RVT Peripheral Arterial Physiologic Testing 3

Question 1

Which statement BEST describes the Windkessel effect and its importance in peripheral arterial testing?

Accepted Answer

It is the elastic recoil of large arteries that dampens pulsatile flow and maintains diastolic pressure

Answer

It refers to venous pooling that affects ABI accuracy

Answer

It describes the collateral recruitment response to arterial occlusion

Answer

It is the pressure gradient measured across a stenosis during exercise

Question 2

A 68-year-old woman has rest pain and an ABI of 0.38. Her toe pressure is 22 mmHg. According to TASC II criteria, this patient most likely has:

Accepted Answer

Critical limb ischemia (Fontaine stage III-IV)

Answer

Claudication (Fontaine stage II)

Answer

Mild peripheral arterial disease

Answer

Non-occlusive mesenteric ischemia

Question 3

When performing thigh PVR measurements, which error would MOST likely cause falsely elevated thigh pressures?

Accepted Answer

Using a cuff that is too narrow relative to thigh circumference

Answer

Using a cuff that is too large for the thigh circumference

Answer

Performing the test in a cold room

Answer

Measuring immediately after exercise

Question 4

On a PVR tracing, which feature represents the dicrotic notch, and what does its absence indicate?

Accepted Answer

A small notch on the downstroke; absence indicates loss of arterial compliance or significant disease

Answer

The initial upstroke; absence indicates venous reflux

Answer

The peak of the waveform; absence indicates arterial calcification

Answer

A secondary positive wave; absence indicates cardiac arrhythmia

Question 5

A patient's right ABI is 0.85 and left ABI is 0.72. The right arm pressure is 130 mmHg and the left arm pressure is 118 mmHg. Which arm pressure should be used to calculate both ABIs?

Accepted Answer

Right arm pressure (130 mmHg)

Answer

Average of both arm pressures (124 mmHg)

Answer

Left arm pressure (118 mmHg)

Answer

Either arm pressure is acceptable

Question 6

Which treadmill protocol is MOST commonly used for standardized ABI exercise testing in peripheral arterial disease evaluation?

Accepted Answer

Standard PAD protocol at 2 mph, 12% grade for 5 minutes

Answer

Bruce protocol at 12% grade, 2.5 mph

Answer

Gardner protocol at 0% grade, variable speed

Answer

Naughton protocol at 3.5 mph, 5% grade

Question 7

What is the physiologic explanation for the brief paradoxical increase in ABI sometimes seen immediately after exercise in a patient with claudication?

Accepted Answer

Arterial vasodilation increases cardiac output and systemic pressure

Answer

Post-exercise brachial artery vasospasm falsely lowers the denominator

Answer

Collateral vessels temporarily dilate beyond their capacity

Answer

Cardiac output decreases, reducing peripheral resistance