Abstract
The following questions for SVU-CME examination are based on the article entitled “A Meta-analysis of Preoperative Duplex Ultrasound Vessel Diameters for Successful Radiocephalic Fistula Placement” by Carolyn Glass, MD, Marcia Johansson, NP, William DiGragio, and Karl A. Illig, MD.
Both true/false and multiple choice questions are included. There is only one (1) correct answer for the multiple choice test items. Answer all the questions as listed below. One (1) SVU-CME will be awarded for successful completion of this test with a grade of 80% or more.
The survival rate of a successfully placed fistula with a 2 year complication-free rate is:
as high as 75%
as high as 90%
as high as 85%
as high as 95%
Failure of a fistula to reach functional status is:
Secondary failure
Tertiary failure
End failure
Primary failure
The Kidney Dialysis Outcomes Quality Initiative recommends as the initial option for dialysis access the use of the:
Scribner shunt
Gore graft AV fistula
radiocephalic wrist AV fistula
arteriovenous grafts
Several studies showed pre-operative measurements of the radial artery diameter (RAD) for successful access:
range from <1.0 mm to >2.8 mm
range from <1.5 mm to >2.6 mm
range from <2.6 mm to >2.9 mm
range from <1.0 mm to >2.0 mm
Several studies showed pre-operative measurements of the cephalic vein diameter (CVD) for successful access:
range from <1.6 mm to >4 mm
range from <1.3 mm to <4 mm
range from <2.0 mm to <4 mm
range from =1.6 mm to >4 mm
The results of this meta-analysis were not used to designate an overall vessel diameter cutoff point for the RAD and CVD based on Duplex ultrasound.
True
False
In this study for meta-analysis purposes, only those fistulas functional at least 4 weeks after creation were considered successful.
True
False
A RAD of >2.0 mm compared to <2.0 resulted in a success rate of nearly
5% higher
10% higher
15% higher
20% higher
A CVD of >2.0 mm compared to <2.0 almost
doubled the primary success rate of the fistula.
halved the primary success rate of the fistula.
trebled the primary success rate of the fistula.
quartered the primary success rate of the fistula.
This data suggests Duplex ultrasound should be used routinely to guide the vascular surgeon in the Cimino-Brescia creation.
True
False
If paying by credit card, the answer sheet may be sent via fax: 301-459-5651. Otherwise, mail it with a check, made payable to SVU (in US funds drawn on a US bank net of all charges) to SVU, P.O. Box 75491, Baltimore, MD 21275-5491.
The following questions for SVU-CME examination are based on the article entitled “Utility of Standing Maneuvers during Abdominal Duplex Ultrasound Examination to Diagnose Median Arcuate Ligament Compression” by Mary C. Downing, MD, Kathryn Ayoub, RVT, Abizer Sakarwala, BS, Susan M. Whitelaw, RT, RDMS, RVT, Sandra Yesenko, RDMS, RVT, and Heather L. Gornik, MD, RVT, RPVI.
Both true/false and multiple choice questions are included. There is only one (1) correct answer for the multiple choice test items. Answer all the questions as listed below. One (1) SVU-CME will be awarded for successful completion of this test with a grade of 80% or more.
MALC stands for
median arcuate long calcification
medial abrupt ligament compression
median arcuate ligament compression
median applicant longitudinal completion
In MALC, during deep inspiration
elevated velocities normalize
lower velocities increase
elevated velocities increase
normal velocities elevate
Performance of the Doppler examination with the patient standing does not lead to improved diagnosis of MALC.
True
False
A (PSV) of ≥250 cm/sec in the celiac artery and a PSV of ≥275 cm/sec in the SMA were consistent with stenosis of:
<50%
50–60%
60–80%
70–99%
MALC is also known as
atherosclerosis
dynamic stenosis
fixed stenosis
moveable stenosis
In this lab a 70–99% stenosis of superior mesenteric artery (SMA) was consistent with a PSV of
≥375
≥275
≥175
≤275
The most common symptom in these patients was
abdominal bruit
unexplained weight loss
abdominal pain
fibromuscular dysplasia
During this standing test when velocities did not normalize it suggested
atherosclerosis
MALC
absence of any disease
thrombus
MALC is also known as celiac axis syndrome or Dunbar syndrome and was first described by Harjola in 1963.
True
False
Most typically affected patients are
slender, older males
portly young females
young, thin females
stout, younger males
If paying by credit card, the answer sheet may be sent via fax: 301-459-5651. Otherwise, mail it with a check, made payable to SVU (in US funds drawn on a US bank net of all charges) to SVU, P.O. Box 75491, Baltimore, MD 21275-5491.
The following questions for SVU-CME examination are based on the article entitled “Arterial Duplex Ultrasound Is the Most Cost-Effective, Noninvasive Diagnostic Imaging Modality Before Treatment of Lower-Extremity Arterial Occlusive Disease” by Thomas H. Schwarcz, MD, RVT, RPVI, Vicki L. Gatz, MSPH, RVT, Stephen Little, RVT, RDMS, and Chrisa F. Geddings, RVT
Both true/false and multiple choice questions are included. There is only one (1) correct answer for the multiple choice test items. Answer all the questions as listed below. One (1) SVU-CME will be awarded for successful completion of this test with a grade of 80% or more.
Pre-intervention imaging studies are done for all of the following reasons, except
assess the ability of the patient to walk
assess the location of disease
to choose a treatment modality
strategic approaches such as optimal endovascular access sites
For the purposes of this study, the combined costs of imaging both the aorto-iliac and infrainguinal arterial segments were calculated, as knowledge of both inflow and runoff vessel status are required prior to revascularization.
True
False
Positive correlation was defined as disagreement between significant duplex finding(s) with the identical arterial segment treated during an intervention.
True
False
Procedural success (of the duplex) was determined based on
endovascular intervention
MRA
CTA
angiography
Of the one hundred thirty-nine endovascular procedures that were planned during the study period
139 endovascular interventions were successfully performed
128 endovascular interventions were successfully performed
108 endovascular interventions were successfully performed
190 endovascular interventions were successfully performed
Arterial duplex imaging was the primary and only diagnostic study performed prior to endovascular treatment in
64% of the procedures
56% of the procedures
84% of the procedures
94% of the procedures
Pre-intervention arterial duplex findings of hemodynamically significant stenosis or arterial occlusion correlated with the treated arterial segment in
78% of patients
<78% of patients
84% of patients
>99% of patients
Factors that affect the quality of CTA imaging include all of the following, except
thinness of the patient
obesity
injection timing
limited use in patients with chronic renal insufficiency
MRA has more limitations than CTA in patients with vascular disease, these include all of the following, except
motion artifacts
overestimation of disease
calcification of the vessel wall
clarity of visualization
If pre-intervention MRA or CTA, instead of arterial duplex, had been universally utilized in the 128 successful procedures in this study, the increase in costs for diagnostic imaging alone would have been
$67,043 and $34,762, respectively
$86,064 and $47,762, respectively
$96,064 and $44,762, respectively
$106,064 and $94,762, respectively
If paying by credit card, the answer sheet may be sent via fax: 301-459-5651. Otherwise, mail it with a check, made payable to SVU (in US funds drawn on a US bank net of all charges) to SVU, P.O. Box 75491, Baltimore, MD 21275-5491.
