CCI Peripheral Venous Evaluation 2 — Questions and Answers
Question 1: Which duplex ultrasound finding is MOST diagnostic of acute deep vein thrombosis (DVT)?
- Vein is non-compressible with direct probe pressure (Correct answer)
- Increased color Doppler flow velocity
- Vein diameter less than 3 mm
- Spontaneous phasic flow present
Correct answer: Vein is non-compressible with direct probe pressure
Non-compressibility of the vein under direct transducer pressure is the primary criterion for diagnosing acute DVT.
Question 2: Augmentation of venous flow during peripheral venous duplex examination is performed by:
- Having the patient perform a Valsalva maneuver
- Compressing the limb distal to the transducer (Correct answer)
- Elevating the limb above heart level
- Compressing the limb proximal to the transducer
Correct answer: Compressing the limb distal to the transducer
Distal limb compression augments venous flow toward the heart, confirming venous patency between the compression site and the transducer.
Question 3: When evaluating the great saphenous vein (GSV), which anatomical landmark identifies its junction with the common femoral vein?
- Saphenofemoral junction (SFJ) at the groin crease (Correct answer)
- Popliteal fossa at the knee
- Mid-thigh perforator level
- Adductor canal
Correct answer: Saphenofemoral junction (SFJ) at the groin crease
The saphenofemoral junction (SFJ) is located near the groin crease where the GSV drains into the common femoral vein.
Question 4: A patient presents with a warm, tender, palpable cord along the medial thigh. Duplex shows a thrombosed great saphenous vein. This condition is BEST classified as:
- Superficial thrombophlebitis (Correct answer)
- Acute iliofemoral DVT
- May-Thurner syndrome
- Chronic venous insufficiency
Correct answer: Superficial thrombophlebitis
Thrombosis of a superficial vein such as the GSV presenting with local inflammation is classified as superficial thrombophlebitis.
Question 5: Which waveform characteristic on spectral Doppler indicates normal venous flow at the common femoral vein level?
- Continuous non-phasic flow
- Phasic variation with respiration (Correct answer)
- High-resistance triphasic arterial pattern
- Absent flow with Valsalva
Correct answer: Phasic variation with respiration
Normal common femoral vein flow is phasic, varying with the respiratory cycle due to changes in intrathoracic pressure.
Question 6: During a lower extremity venous duplex exam, reflux in the great saphenous vein is defined as retrograde flow lasting longer than:
- 0.5 seconds (Correct answer)
- 1.0 second
- 2.0 seconds
- 3.0 seconds
Correct answer: 0.5 seconds
Reflux in superficial veins (GSV, SSV) is defined as retrograde flow duration exceeding 0.5 seconds after augmentation release.
Question 7: Which vein is evaluated at the popliteal fossa to assess for small saphenous vein (SSV) termination?
- Saphenopopliteal junction (SPJ) (Correct answer)
- Gastrocnemial vein junction
- Tibial-peroneal trunk junction
- Soleal vein confluence
Correct answer: Saphenopopliteal junction (SPJ)
The saphenopopliteal junction (SPJ) is the site where the small saphenous vein drains into the popliteal vein, and its exact level is variable.
CCI Peripheral Venous Evaluation 2
Which duplex ultrasound finding is MOST diagnostic of acute deep vein thrombosis (DVT)?