RVT - Registered Vascular Technologist Abdominal Vascular Duplex Exams Questions and Answers

Question 1

A patient with refractory hypertension is referred for a renal artery duplex exam.
The peak systolic velocity (PSV) in the suprarenal aorta is 80 cm/s.
The highest PSV obtained in the proximal right renal artery is 300 cm/s.
What is the calculated Renal-Aortic Ratio (RAR), and what is the most likely interpretation?

Accepted Answer

RAR is 3.75, suggestive of a hemodynamically significant stenosis (>60%).

Answer

RAR is 0.27, which is within normal limits.

Answer

RAR is 3.75, which is within normal limits.

Answer

RAR is 2.50, suggestive of a non-hemodynamically significant stenosis (<50%).

Question 2

When measuring the maximum diameter of an abdominal aortic aneurysm (AAA) via duplex ultrasound for surveillance, which of the following is the standard, most reproducible technique?

Accepted Answer

Anterior-posterior diameter measured from outer wall to outer wall in a transverse plane.

Answer

Anterior-posterior diameter measured from inner wall to inner wall in a sagittal plane.

Answer

Lumen diameter only, excluding any mural thrombus, in a transverse plane.

Answer

Transverse diameter measured from outer wall to outer wall in a sagittal plane.

Question 3

A 40-year-old patient presents with post-prandial epigastric pain. During a mesenteric duplex exam, the celiac artery PSV is 140 cm/s during quiet inspiration. When the patient performs a deep expiration, the PSV increases sharply to 360 cm/s with associated post-stenotic turbulence. These findings are most characteristic of:

Accepted Answer

Median Arcuate Ligament Syndrome (MALS).

Answer

Atherosclerotic celiac artery stenosis.

Answer

Celiac artery dissection.

Answer

Superior Mesenteric Artery (SMA) syndrome.

Question 4

A patient with a history of chronic liver disease undergoes an abdominal duplex exam. Which of the following findings is the most specific indicator of severe portal hypertension?

Accepted Answer

Hepatofugal (reversed) flow in the main portal vein.

Answer

A main portal vein diameter of 14 mm.

Answer

Splenomegaly with a spleen length of 15 cm.

Answer

A continuous, non-phasic waveform in the hepatic veins.

Question 5

A patient with ascites, hepatomegaly, and abdominal pain is referred for an abdominal vascular duplex exam. Which of the following findings would be most consistent with a diagnosis of Budd-Chiari syndrome?

Accepted Answer

Absence of detectable flow or visualization of thrombus within the major hepatic veins.

Answer

A highly pulsatile, 'to-and-fro' waveform in the main portal vein.

Answer

Markedly elevated velocities (>400 cm/s) in the superior mesenteric artery.

Answer

A patent Transjugular Intrahepatic Portosystemic Shunt (TIPS).

Question 6

A patient with a history of 'food fear' and significant weight loss is evaluated for chronic mesenteric ischemia. In a fasting state, which of the following duplex findings would be most indicative of a hemodynamically significant (>70%) stenosis?

Accepted Answer

A peak systolic velocity (PSV) greater than 280 cm/s in the superior mesenteric artery (SMA).

Answer

A low-resistance waveform in the superior mesenteric artery (SMA).

Answer

A peak systolic velocity (PSV) of 150 cm/s in the celiac artery.

Answer

Retrograde flow in the common hepatic artery.