RVT - Registered Vascular Technologist Peripheral Arterial Physiologic Testing Questions and Answers

Question 1

A patient presents with claudication. The right brachial pressure is 140 mmHg and the left brachial pressure is 130 mmHg. The right posterior tibial artery pressure is 70 mmHg and the right dorsalis pedis artery pressure is 65 mmHg. What is the correct Ankle-Brachial Index (ABI) for the right leg?

Accepted Answer

0.50

Answer

To calculate the ABI, the highest ankle pressure on one side is divided by the highest of the two brachial pressures. In this case, the highest right ankle pressure is 70 mmHg (from the posterior tibial artery) and the highest brachial pressure is 140 mmHg. Therefore, 70 / 140 = 0.50. This value indicates moderate to severe peripheral arterial disease.

Question 2

A patient undergoes a segmental pressure study. The following resting systolic pressures are obtained: Right Brachial: 150 mmHg, Right High Thigh: 130 mmHg, Right Above Knee: 125 mmHg, Right Below Knee: 120 mmHg, Right Ankle: 115 mmHg. Which of the following is the most likely location of significant arterial disease?

Accepted Answer

Right iliofemoral arteries

Answer

A pressure drop of more than 20-30 mmHg between adjacent segments is considered significant for arterial occlusive disease. In this case, there is a 20 mmHg pressure drop between the brachial pressure (inflow) and the high thigh, indicating a likely stenosis in the aortoiliac or common femoral artery segment. The subsequent drops down the leg are less than 20 mmHg.

Question 3

Which of the following is a primary purpose for performing an exercise stress test in a patient with suspected peripheral arterial disease (PAD) and a borderline resting ABI?

Accepted Answer

To unmask a hemodynamically significant stenosis that is not apparent at rest.

Answer

Exercise increases blood flow demand in the lower extremities. In a patient with PAD, a stenosis that is not flow-limiting at rest may become significant during exercise, causing a drop in ankle pressures. This helps to confirm the diagnosis and assess the functional severity of the disease when resting studies are inconclusive.

Question 4

While performing a Doppler assessment of the femoral artery, a technologist observes a waveform with a sharp systolic upstroke, followed by a brief period of flow reversal in early diastole, and a final phase of low-level forward flow in late diastole. How would this waveform be best characterized?

Accepted Answer

Triphasic

Answer

A normal, high-resistance peripheral artery at rest exhibits a triphasic waveform. This pattern consists of: 1) rapid antegrade flow during systole, 2) transient retrograde flow in early diastole due to vessel wall compliance and peripheral resistance, and 3) a smaller, brief antegrade flow in late diastole as the vessel wall recoils.

Question 5

A patient with diabetes and suspected digital ischemia undergoes photoplethysmography (PPG) of the great toe. The resulting waveform is severely dampened with a delayed upstroke and a rounded peak. What is the most likely interpretation of this finding?

Accepted Answer

Significant proximal arterial occlusive disease

Answer

Photoplethysmography (PPG) assesses changes in blood volume in the capillary beds. A normal PPG waveform has a sharp systolic upstroke and a dicrotic notch. A dampened, rounded waveform with a slow upstroke indicates poor arterial perfusion, which is characteristic of significant proximal (upstream) arterial stenosis or occlusion that reduces pulsatile flow to the digits.

(RVT) Registered Vascular Technologist Practice Test

(RVT) Registered Vascular Technologist Practice Test

RVT - Registered Vascular Technologist Peripheral Arterial Physiologic Testing Questions and Answers