UT-15 LE part 1

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51 Questions - Developed by: Joel - Developed on: - 1.876 taken

  • 1
    Patients presenting with symptoms of claudication complain of:
    Cramping pain in the calf, thigh or buttocks with exercise not relieved by rest
    Nocturnal muscle cramps
    Cramping pain in the calf, thigh or buttock with exercise and relieved by rest
    Pain in hips or knees not relieved by rest
    Numbing weakness in the legs while standing
  • 2
    Muscular veins of the calf that empty into the popliteal vein behind the knee are:
    Femoral veins
    Soleal veins
    Gastrocnemius veins
    Adductor veins
  • 3
    Peripheral resistance is controlled by:
    Flow volume
    Heart rate
    Stroke volume
    Vasoconstriction and vasodilation of the arterioles
    Muscle contraction
  • 4
    A body condition in which the body tissue contains excessive fluid is termed:
  • 5
    The symptom or sign most likely not associated with acute arterial occlusion is:
    Pain of sudden onset
    Blue toe
    Pale or white extremity
  • 6
    According to poieseuille's law, what would occur to the pressure gradient across an arterial segment in which the radius has been reduced by on-half?
    It would decrease
    None of the above
    It would increase
    There is not enough information to determine
  • 7
    Peripheral resistance increases with:
    Shorter length, smaller diameter, lower blood viscosity
    Greater length, smaller diameter, higher blood viscosity
    Greater length, smaller diameter, lower blood viscosity
    Shorter length, larger diameter, lower blood viscosity
    Greater length, larger diameter, higher blood viscosity
  • 8
    Which patient position would result in the greatest hydrostatic pressures?
    Hydrostatic pressure does not vary with position
  • 9
    The term phasisity in reference to the venous system refers to:
    The rate at which the valves open and close
    The influence of the cardiac cycle on venous flow
    The effect of intrinsic and extrinsic pressure on venous wall stiffness
    The ebb and flow in the veins that occurs in response to respiration
    The changes in hydrostatic pressure with changes in position
  • 10
    Which of the following statements about venous valves is false?
    They consist of endothelial tissue
    They are essential to the muscle pump
    They allow flow only away from the heart
    They are bicuspid
    They have sinuses to facilitate closure
  • 11
    Which of the following is always true of patients who suffer from intermittent claudication?
    There is pressure drop distal to the obstructed segment after exercise
    Peripheral blood flow is reduced at rest
    There is always a pressure drop distal to the obstructed segment at rest
    No increase in blood flow occurs through the affected segment during exercise
    Marked peripheral vasoconstriction occurs in response to exercise
  • 12
    Doppler waveform abnormalities in the lower extremity arterial circulation distal to a hemodynamically significant stenosis include:
    An absent flow reversal component, blunting of peak velocity, and prolonged upslope and downslope
    The presence of dicrotic notch on the downslope
    A triphasic waveform
    Increased peak-to peak amplitude
    Absent doppler signal
  • 13
    Rubor is defined as:
    Slackening of the muscles of an ischemic foot
    Red skin color
    Abnormal stiffness of digits
    Thickened, wrinkled skin
    Small, purple areas of discoloration on the dorsum of the foot
  • 14
    Which of the following vessels is not found on or near the foot?
    Dorsalis pedis
    All are found on or near the foot
    Posterial tibia
  • 15
    Which of the following factors has the greatest influence on flow resistance?
    Pressure gradient
    Vessel length
    Distance from the heart
    Vessel radius
  • 16
    Which of the following statements regarding popliteal aneurysms is not true?
    They pose a significant risk to the patient due to rupture
    Cause symptoms by compressing contiguous structures
    A patient with a popliteal aneurysm is at increased risk of having another aneurysm
    They pose a significant risk of limb loss due to embolism or occlusion
    They are found bilaterally in >10% of cases where they exist
  • 17
    The bernoulli effect describes:
    Decrease flow volume in critical stenosis
    Decreased velocities in regions of flow turbulence
    Decrease pressure in regions of high flow velocity
    Increased pressure in region of high flow velocity
    Decrease resistance distal to a stenosis
  • 18
    The absence of a bruit at the common femoral level:
    Rules out significant stenosis at that level
    Suggest total occlusion at that level
    Suggests stenosis proximal to that level
    Suggests stenosis distal to that level
    Cannot rule out significant stenosis at that level
  • 19
    A 28-yr old male complains of exercise-induced cramping of the right calf that occurs after walking six blocks and is relieved within 5 mins of rest. Bouding pedal pulses are noted and resting ankle pressures are normal. The symptoms are reproduced with exercise. The ankle pressure remains normal on the left but drops to 40 mmHg on the right. These signs are consistent with:
    Occlusion of the femoral artery
    Popliteal entrapment
    Coarctation of the aorta
    Deep vein thrombosis
    Compartment syndrome
  • 20
    Diastolic flow reversal:
    Is always present in vasodilated limbs
    None of the above
    May be absent in vasodilated limbs
    Is always present in all abnormal limbs
    Is absent in vasoconstricted limbs
  • 21
    The left common iliac vein
    Crosses anterior to the left common iliac artery just distal to the aortic bifurcation
    Does not cross either common iliac artery
    Crosses anterior to the right common iliac artery just distal to the aortic bifurcation
    Crosses posterior to the left common iliac artery just distal to the aortic bifurcation
    Crosses posterior to the right common iliac artery just distal to the aortic bifurcation
  • 22
    Normal doppler waveform morphology for a peripheral artery includes:
    A sharp upslope and downslope and a prominent reverse flow component
    Augmentation with distal compression maneuvers
    Phasisty with repiration
    A rounded, extended acceleration with no diastolic wave
    A delayed systolic peak and downslope bowed away from baseline
  • 23
    The doppler beam may be attenuated if:
    1. the sound beam must pass through scar tissue, a hematoma or excessive fat
    3. output settings form the doppler to the recording device are not amplified
    1. 2. and 3 is correct
    1. and 2. only
    2. the vessel has calcific plaque on the anterior wall
  • 24
    A patient has a 50% diameter stenosis in a lower extremity vein graft. the systolic velocity at the stenosis:
    Will be 100% greater than the prestenotic velocity followed by a drop in velocity
    Is less than 45 mm/sex
    Is the same as velocities measured distally to the graft
    Is greater than 150 mm/sec, less than 240 mm/sec
    Will be 50% higher than the prestenotic velocity
  • 25
    The most important reason doppler evaluations should be performed with a patient in basal state and warm temperature is:
    The results can be expected to vary from day to day
    The results are influenced by the patients' peripheral resistance
    The results are influenced by the pressure differential found in each vessel
    The exam will be easier to perform
    Metabolic activity is increased, making results more reliable
  • 26
    The risk of claudication in a diabetic patient is:
    Equal to the risk of the general population
    Greater than 4 times the risk in the general population
    Lower than that in the general population
    Claudication is not an ischemic symptom for diabetics
    Close to 10% of the risk in the general population
  • 27
    In the lower extremity circulation, the most common site of atherosclerosis is:
    The arterial segment t the iliac bifurcation
    The arterial segment beginning at the popliteal artery
    The proximal tibial vessels
    The arterial segment at the popliteal trifurcations
    The arterial segment beginning in the hunter's canal
  • 28
    Which statement is not true regarding intrathoracic pressure?
    Intrathoracic pressure has a major effect on venous return
    Venous return from the upper extremities is reduced when intrathoracic pressure is high
    Intrathoracic pressure is increased with inspiration
    Intrathoracic pressure is increased with valsalva maneuver
    None of the above
  • 29
    Which of the following would not be true of the calf muscle pump
    Contraction of the muscle propels blood towards the heart
    Competent valves stop blood from flowing retrograde during muscle contraction
    Walking produces the muscle-pump effect
    Hydrostatic pressure is increased in veins at the ankle with contraction of the muscle pump
    Muscular contraction increase venous return and therefore cardiac output
  • 30
    The resistance to flow offered by the fluid in motion is termed:
    Pressure gradient
    Kinetic energy
  • 31
    Rt arm 180/100 mmHg
    Lt arm 120/60 mmHg
    Rt posterior tibial artery 100mHg
    Lt posterior tibial artery 90mmHg
    Referring to the readings listed above, the left ankle/brachial index is:
  • 32
    The symptoms of anterior tibial compartment syndrome are:
    Weakness of the muscles in the compartment
    Swelling and/or palpable tenderness over a muscle compartment
    All of the choices
    Pain on passive stretch of the muscles in the compartment
    Sensory deficit or paresthesis
  • 33
    The popliteal trifurcation is actually a double bifurcation. Which pairs form these two bifurcations?
    Anterior tibial and popliteal, then posterior tibial and peroneal
    Peroneal and tibioperoneal trunk, then posterior and anterior tibials
    Posteir tibial and popliteal, then anterior tibial and peroneal
    Posterior tibial and tibioperoneal trunk, then anterior tibial and peroneal
    Anterior tibial and tibioperoneal trunk, then posterior tibial and peroneal
  • 34
    Patients with advanced peripheral arterial occlusive disease exhibit which of the following skin changes?
    4.stasis pigmentation
    1. 2. and 3.
    3. pallor on elevation
    1. shiny, scaly skin
    2.dependant rubor
  • 35
    Intraabdominal pressure decreases with:
    Valsalva maneuver
    None of the above
    Inspiration and valsalva
  • 36
    The energy of something in motion is termed:
    Potential energy
    Kinetic energy
    Viscous energy
    Static energy
    Fluid energy
  • 37
    Ulcers due to arterial insufficiency are found most often:
    Behind the knee
    On the toes and distal foot
    Along the hunter canal
    In the gaiter area, near the medial malleolus
  • 38
    Which of the following would NOT be true regarding lower extremity veins in an individual who has been standing for a long tiem?
    Pooling of blood would occur in the lower extremity veins
    None of the above
    Hydrostatic pressure would be high in the lower extremity veins
    Hypotension would occur due to diminshed cardiac output
    The veins of the lower extremity would collapse under the increase pressure
  • 39
    Aneurysms are most often caused by:
    Systemic infection
    Bifurcated laminar flow
    Congenital arterial wall weakness
  • 40
    Which of the following does not accureately describe events during calf muscle contraction and relaxation
    Soleal sinuses empty during contraction
    A potential space is created in the deep system with very low pressure during relaxation
    Blood is forced cephalad during contraction
    Blood flows from the deep system into the superficial system via the perforators during relaxation
    None of the above
  • 41
    The reynolds number describes the:
    Point at which resistance to flow is increased in a stenosis
    Effect of arteriolar vasodilation or vasoconstriction on flow velocity
    Point at which flow becomes turbulent
    Effect of pressure on flow
    Point at which turbulent flow normalizes
  • 42
    In the calculation of ankle/brachial systolic pressure ratios, the floowing arm pressure is commonly selected as the denominator
    The lower of the right or left arm pressures
    The higher of the right or left arm pressures
    Random selection of the right or arm pressure
    The right arm pressure
    The left arm pressure
  • 43
    Which statement is not true regarding arteriovenous malformations
    They can be defined as a direct communication between an artery and a vein
    They are present at birth
    They may be asymptomatic
    They can occur anywhere in the body
  • 44
    Rest pain is characterized by:
    Pain while walking that goes away with rest
    Pain at night in the forefoot or foot that may go away with leg dependency
    Any calf pain that goes away with leg dependency
    Upper calf pain that goes away with leg dependency
    Upper calf pain
  • 45
    Which of the following accurately describes the exit effects of flow through a stenosis?
    Boundary layer separation occurs
    The flow profile elongates and eventually reestablishes as parabolic
    None fo the above
    All of the above
    Flow near the vessel edge becomes stagnant or retrograde
  • 46
    All fo the following can apply to a high=resistance signal except
    Reverse component
    Triphasic pattern
  • 47
    What changes would be seen in a doppler waveform of the femoral artery that is taken after exercise?
    Delayed systolic rise time
    No changes
    Increase flow throughout diastole
    Increase reverse component in early diastole
    All of the above
  • 48
    What is the effect of inspiration on venous flow in the lower extremities?
    If the calf muscle is contraced the flow will course toward the ankle during inspiration
    During inspiration flow courses from the perforating veins into the superficial veins
    Inspiration has no efect on venous flow in the lower extremities
    With competent valves, venous flow augments during inspiration and reverses during expiration
    In the supine position, venous flow in the lower extremities stops during inspiration and returns during expiration
  • 49
    The term muscle pump refers to:
    The pulmonary arteries
    The veins in the groin
    The calf muscles
    The right atrium of heart
    The ventricles of heart
  • 50
    The ability of veins to accommodate large shifts in volume with only limited changes in venous pressure is known as:
    Transmural pressure
    Transluminal pressure
  • 51
    The two flow characteristics that define arterial stenosis anywhere int he body include focal accerleration of velocities and:
    Decrease diastolic flow
    Increased flow reversal
    Decreased resistance proximally
    Distal disturbance
    Increased pulsatility distally

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