RVT Quality Assurance and Safety 3

Question 1

A carotid duplex study is flagged during a QA review because the ICA/CCA PSV ratio is 4.2 but the ICA PSV is only 110 cm/s. What is the BEST next step?

Accepted Answer

Correlate with waveform morphology and assess for contralateral occlusion

Answer

Report as high-grade stenosis based on the ratio alone

Answer

Repeat the study immediately with a different transducer

Answer

Discard the ratio and classify by PSV alone

Question 2

Which accreditation body specifically focuses on vascular testing laboratories and requires compliance with published testing protocols?

Accepted Answer

Intersocietal Accreditation Commission for Vascular Laboratories (ICAVL)

Answer

The Joint Commission (TJC)

Answer

American College of Radiology (ACR)

Answer

College of American Pathologists (CAP)

Question 3

When establishing normal reference ranges for a vascular lab's ankle-brachial index (ABI) measurements, the data should be stratified by:

Accepted Answer

Patient age, sex, and clinical indication

Answer

Sonographer seniority level

Answer

Equipment manufacturer

Answer

Time of day the test was performed

Question 4

What does the term 'sentinel event' mean in the context of vascular laboratory patient safety?

Accepted Answer

An unexpected occurrence involving death or serious physical harm to a patient

Answer

A near-miss event that was caught before reaching the patient

Answer

A quarterly report submitted to the accreditation body

Answer

A false-positive ultrasound finding requiring follow-up imaging

Question 5

A technologist notices the real-time B-mode image has a 'dropout' artifact in the far field during routine phantom testing. The MOST likely cause is:

Accepted Answer

Air bubble trapped between the transducer and the phantom surface

Answer

Excessive gain setting

Answer

Time-gain compensation (TGC) set too low in the far field

Answer

Incorrect Doppler angle selected

Question 6

In ALARA (As Low As Reasonably Achievable) practice for diagnostic ultrasound, which action BEST reduces thermal bioeffect risk during a vascular study?

Accepted Answer

Minimize total scan time and use the lowest output power necessary to obtain diagnostic images

Answer

Increase the number of focal zones to improve resolution

Answer

Use continuous wave Doppler rather than pulsed wave Doppler

Answer

Increase frame rate to capture fast-flow events

Question 7

Which quality control metric is used to evaluate the consistency of a vascular lab's duplex grading of renal artery stenosis compared to subsequent CTA or angiography findings?

Accepted Answer

Sensitivity and specificity with correlation to reference standard

Answer

Test-retest reliability coefficient

Answer

Cronbach's alpha for internal consistency

Answer

Intraclass correlation coefficient for PSV measurements only