RVT Vascular Pathology and Aneurysms 2

Question 1

Which sonographic finding is most characteristic of a mycotic aneurysm compared to an atherosclerotic aneurysm?

Accepted Answer

Irregular, saccular morphology with surrounding soft tissue changes

Answer

Fusiform dilation with calcified wall

Answer

Smooth intimal surface with laminated thrombus

Answer

Bilateral symmetric involvement

Question 2

A patient presents with a pulsatile abdominal mass and a bruit. Duplex ultrasound shows an aortic diameter of 4.2 cm. According to standard guidelines, what is the recommended surveillance interval?

Accepted Answer

Every 12 months

Answer

Every 6 months

Answer

Every 3 months

Answer

Immediate surgical referral

Question 3

What is the primary mechanism by which turbulent flow contributes to aneurysm wall stress?

Accepted Answer

Increased wall shear stress causes smooth muscle cell apoptosis and extracellular matrix degradation

Answer

Decreased velocity reduces oxygen delivery to the adventitia

Answer

Laminar flow disruption causes thrombus embolization

Answer

Elevated venous pressure transmits back to the arterial wall

Question 4

On duplex ultrasound of a peripheral artery aneurysm, which waveform pattern within the aneurysm sac is most commonly observed?

Accepted Answer

To-and-fro or swirling flow with low-velocity turbulence

Answer

Monophasic low-resistance flow throughout

Answer

High-resistance triphasic flow

Answer

Absent flow signal despite patent lumen

Question 5

Which of the following best defines a pseudoaneurysm (false aneurysm)?

Accepted Answer

A contained hematoma communicating with the arterial lumen through a wall defect

Answer

Dilation involving all three layers of the arterial wall

Answer

An arteriovenous fistula with aneurysmal dilation

Answer

Concentric calcification of the arterial wall without dilation

Question 6

Femoral pseudoaneurysms are most commonly caused by which etiology in contemporary vascular practice?

Accepted Answer

Iatrogenic arterial puncture (post-catheterization)

Answer

Blunt trauma

Answer

Atherosclerotic degeneration

Answer

Connective tissue disorder

Question 7

When performing ultrasound-guided thrombin injection for a femoral pseudoaneurysm, what is the most critical step before injection?

Accepted Answer

Confirm absence of AV fistula and clearly visualize the neck of the pseudoaneurysm

Answer

Administer systemic anticoagulation to prevent distal thrombosis

Answer

Compress the femoral vein to redirect flow

Answer

Measure the peak systolic velocity in the native artery