteristics of arterial ulcer? a. shiny skin b. varicosities c. loss of hair d. thickened toenails ans-b 17. Edema is one of the most consistent signs of elevated peripheral venous pressure.It is a condition in which the body tissue containsa. less fluid b. excessive fluid c. normal fluid d. no fluid ans-b 18. Pitting edema is an accumulation of fluid in the subcutaneous tissue.When manual pressure is applied on the tissue, some fluid is dis placed.It may be secondary toa. fluid retention b. renal dysfunction c. an electrolyte balance d. congestive heart failure ans-c

Chap29 1. Impedence plethysmography (IPG) can detect thrombi in some veins. Which of the following is not one of them? a. popliteal vein b. axillary vein c. femoral vein d. iliac vein ans-b 2. Which of the following is not the limitation of Impedence plethysmography (IPG)? a. pregnancy b. pain or anxiety c. improper patient positioning d. detection of thrombi ans-d 3. Which of the following is not included in the positioning of patient of Impedence plethysmography (IPG)? a. should be supine in a bed b. hips and knees should be flexed c. legs internally rotated d. calves above the level of heart ans-c 4. In the peripheral vasculature, the changes are caused by changes in blood. Plethysmography is any technique that measures a. color changes b. temperature changes c. pressure changes d. volume changes ans-d 5. Ohms Law provides the basis of the Impedence plethysmography (IPG).Which of the following is not the exact relationship of voltage, current and resistance? a. I=V/R b. R=V/I c. V=RxI d. I=R/V ans-d 6. Ohms Law is very similar to the concept of Poiseulles equation, which describes the relationship among pressure, volume flow and resistance. Which of the following is not related to the Poiseulles equation? a. Q=P/R b. P=Q/R c. R=P/Q d. P=RxQ ans-b 7. DC coupling is an electrical voltage that is either positive or negative with current flowing in only one direction.AC coupling, on the other hand, is an electrical voltage that reverses its polarity in a second.How many times does it change? a. 40 times b. 50 times c. 60 times

d. 70 times ans-c 8. Used in arterial studies, AC coupling requires more intense changes to produce a measurable signal.In the Unoted States, what volts of AC current is delivered in standard household outlets? a. 100 volts b. 110 volts c. 120 volts d. 130 volts ans-c 9. Abnormal results following the initial run require that the test be repeated.Which of the following job is not required before the study can not be considered to be abnormal? a. patient position b. patient temperature c. adjustment to cuff placement d. subsequent repetitions ans-b 10. Outflow is the amount of venous emptying that occurs after deflation of the occluding thigh cuff.The tracing should fall to the baseline within which of the following time limit of thigh cuff deflation? a. 3 seconds b. 5 seconds c. 7 seconds d. 10 seconds ans-a

Chap30 1. Strain gauge plethysmography (SPG) is used to detect venous obstruction in the large veins above thea. foot b. ankle c. knee d. thigh ans-c 2. The extreme sensitivity of strain gauge plethysmography limits its usefulness in some clinical applications.Extrinsic compression can result from the following occurances except one. Which one is that? a. pregnancy b. loose clothing c. improper positioning d. tumors ans-b 3. Which of the following is not the limitations of the strain gauge plethysmography (SPG)? a. extreme sensitivity b. extrinsic compression c. COPD d. detection of venous obstruction ans-d 4. Which of the following is not included in the positioning of patient of Impedence plethysmography (IPG)? a. should be supine in a bed b. hips and knees should be flexed c. legs internally rotated d. calves above the level of heart ans-c 5. Strain gauge plethysmography utilizes a mercury-in-Silastic strain gauge that indirectly senses changes in blood volume by measuring the circumference of the limb.What kind of rubber tube is used here? a. platinum b. titanium c. silicon d. iron ans-c 6. Strain gauge plethysmography utilizes a mercury-in-Silastic strain gauge that indirectly senses changes in blood volume by measuring the circumference of the limb.What kind of electrode is used here? a. zinc b. copper c. iron d. carbon ans-b 7. In case of the technique of the Strain gauge plethysmography, a pneumatic cuff is placed around the thigh and a gauge is wrapped around the widest part of the cuff.What kind of gauge? a. iron-in-Silastic

b. zinc-in-Silastic c. copper-in-Silastic d. mercury-in-Silastic ans-d 8. In case of the technique of the Strain gauge plethysmography, a pneumatic cuff is placed around the thigh and mercury-in-Silastic gauge is wrapped around the widest part of the cuff.What should be the length of the unstretched gauge of the circumference of the limb? a. 75% b. 70% c. 80% d. 90% ans-d 9. As the volume increase stabilizes, the occluding cuff is quickly deflated.The rate at which the cuff empties is also recorded and is considered maximum venous outflow.How much time usually it takes? a. 15 seconds b. 30 seconds c. 45 seconds d. 60 seconds ans-c 10. Outflow is the amount of venous emptying that occurs after deflation of the occluding thigh cuff. The tracing should fall to the baseline within a time of thigh cuff deflation.What is the time? a. 2 seconds b. 3 seconds c. 5 seconds d. 7 seconds ans-b 11. As with impedance plethysmography, the absence or presence of venous obstruction is determined by where the outflow and capacitance values fall on the scoring grid.Where are the values plotted when they are within normal limits? a. above the discriminating line b. below the discriminating line c. along with the discriminating line d. just below the discriminating line ans-a

Chap31 1. Which of the following is not the limitations of the photoplethysmography (PPG)? a. improper placement of PPG sensor b. thickening of skin c. evaluation of venous insufficiency d. must be placed on intact skin ans-c 2. The photoplethysmography photocell which consists of a light emitting diode and a photosensor , transmits light into the a. epithelial tisssues b. connective tissues c. neural tissues d. subcutaneous tissues ans-d 3. DC coupling is an electrical voltage that is either positive or negative with current flowing in only one direction.AC coupling, on the other hand, is an electrical voltage that reverses its polarity in a second.How many times does it change? a. 40 times b. 50 times c. 60 times d. 70 times ans-c 4. Used in arterial studies, AC coupling requires more intense changes to produce a measurable signal.In the Unoted States, what volts of AC current is delivered in standard household outlets? a. 100 volts b. 110 volts c. 120 volts d. 130 volts ans-c 5. Although photoplethysmography can not be calibrated volumetrically as some other types of plethysmography, it is important to maintain the same size or gain setting throughout the entire study to ensure that a significant difference in the tracing can be reliably interpreted as a significant difference in thea. blood volume b. blood color c. blood temperature d. blood pressure ans-a 6. The photoplethysmography sensor is applied to the patients lower leg.Care must be taken so that the sensor is not over a varicosity.Which one of the following is the approximate range? a. 5-10 cm above the medial malleolus b. 2-5 cm above the medial malleolus c. 3-8 cm above the medial malleolus d. 10-12 cm above the medial malleolus ans-a 7. If the venous refill time is greater than a particular time, the study is considered to be normal.If the VRT is less than the particular time, a tourniquest is applied just above the

knee to eliminate the influence of the superficial venous system.What is the particular time? a. 10 seconds b. 20 seconds c. 30 seconds d. 40 seconds ans-b 8. If the venous refill time is greater than 20 seconds time, the study is considered to be normal.If the VRT is less than 20 seconds, a tourniquet is applied just above the knee to eliminate the influence of the superficial venous system.If a blood pressure cuff is used instead of tourniquet, the examiner inflates it toa. 20 mmHg b. 30 mmHg c. 40 mmHg d. 50 mmHg ans-d 9. If a blood pressure cuff is used instead of tourniquet, the examiner inflates it to 20 mmHg. The dorsiflexions are repeated to determine the VRT. Please refer to the manufacturers interpretation guidelines for the laboratories partiular type of equipment since normal may vary froma. 4-15 seconds b. 10-20 seconds c. 18-25 seconds d. 25-30 seconds ans-c 10. Very fast refilling indicates that the vessel is filling via retrograde venous flow. Which of the following indicates that it is in normal limits without tourniquet? a. VRT > 10 b. VRT > 20 c. VRT < 10 d. VRT < 20 ans-b 11. Very fast refilling indicates that the vessel is filling via retrograde venous flow. Which of the following indicates that it is insufficient of the deep system with and without tourniquet ? a. VRT > 10 b. VRT > 20 c. VRT < 10 d. VRT < 20 ans-d

Chap32 1. Which of the following is not included in the limitations of air plethysmography? a. if the patient is not able to perform exercise b. the presence of cast c. determination of venous insufficiency d. can not be used to to diagnose incompetent perforators ans-c 2. In case of physical principles of air plethysmography, the pneumatic cuff wrapped around the limb is connected to a pressure transducer that detects changes. What kind of changes are detected? a. pressure change b. volume change c. color change d. temperature change ans-b 3. With the patient supine, a large cuff is applied to the lower leg and inflated to about 6mmHg.The test leg is somewhat elevated with foot positioned on a hard cushion measuringa. 5-7 inches in height b. 7-10 inches in height c. 10-12 inches in height d. 12-15 inches in height ans-d 4. With the patient supine, a large cuff is applied to the lower leg and inflated to about 6mmHg.The test leg is somewhat elevated with foot positioned on a hard cushion measuring 12-15 inches in height. The leg is passively elevated to empty the venous system and what venous volume is documented? a. zero b. one c. two d. three ans-a 5. For the technique of air plethysmography, the patient stands with weight distributed equally over both feet and what exercise is performed to activate the calf muscle pump? a. 10 tip-toe exercise b. 5 tip-toe exercise c. 3 tip-toe exercise d. 1 tip-toe exercise ans-d 6. For the technique of air plethysmography, the patient stands with weight distributed equally over both feet and 1 tip-toe exercise is performed to activate the calf muscle pump.How many maneuvers are then completed? a. 10 tip-toe exercise b. 5 tip-toe exercise c. 3 tip-toe exercise d. 2 tip-toe exercise ans-a 7. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.Which of the following is the

exact equation? a. VFI=VFT90/90%VV b. VFI=90%VVxVFT90 c. VFI=90%VV/VFT90 d. VFT90=VFIx90%VV ans-c 8. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.The exact equation is VFI=90%VV/VFT90.What is the normal range of VFI? a. 1.0 b. 2.0 c. 3.0 d. 4.0 ans-b 9. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.The exact equation is VFI=90%VV/VFT90.What is the minor-to-moderate reflux range of VFI? a. 1.0 b. 2.0 c. 3.0 d. 4.0 ans-b 10. The venous filling index (VFI) documents the rate of venous refilling.The VFI is calculated using venous volume and venous filling time.The exact equation is VFI=90%VV/VFT90.What is the severe reflux range of VFI? a. > 3.0 b. > 5.0 c. > 8.0 d. > 10.0 ans-d 11. The ejection fraction measures the calf muscle pump function after one toe-up exercise by quantifying how much venous blood is left in the leg after one contraction of the calf muscle pump. Which of the following is the exact equation? a. EF=EV/W100 b. EF=EVxW100 c. EF= W100/ EV d. W100=EVxEF ans-a 12. The ejection fraction measures the calf muscle pump function after one toe-up exercise by quantifying how much venous blood is left in the leg after one contraction of the calf muscle pump. The exact equation is EF=EV/W100. What is the normal range? a. > 40% b. > 50% c. > 60% d. > 70% ans-c 13. The residual volume fraction is calculated as the percentage of venous volume remaining after 10 toe-up movements and is equivalent to the ambulatory venous pressure in mmHg. Which of the following is the exact equation? a. VV=RVFxRV b. RVF=RVxVV

c. RVF=VV/RV d. RVF=RV/VV ans-d 14. The residual volume fraction is calculated as the percentage of venous volume remaining after 10 toe-up movements and is equivalent to the ambulatory venous pressure in mmHg. The exact equation is RVF=RV/VV. What is the normal range? a. < 30% b. < 35% c. < 40% d. < 45% ans-b

Chap33 1. In case of continuous wave Doppler, which of the following is not the limitation? a. difficulties to differentiate b. paired deep veins c. sources of a false positive study d. venous incompetence evaluation ans-d 2. In case of continuous wave Doppler, which of the following is not the sources of false positive study? a. chronic obstructive pulmonary disease b. paired deep veins c. peripheral arterial disease d. extrinsic compression ans-b 3. In case of continuous wave Doppler, which of the following is not the sources of false negative study? a. partial thrombosis b. improper Doppler angle c. collateral development d. presence of bifid system ans-b 4. In case of continuous wave Doppler, which of the following is not the proper positioning of the patient? a. the body slightly shifted to the side being evaluated b. the leg should be extremely rotated c. the extremities should be lower than the level of the heart d. abnormal venous should be repositioned ans-b 5. Continuous wave Doppler uses two piezoelectric crystals, one to continuously emit ultrasound and the other to continuously receive the reflected waves.What probe should be held to maximize the quality of the Doppler venous signal? a. 2 MHz probe b. 3 MHz probe c. 5 MHz probe d. 10 MHz probe ans-c 6. Continuous wave Doppler uses two piezoelectric crystals, one to continuously emit ultrasound and the other to continuously receive the reflected waves. To maximize the quality of the Doppler venous signal, a 5 MHz probe should be held at approximatelya. 1-15 degrees b. 15-30 degrees c. 30-45 degrees d. 45-60 degrees ans-d 7. In case of the technique of continuous wave Doppler, the Examiner begins with the asymptomatic side, placing the probe at the inguinal ligament.Which of the common pulsatile artery then identified? a. pulmonary b. renal

c. femoral d. brachial ans-c 8. In case of the technique of continuous wave Doppler, the Examiner begins with the asymptomatic side, placing the probe at the inguinal ligament,identifying the pulsatile common femoral artery,and then moving the probe medially in order to insonate the commona. pulmonary vein b. renal vein c. femoral vein d. brachial vein ans-c 9. In case of the qualitative interpretation of spontaneity, the venous signal must be clearly heard at all sites with the exception of thea. femoral vein b. popliteal vein c. saphenous vein d. posterior tibial vein ans-c 10. In case of the qualitative interpretation of patency, spontaneous flow or flow following distal augmentation in some veins provide documentation that the vessel is patient,i.e., open.Which of the following is not that vein? a. ulnar vein b. radial vein c. tibial vein d. femoral vein ans-d 11. In case of the qualitative interpretation for respiratory patterns/phasicity of continuous wave Doppler, the lower extremity venous signal is normally phasic with respirationa. both increasing with expiration b. decreasing with expiration and increasing with inspiration c. increasing with expiration and decreasing with inspiration d. both decreasing with inspiration ans-c 12. When venous flow is augmented following the maneuver, decreased augmentation suggests obstruction. Augmentation during the maneuver signifies reflux.What is it called? a. proximal compression b. valsalva maneuver c. extrinsic compression d. venous pulsatility ans-b 13. Pressure on the vessels from surrounding tissues and/or structures (e.g., tumors, pregnancy, ascites, etc.) can alter normal flow patterns. Which of the following is related with this description? a. proximal compression b. valsalva maneuver c. extrinsic compression d. venous pulsatility ans-c

14. Pulsatile venous flow is commonly -and normally- heard in the subclavian vein because of its close proximity to the heart. Which of the following is related with this description? a. proximal compression b. valsalva maneuver c. extrinsic compression d. venous pulsatility ans-d

Chap34 1. For the duplex scanning and color flow imaging, which of the following is not the capabilities of peripheral veins? a. it can differentiate an acute from a subacute process b. it can be used to evaluate nonocclusive thrombosis c. it can reveal recanalized channels d. it can reveal venous thrombosis ans-d 2. For the duplex scanning and color flow imaging, which of the following is not the capabilities of abdominal and pelvic veins? a. it can reveal venous thrombosis b. it can evaluate the patency of inferior vena cava c. it can reveal recanalized channels d. it is capable of assessing protocaval shunts ans-c 3. It may be difficult to thoroughly evaluate all of the infrapopliteal veins secondary to edema, scarring, recent surgery or obesity. Which of the following limitation is related with this description? a. peripheral veins of the lower extremity b. peripheral veins of the upper extremity c. abdominal and pelvic veins d. false positive studies ans-a 4. It may be difficult to thoroughly evaluate the subclavian and brachiophelic/innominate veins because of the bony structures of the chest.Which of the following limitation is related with this description? a. peripheral veins of the lower extremity b. peripheral veins of the upper extremity c. abdominal and pelvic veins d. false positive studies ans-b 5. It may be difficult to thoroughly evaluate all of the abdominal veins because of the depth of vessels and the presence of bowel gas.Which of the following limitation is related with this description? a. peripheral veins of the lower extremity b. peripheral veins of the upper extremity c. abdominal and pelvic veins d. false positive studies ans-c 6. Which of the following is not included in the limitations of the sources of false positive studies of the duplex scanning and color flow imaging? a. extrinsic compression b. peripheral arterial disease c. improper Doppler angle d. abdominal and pelvic veins ans-d 7. Which of the following is not the correct positioning for the the duplex scanning and color flow imaging? a. turned toward the symptomic side

b. left and/or right lateral decubitus with head c. trendelenburg position d. supine with head slightly ans-c 8. Which of the following is not the physical principle of the the duplex scanning and color flow imaging? a. combination of straight and sagittal view b. velocity signals should be obtained c. the peripheral vein must be clearly visualized d. the vein must be properly identified ans-a 9. The femoral vein is evident as the probe is slowly moved down the medial aspect of the thigh.How the Doppler venous signals are obtained? a. straight view b. horizontal view c. sagittal view d. vertical view ans-c 10. In case of the the duplex scanning and color flow imaging, for the distal third of the thigh, which of the following vein dives deep? a. axillary vein b. hepatic vein c. renal vein d. femoral vein ans-c 11. In case of the the duplex scanning and color flow imaging, the probe is moved slowly through out the popliteal fossa to evaluate the popliteal vein. It is also necessary to observe any cystic structures or masses.Which of the following vein is difficult to visualize in this approach? a. anterior tibial vein b. radial vein c. pulmonary vein d. jugular vein ans-a 12. After evaluating the calf vessels for a review of the anatomy, the examiner moves the probe to the space between the medial malleolus and Achilles tendon. Which of the following vein is located by this process? a. jugular veins b. splenic veins c. femoral veins d. posterior tibial veins ans-d 13. In case of the duplex scanning and color flow imaging, for the peripheral veins of the lower extremity-chronic venous insufficiency,if reflux is not evident reversed Trendelenburg Position, the study must be repeated with the a. patient supine b. patient supine at 45 degree c. patient sitting d. patient standing ans-d

14. In case of manual standing position technique of the peripheral veins of the lower extremity-chronic venous insufficiency, which of the following is not concerned? a. the leg to be examined is not bearing weight b. Doppler color flow imaging is not used c. spectral analysis is activated d. manual compression is applied ans-b 15. In case of standing position: using an automatic cuff inflator for peripheral veins of the lower extremity-chronic venous insufficiency, the leg to be examined is not to be bearing weight. What is the measurement of the cuff which is applied to the high-thigh portion of the leg? a. 12x30 cm b. 10x40 cm c. 12x40 cm d. 10x30 cm ans-c 16. In case of standing position: using an automatic cuff inflator for peripheral veins of the lower extremity-chronic venous insufficiency, the duplex system is used to obtain an image and continuous Doppler spectral analysis of the common femoral vein. The transducer is positioned proximal to and withina. 3 cm of the cuff b. 5 cm of the cuff c. 8 cm of the cuff d. 10 cm of the cuff ans-b 17. Although it is crucial to maintain probe position over the site of interest so the signal is not lost during the cuff inflation and deflation.Once the optimal Doppler signal is obtained, the examiner tries to maintain the probe at what degree? a. 60 degree b. 70 degree c. 80 degree d. 90 degree ans-a 18. Although it is crucial to maintain probe position over the site of interest so the signal is not lost during the cuff inflation and deflation.Once the optimal Doppler signal is obtained, the examiner tries to maintain the probe at 60 degree.At what range, the cuff is iinflated? a. 70 mmHg b. 80 mmHg c. 90 mmHg d. 100 mmHg ans-b 19. Although it is crucial to maintain probe position over the site of interest so the signal is not lost during the cuff inflation and deflation.Once the optimal Doppler signal is obtained, the examiner tries to maintain the probe at 60 degree, the cuff is iinflated to 80 mmHg. How long it is maintained? a. 1-2 seconds b. 2-5 seconds c. 5-8 seconds

d. 8-10 seconds ans-a 20. In case of standing position: using an automatic cuff inflator for popliteal and great saphenous veins of the lower extremity-chronic venous insufficiency, the leg to be examined is not to be bearing weight. What is the measurement of the cuff which is applied to the knee of the leg? a. 12x30 cm b. 10x40 cm c. 12x40 cm d. 10x30 cm ans-c 21. To evaluate the popliteal vein and great saphenous vein to the knee, the 12x40 cm cuff is placed at the cuff level.At what range, the cuff is iinflated? a. 70 mmHg b. 80 mmHg c. 90 mmHg d. 100 mmHg ans-d 22. In case of standing position: using an automatic cuff inflator for posterior tibial veins of the lower extremity-chronic venous insufficiency, the leg to be examined is not to be bearing weight. What is the measurement of the cuff which is applied to the TM of the leg? a. 12x30 cm b. 10x40 cm c. 12x40 cm d. 10x30 cm ans-c 23. To evaluate the posterior tibial vein to the knee, the 12x40 cm cuff is placed at the cuff level.At what range, the cuff is iinflated? a. 70 mmHg b. 80 mmHg c. 90 mmHg d. 120 mmHg ans-d 24. For the peripheral veins of the upper extremity, in a transverse orientation, the examiner begins imaging the internal jugular vein along the lateral side of the neck, moving toward and under a clavicle, where the internal jugulat vein joins the subclavian vein to form thea. mesenteric vein b. splenic vein c. radial vein d. innominate vein ans-d 25. In case of the peripheral veins of the upper extremity, the examiner instructs the patient to raise the arm so that the probe can be placed in the axilla. Which of the following vein is evaluated in this way? a. axillary vein b. jugular vein c. femoral vein d. hepatic vein ans-a

26. In case of the peripheral veins of the upper extremity, travelling towards the hand, which of the following veins are evident formed by the confluence of the paired radial and ulnar veins? a. axillary veins b. brachial veins c. jugular veins d. popliteal veins ans-b 27. In case of the peripheral veins of the upper extremity, which of the following vein runs down while the basilic courses medially? a. renal vein b. femoral vein c. hepatic vein d. cephalic vein ans-d 28. The evaluation of the inferior vena cava and pelvic veins begins at the level of the umbilicus. Evaluation of the other abdominal vessels begins in thea. transverse view b. vertical view c. horizontal view d. sagittal view ans-a 29. Veins must be completely compressible to be considered normal. Slightly more than usual pressure or changes in probe position may be necessary to completely compress the commona. brachial vein b. ulnar vein c. radial vein d. femoral vein ans-d 30. In case of normal peripheral veins of the upprer extremity, pulsatile venous Doppler signals in the internal, jugular, subclavian and innominate veins area. semi-normal b. normal c. semi-abnormal d. abnormal ans-b 31. In case of normal peripheral veins of the upprer extremity, if the patient has a patent dialysis access graft in the extremity being evaluated, what kind of changes are expected from the following except one? a. pulsatile flow b. no response to distal compression c. decreased flow velocity d. incompressible vessel ans-c 32. In case of normal abdominal and pelvic veins, which of the following vein is formed by the superior mesenteric vein and splenic veins carries blood into the sinusoids of the liver? a. brachial vein b. axillary vein c. portal vein

d. jugular vein ans-c 33. In case of normal abdominal and pelvic veins, which of the following vein is characterized by the flow patterns that exhibit minimally phasic, almost continuous Doppler signals? a. brachial vein flow b. axillary vein flow c. portal vein flow d. jugular vein flow ans-c 34. In case of normal abdominal and pelvic veins, which of the following veins carry blood from liver into the vena cava? a. hepatic vein b. axillary vein c. portal vein d. jugular vein ans-a 35. In case of normal abdominal and pelvic veins, which of the following vein is characterized by the flow patterns that exhibit a minimally phasic, bidirectional or pulsatile appearing Doppler signal? a. hepatic vein b. axillary vein c. portal vein d. jugular vein ans-a 36. In case of normal abdominal and pelvic veins, which of the following veins carry blood liver into the vena cava and is characterized by the flow patterns that exhibit a minimally phasic, bidirectional or pulsatile appearing Doppler signal? a. renal vein b. axillary vein c. portal vein d. jugular vein ans-a 37. In case of acute thrombosis for the duplex scanning and color flow imaging, which of the following is not evident as abnormal Doppler signals? a. if flow is not spontaneous b. if flow is not phasic c. if there is no augmentation with distal compression d. if flow decreases during proximal compression ans-d 38. In case of CVI, no reflux should be observed with Doppler spectral analysis,during proximal manual compression, or the valsalva maneuver, nor should there be reflux following distal compression. Which of the following time is considered as normal? a. < 0.5 sec b. < 1.0 sec c. < 2.5 sec d. <3.0 sec ans-a 39. In case of CVI, no reflux should be observed with Doppler spectral analysis,during proximal manual compression, or the valsalva maneuver, nor should there be reflux following distal compression. Which of the following time is considered as abnormal?

a. > 1 sec b. > 2 sec c. > 3 sec d. > 4 sec ans-a 40. Which of the following has a structure, composed primarily of synuvial fluid is found posterior and medial to the knee joint and may account fot the patients pain and swelling? a. Bakers cyst b. hematoma c. muscle tear d. lymph node ans-a 41. Which of the following is not true about the portal hypertension within the portal vein for the miscellaneous findings in the abdomen? a. B-mode findings b. includes cirrhosis, cancer, pancreatitis, thrombosis and trauma c. results hepatopetal flow d. increased resistance to blood flow ans-c 42. In case of chronic venous insufficiency, which of the following has various appearances from well-to-ill cefined, heterogenous sonographic presentation ? a. hematoma b. effusion c. cyst d. abscess ans-d 43. In case of chronic venous insufficiency, which of the following has well defined structure filled with synovial fluid, usually anechoic, connection to joint space is evident, if ruptured, fluid leaking into tissue has appearance of rat-tail? a. hematoma b. effusion c. Bakers cyst d. abscess ans-c 44. In case of chronic venous insufficiency, which of the following is anechoic, placed at near joint, usually midline and symptoms are shown near or at the joint? a. hematoma b. effusion c. Bakers cyst d. abscess ans-b 45. In case of chronic venous insufficiency, which of the following has various appearances from well- to ill defined, usually heterogeneous with low level echoes initially, may become anechoic over time, little or no through-transmission? a. hematoma b. effusion c. Bakers cyst d. abscess ans-a

46. In case of chronic venous insufficiency, which of the following has hyperechoic with shadowing, placed at recess of knee and most often associated with calcium? a. hematoma b. effusion c. Bakers cyst d. loose bodies in synovial fluid ans-d 47. In case of miscellaneous findings in the extremities, which of the following has hyperechoic oval-shaped center encircled by a hypoechoic halo, blood flow usually seen in center of node, flow around perimeter may indicate neoplasm/ a. tendon b. nerve c. meniscal cyst d. lymph node ans-d 48. In case of miscellaneous findings in the extremities, which of the following has variable presentation and location and noted neuroma, sarcoma and schwannoma? a. tendon b. mass superficial c. meniscal cyst d. lymph node ans-b 49. In case of miscellaneous findings in the extremities, which of the following has heterogeneous presentation, placed at lateral knee area and mixed echoes? a. tendon b. mass superficial c. meniscal cyst d. lymph node ans-c 50. In case of miscellaneous findings in the extremities, which of the following is related to amount of bleeding in size and shape, initially hyperechoic with decreasing echogenicity over time and placed at site of injury? a. tendon b. muscle tear c. meniscal cyst d. lymph node ans-b 51. In case of miscellaneous findings in the extremities, which of the following is heterogeneous with straitions seen in sagittal view and travels adjacent to vessels? a. nerve b. muscle tear c. meniscal cyst d. lymph node ans-a 52. In case of miscellaneous findings in the extremities, which of the following is hyperechoic, echigenicity changes with angulation of transducer and does not travel adjacent to vessels? a. tendon b. muscle tear c. meniscal cyst

d. lymph node ans-a

Chap35 1. In case of invasive tests and therapeutic interventions, which of the following is not the D-dimer capability? a. it is a measurable product of the thrombotic process b. a negative result implies the absence of a thrombotic process c. a negative result is consistent with breakdown d. a positive result is consistent with lysis ans-c 2. In case of invasive tests and therapeutic interventions, which of the following is not the D-dimer limitation? a. many different methods are available b. may be elevated with pregnancy c. a positive finding is not highly sensitive d. should not be used with caution on inpatients ans-d 3. Although contrast venography may still be considered the gold standard by which all other venous tests are compared, its use has markedly decreased because of duplex scanning. How many venograms are performed? a. four b. three c. two d. one ans-c 4. Although contrast venography may still be considered the gold standard by which all other venous tests are compared, its use has markedly decreased because of duplex scanning.Which of the following is not the limitation of the contrast venography? a. it is highly technical in technique b. it is relatively expensive c. it may be comfortable for the patient d. it can produce adverse effect ans-c 5. Although contrast venography may still be considered the gold standard by which all other venous tests are compared, its use has markedly decreased because of duplex scanning.Which of the following is not the technique of contrast venography? a. a radiopaque contrast material is injected b. ascending venography c. descending venography d. one x-ray is taken ans-d 6. In case of the invasive tests and therapeutic interventions, which of the following is not the capability of lung perfusion scan? a. firstly lodges in the small vessels b. it is a screening test c. detection of the perfusion defects of the lungs d. most commonly attributed to a pulmonary embolism ans-a 7. In case of the invasive tests and therapeutic interventions, which of the following is not the limitation of lung perfusion scan? a. emphysema

b. asthma c. multiple blood transfusion d. pretoperative phenomena ans-d 8. In case of the invasive tests and therapeutic interventions, which of the following is not the technique of lung perfusion scan? a. radioactive contrast medium is injected b. images of lung perfusion is taken c. scans are interpreted d. scans may be considered primary ans-d 9. In case of the invasive tests and therapeutic interventions, all risk factors fall into the one of the three causes of venous thrombosis. Which of the following name is related with this law? a. Victors triad b. Virchows triad c. Addisons triad d. Herberts triad ans-b 10. In case of the anticoagulant therapy for prophylaxis for invasive tests and therapeutic interventions, low-dose unfractionated heparin is given.What is the time period for 5000 units? a. 8 hours before and after the surgery b. 10 hours before and after the surgery c. 12 hours before and after the surgery d. 6 hours before and after the surgery ans-c 11. In case of the anticoagulant therapy for acute DVT and/or PE, a loading dose of 10000 units of heparin followed by continuous intravenous infusion may be recommended for the treatment. What is the period? a. 1-3 days b. 3-5 days c. 5-10 days d. 1-7 days ans-c 12. In case of the anticoagulant therapy for acute DVT and/or PE, dosage is regulated to ensure that the patients partial thromboplastin time (PTT)-the time needed for a fibrin clot to form is a. 1-1.5 times nrmal b. 1.5-2 times nrmal c. 2.5-3 times nrmal d. 3.5-4 times nrmal ans-b 13. In case of the anticoagulant therapy for acute DVT and/or PE, oral anticoagulation is also administered. The dosage is regulated to ensure that the patients prothrombin time isa. 1-1.5 times nrmal b. 1.5-2 times nrmal c. 2.5-3 times nrmal d. 3.5-4 times nrmal ans-b

14. In case of the anticoagulant therapy for acute DVT and/or PE, heparin can be discontinued if there has been sufficient overlap with the coumadin, if the PT and PTT remain at therapeutic levels. After how many days it can be discontinued? a. 1-3 days b. 2-5 days c. 5-10 days d. 7-15 days ans-c 15. In case of chronic venous insufficiency for surgical and endovascular therapy, which of the following may not be treated for nonhealing venous ulcers? a. medicated wrap b. hyperbaric oxygen therapy c. ligation of incompetent perforators d. valvular reconstruction ans-d 16. In case of varicose veins for the for surgical and endovascular therapy, follow-up duplex scans are performed to ascertain that the vein has been ablated and that other vessels have not been affected by the particular procedure. Which of the following time limit is concerned here? a. 12-24 hours b. 12-48 hours c. 24-48 hours d. 48-72 hours ans-d 17. In case of varicose veins for the for surgical and endovascular therapy, follow-up duplex scans are performed to ascertain that the vein has been ablated and that other vessels have not been affected by the particular procedure.Subsequent venous duplex studies may also be scheduled fora. 1-2 months b. 1-3 months c. 3-6 months d. 6-9 months ans-c 18. TIPS or TIPSS is a percutaneous procedure to create a shunt/communication to between the portal and hepatic veins to decompress the portal veins. Which of the following is not the procedure of TIPSS? a. inserting a catheter b. advancing the catheter into right hepatic vein c. creating bridge into hepatic vein d. supporting the bridge with endoprosthesis ans-c

Chap36 1. Realistically, noninvasive studies that by all measures correlate with the gold standard 90% or more of the time are good. How many measures are there by which the comparisons are analyzed? a. 3 b. 4 c. 5 d. 6 ans-c 2. The ability of a test to detect disease. The abnormal noninvasive test result is confirmed or supported by an abnormal result of the gold standard. Which of the following measure is related with this description? a. negative predictive value b. positive predictive value c. specificity d. sensitivity ans-d 3. The ability of a test to identify normality. The normal test result is confirmed or supported by a normal gold standard result. Which of the following measure is related with this description? a. negative predictive value b. positive predictive value c. specificity d. sensitivity ans-c 4. The percentage of non invasive test results that accurately predict abnormality. Which of the following measure is related with this description? a. negative predictive value b. positive predictive value c. specificity d. sensitivity ans-b 5. The percentage of non invasive test results that accurately predict normality. Which of the following measure is related with this description? a. negative predictive value b. positive predictive value c. specificity d. sensitivity ans-a 6. Percentage of correct noninvasive diagnoses. Which of the following measure is related with this description? a. positive predictive value b. accuracy c. specificity d. sensitivity ans-b 7. In case of comparing noninvasive and gold standard results, what kind of table provides a well-accepted method of calculating statistics appropriate for the vascular laboratory? a. 2x2

b. 3x3 c. 4x4 d. 5x5 ans-a 8. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating sensitivity? a. TP/(TP+FN) b. (TP+FN)/TP c. TP/(TP-FN) d. (TP-FN)/TP ans-a 9. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating specificity? a. (TN-FN)/TN b. TN/(TN-FN) c. (TN+FN)/TN d. TN/(TN+FN) ans-d 10. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating positive predictive value? a. (TP+FP)/TP b. (TP-FP)/TP c. TP/(TP+FP) d. TP/(TP-FP) ans-c 11. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating negative predictive value? a. TN/(TN-FN) b. TN/(TN+FN) c. (TN+FN)/TN d. (TN-FN)/TN ans-b 12. After comparing the results of noninvasive and gold standard studies and placing the numbers in the correct boxes, the five standard values are calculated. Which of the following is the right rule for calculating accuracy? a. (TP+TN)/(TP+FP+FN+TN) b. (TP-TN)/(TP+FP+FN+TN) c. (TP+FP+FN+TN)/ (TP+TN) d. (TP+FP+FN+TN)/ (TP-TN) ans-a 13. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the number of true

positive? a. 120 b. 132 c. 98 d. 34 ans-b 14. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the number of true negative? a. 120 b. 132 c. 98 d. 34 ans-c 15. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the sensitivity percentage? a. 97% b. 95% c. 93% d. 98% ans-d 16. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the specificity percentage? a. 97% b. 95% c. 93% d. 98% ans-c 17. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal

limits by duplex had significant disease on angiography. What is the positive predictive value? a. 97% b. 95% c. 93% d. 98% ans-b 18. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the negative predictive value? a. 97% b. 95% c. 93% d. 98% ans-a 19. 120 patients had 4-vessel had cerebral angiography performed following duplex evaluation. 132 of the noninvasive studies documented a hemodynamically significant stenosis of the internal carotid artery(ICA). 98 ICAs showed very mild occlusive disease by both methods. However, there was disagreement between the invasive and noninvasive findings in 10 vessels. 7 ICAs were thought to have significant stenosis by duplex. But the angiogram showed mild disease. 3 vessels thought to be within normal limits by duplex had significant disease on angiography. What is the accuracy? a. 97% b. 95% c. 93% d. 96% ans-d

Chap37 1. In case of general guidelines for the universal precautions and high-level disinfection, gluteraldehyde and hydrogen peroxide is included. What is the percentage of hydrogen peroxide? a. 3% b. 4% c. 5% d. 6% ans-d 2. In case of general guidelines for the universal precautions and low-level disinfection, quarternary ammonium and N-alkyl is included. Which of the following example is not included? a. T-Sptay II b. Sani-Cloth c. Cidex d. hydrogen peroxide ( 3%) ans-c