RVT Peripheral Arterial Physiologic Testing 2

Question 1

A patient with claudication has an ABI of 0.62 at rest. After treadmill exercise, the ABI drops to 0.31 and takes 8 minutes to recover. What does this pattern indicate?

Accepted Answer

Moderate-to-severe arterial disease with poor collateral compensation

Answer

Mild arterial disease with good collateral flow

Answer

Normal exercise response with physiologic hyperemia

Answer

Venous insufficiency masking arterial disease

Question 2

Which waveform characteristic on PVR (pulse volume recording) is MOST consistent with proximal aortoiliac occlusive disease?

Accepted Answer

Flat, broad waveform with absent dicrotic notch throughout the limb

Answer

Peaked systolic upstroke with sharp dicrotic notch

Answer

Normal waveform at thigh with abnormal calf waveform

Answer

Biphasic waveform at the ankle with triphasic at the thigh

Question 3

During segmental pressure testing, a 30 mmHg pressure gradient is found between the proximal thigh and above-knee segments. Where is the disease most likely located?

Accepted Answer

Superficial femoral artery

Answer

Aortoiliac segment

Answer

Popliteal artery

Answer

Tibial vessels

Question 4

A diabetic patient has non-compressible tibial arteries with ABIs >1.3. Which alternative test is MOST reliable for assessing arterial perfusion in this patient?

Accepted Answer

Toe-brachial index (TBI)

Answer

Segmental limb pressures

Answer

Venous duplex ultrasound

Answer

CT angiography without contrast

Question 5

What is the normal toe-brachial index (TBI) value in a healthy adult?

Accepted Answer

>0.60

Answer

>0.80

Answer

>1.00

Answer

>0.40

Question 6

Which finding on continuous-wave Doppler examination is MOST indicative of a hemodynamically significant proximal stenosis?

Accepted Answer

Monophasic, low-velocity signal with loss of reverse flow component

Answer

High-pitched, multiphasic signal with clear window

Answer

Biphasic signal with mild spectral broadening

Answer

Triphasic waveform with normal peak systolic velocity

Question 7

A patient undergoing reactive hyperemia testing shows an ABI that falls from 1.0 to 0.55 after 3 minutes of cuff occlusion and takes 5 minutes to return to baseline. What does this indicate?

Accepted Answer

Hemodynamically significant arterial disease

Answer

Normal arterial response to ischemic stress

Answer

Venous obstruction mimicking arterial disease

Answer

Sympathetic nervous system dysfunction