Abstract
The following questions for SVU-CME examination are based on the article entitled “Comparison of Duplex Ultrasound and Computed Tomography Surveillance after Endovascular Aneurysm Repair in Determining Proximal Endograft Location” by Babatunde H. Almaroof, MD; Sadaf S. Ahanchi, MD; Brian L. Chen, MD; Jarrod D. Day, MD; Courtney R. Nelms, BS, RVT, RDMS, FSVU; Jean M. Panneton, 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. Thank you Dianne Masri for these questions.
The method for Duplex ultrasound measurements were obtained from the superior mesenteric artery to the:
proximal endograft using digital calipers in a non fasting patient
inferior mesenteric artery in a fasting patient
hyperechoic proximal endograft in a fasting patient
proximal endograft using digital calipers in a fasting patient
Color Duplex ultrasound does not expose patients to risks of contrast-related nephrotoxicity and cumulative radiation effects.
True
False
The SMA was chosen as the point of reference for Duplex imaging in this study because
it is an ICAVL standard and recommendation
bowel gas is minimized by this imaging protocol
the celiac artery is difficult to image
it is easier to visualize off the aorta in the sagittal view when compared to the renal arteries.
CTA results were interpreted by the radiologist, but the distance measurements in millimeter (mm) between the SMA and the proximal Endograft was obtained by a (n)
vascular surgeon using color images
vascular surgeon on 3-D reconstructed images
radiologist on 3-dimentional reconstructed images
ultrasound technologist using B mode imaging
CTA measurements were presumed as the gold standard measurements against the correlated Duplex measurements.
True
False
According to the study, there are many studies which have demonstrated that Duplex imaging is
the gold standard in surveillance for endoleaks
an integral part of post-operative care following EVAR
the modality of choice and is as good, if not better than CTA in surveillance for endoleaks
a poor choice modality in surveillance for endoleaks
According to the authors and this study research
CTA is limited in visualization due to the anatomy of the aneurysm and endograft migration
CTA is the imaging of choice for assessing endograft migration due to visualization using 3-dimentional reconstruction images
Duplex imaging is the imaging of choice for better visualization for endograft migration
Duplex imaging is the imaging of choice for assessing endograft migration due to visualization using 3-dimentional reconstruction images
Endograft migration generally occurs as a result of
the patient performing strenuous exercise
abdominal pressure by repeated ultrasounds
cardiac output and blood flow hemodynamics
unstable proximal attachment
Endografts most likely to migrate caudally are due to
miscalculation of endograft size pre-operatively
endograft placed in sac with acute angulated aortic necks
endograft placed in sac with linear aortic necks
instability of large aneurysm
According to the authors, endograft migration can result in
aneurysm sac regression
aortic wall remodeling
proximal type I leak and ultimately aneurysm rupture
proximal type I leak and ultimately renal artery compression
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.
Comparison of Duplex Ultrasound and Computed Tomography Surveillance after Endovascular Aneurysm Repair in Determining Proximal Endograft Location
The following questions for SVU-CME examination are based on the article entitled “Duplex Ultrasound Findings in Intravenous Drug Users with Femoral Vein Injection” by Watson B. Smith, BA, RDMS, RVT; Kari A. Campbell, BS, RVT; R. Eugene Zierler, MD, 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. Thank you Kimberly Sorrentino for these questions.
The authors state that ____ is often the initial imaging modality used when intravenous drug users who access their common femoral vein repetitively present with signs and symptoms of vascular complications.
Angiogram
CT scan
MRI
Duplex ultrasound
In this review, CFV stricture was identified in ____ of the limbs and progression to DVT was observed in ____ of the CFV strictures.
63% and 21%
92% and 44%
63% and 45%
92% and 45%
According to the article, is this statement true or false? Abnormalities were present on duplex ultrasound in 98% of the limbs evaluated in this review.
True
False
What are listed as the most common indications for duplex ultrasound in this review?
Mass and pain
Erythema and swelling
Mass and erythema
Pain and swelling
According to the article, is the following statement true or false? 45% of the CFV strictures identified in this review were seen to progress to thrombotic occlusion on follow-up examinations.
True
False
What is the definition of a phlegmon?
A focal acute inflammatory process in the subcutaneous tissue.
A focal chronic inflammatory process in the subcutaneous tissue.
A diffuse acute inflammatory process in the subcutaneous tissue.
A diffuse chronic inflammatory process in the subcutaneous tissue.
How do the authors describe the ultrasound appearance of a phlegmon?
A poorly circumscribed darkened area without posterior enhancement.
A poorly circumscribed darkened area with posterior enhancement.
A poorly circumscribed echogenic area without posterior enhancement.
A poorly circumscribed echogenic area with posterior enhancement.
According to this article, is the following statement true or false? Pulmonary embolism was identified on CT angiography in one patient in this review.
True
False
All of the following arterial lesions were identified in this retrospective review EXCEPT:
Arterial thrombosis
Mycotic arterial aneurysm
Acute hemorrhage
Arterial pseudoaneurysm
The results of this study suggest that the initial duplex ultrasound examination for intravenous drug users with injection into the CFV should include evaluation of all of the following EXCEPT:
Full lower extremity venous duplex exam
Distal iliac and proximal femoral arteries
Distal femoral and popliteal arteries
Soft tissues in the proximal thigh
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.
Duplex Ultrasound Findings in Intravenous Drug Users with Femoral Vein Injection
The following questions for SVU-CME examination are based on the article entitled “Impact of Routine Use of a Tourniquet during Preoperative Vein Mapping on the Diameter of Arm Veins and Creation of Functional Arteriovenous Fistulas” by Arjun Jayaraj, MD; Courtney Crawford, BS; Christine Logar, MD; Thomas Hatsukami, MD; Brenda Allen, ARNP; Nam Tran, 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. Thank you Kimberly Sorrentino for these questions.
What are the criteria for AVF creation used in this study?
Superficial veins with diameter ≥3.0 mm and continuity with proximal superficial veins.
Superficial veins with diameter ≥3.0 cm and continuity with proximal deep veins.
Superficial veins with diameter ≥2.0 mm and continuity with proximal superficial veins.
Superficial veins with diameter ≥2.0 mm and continuity with proximal deep veins.
The failure rate of the AVF's in Group I was ____, while the failure rate of the AVF's in Group II was ____.
86% and 37.5%
37.5% and 68%
68% and 37.5%
37.5% and 86%
What was the primary outcome of this study defined as?
Functional AVF within 1 year of surgery.
Functional AVF within 9 months of surgery.
Functional AVF within 6 months of surgery.
Functional AVF within 3 months of surgery.
Which of the following statements is true?
The vein diameters of the patients in Group I were achieved with a tourniquet.
The vein diameters of the patients in Group II were achieved with a tourniquet.
The vein diameters of the patients in Group II were achieved without a tourniquet.
The vein diameters of the patients in both Groups I and II were achieved without a tourniquet.
According to the article, is the following statement true or false? The use of a tourniquet results in a higher number of patients qualifying for AVF creation.
True
False
According to the article, is the following statement true or false? AVF's created using vein diameters obtained from the application of a tourniquet have much higher failure rates when compared to AVF's created using veins of similar diameters but without a tourniquet.
True
False
Which of the following is true in regards to using autogenous arteriovenous fistulas for hemodialysis when compared to using non-autogenous arteriovenous grafts?
Autogenous arteriovenous fistulas generally have improved patency rates and increased rates of infection.
Autogenous arteriovenous fistulas generally have improved patency rates and reduced rates of infection.
Autogenous arteriovenous fistulas generally have reduced patency rates and increased rates of infection.
Autogenous arteriovenous fistulas generally have reduced patency rates and reduced rates of infection.
In this study, autogenous AVF's were allowed a period of up to ____ weeks for maturation before attempts at cannulation depending on the location of the AVF.
18
16
14
12
How many patients were excluded from this study secondary to having undergone AVG creation?
10
20
30
40
What is listed as the predominant reason for failure of the fistula in both Groups I and II?
Failure to mature
Thrombosis of the fistula before initiation of dialysis
Thrombosis of the fistula after initiation of dialysis
Excessively turbulent blood flow
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.
Impact of Routine Use of a Tourniquet during Preoperative Vein Mapping on the Diameter of Arm Veins and Creation of Functional Arteriovenous Fistulas