Sample Questions

        
Endovascular Sample Questions


The arteriogram shown below reveals the superior mesenteric artery (SMA) with which of the following anatomic variations?
 

A. A large artery of Drummond
B. A large collateral artery to the celiac artery
C. The celiac artery arising from the SMA
D. The right hepatic artery arising from the SMA

(Key = D)

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The figure shown below reveals a foot with nonblanching erythema after percutaneous intervention for tibial occlusive disease. The opposite foot appears normal. The patient reports having less pain after the procedure, with primarily a "pins and needles" sensation on the bottom of the foot when walking. The most appropriate treatment would be:

A. antibiotic therapy.
B. corticosteroid therapy.
C. anticoagulation therapy.
D. repeat angiography with reintervention if needed.

(Key = C)

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A 62-year-old patient with claudication undergoes attempted traversal of a short-segmented occlusion of the superficial femoral artery (SFA) in anticipation of balloon angioplasty with stenting. The patient describes pain in the thigh. The arteriogram shown below reveals a perforation of the SFA. Given that the patient is hemodynamically stable, the next best step in management would be to:

A. abort the procedure immediately and reattempt it from a retropopliteal approach in 2 weeks.
B. place an occlusion balloon in the proximal SFA for 10 minutes and reassess for bleeding.
C. continue attempting to traverse the lesion to allow percutaneous transluminal angiography with stenting.
D. refer the patient to vascular surgery for emergency bypass surgery.

(Key = B)

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General Vascular Medicine Sample Questions

 

 A 74-year-old patient underwent a percutaneous intervention of the coronary arteries via the right femoral artery and developed a bruit in the groin.  The color duplex ultrasound findings are shown below.  Which of the following Doppler waveforms is most likely to be associated with this abnormality?

A. Lack of respiratory variation in the outflow common femoral vein
B. A "to-and-fro" waveform at the site of communication between the artery and vein
C. Low resistance in the inflow superficial femoral artery
D. High resistance in the inflow superficial femoral artery


(Key = C)

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A 62-year-old woman experiences deep vein thrombosis 1 week after undergoing cholecystectomy. Prior to surgery, she had been receiving unfractionated heparin, 5,000 units tid. Laboratory results before and after surgery are as follows:  

After Surgery Before Surgery One Week
Hemoglobin 13.8 g/dL 12.9 g/dL
Hematocrit 40% 37%
WBC 7,200/µL 9,300/µL
Platelets 194,000/µL 89,000/µL
aPTT 34 sec 36 sec
PT (INR) 1.1 1.1


Which of the following findings most likely caused the patient's venous thrombosis?



A. Antibodies to Factor V
B. Antibodies to heparin:platelet factor 4 complexes
C. Antibodies to heparin:antithrombin III complexes
D. Antibodies to anticardiolipin


(Key = B)

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A 26-year-old woman has discomfort in her left arm and lightheadedness while washing her hair. She has no history of hypertension, diabetes mellitus, or hypercholesterolemia. She smokes one pack of cigarettes daily. She has a blood pressure of 94/72 mm Hg in the right arm and 64/40 in the left arm, and she has a left supraclavicular bruit. Her erythrocyte sedimentation rate (ESR) is 72 mm/hr. Magnetic resonance angiography reveals a 90% tubular stenosis of the left subclavian artery and a 50% stenosis at the ostium of the innominate artery. The most appropriate initial treatment would be:

A. smoking cessation.
B. administration of prednisone.
C. percutaneous angioplasty and stenting of the left subclavian artery.
D. left carotid to subclavian artery bypass surgery.

(Key = B)

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