CCI RVS EXAM, CCI RVS EX AM PREP, CCI RVS
PRACTICE EXAM QUESTIONS, LATEST 400+
QUESTIONS AND CORRECT DETAILED
ANSW ERS W ITH RATIOALES, ALREADY
GRADED A+
Abdominal Aorta waveform(s) - ANSWER- Low resistance proximal, Higher resistance
beyond renals
Celiac Artery supplies - ANSWER- Liver, spleen, stomach, & proximal small bowel
Branches of the Abdominal AO - ANSWER- 1st major-Celiac artery (trunk/axis)
2nd major-SMA
Renals
3rd major-IMA (after renals)
Celiac Axis - ANSWER- Branches into Common Hepatic (to right), Splenic, & Left
Gastric (off left)
Common Hepatic Arteries - ANSWER- Gives rise to the Gastroduodenal artery in PANC
head & divides into Rt & Lt Hepatics
Splenic Artery - ANSWER- Branches left and posteriosuperior to PANC body/tail
SMA/IMA waveforms - ANSWER- High resistance preprandial/Low resistance
postprandial
SMA supplies - ANSWER- Bowel from duodenum to prox small bowel
IMA supplies - ANSWER- Bowel descending & rectosigmoid colon
Right Renal Artery - ANSWER- Branches anterolateral, posterior to IVC
,Left Renal Artery - ANSWER- Branches posterolateral
Renal Artery waveform - ANSWER- Low resistance
Portal vein is usually formed by the confluence of - ANSWER- SMV & Splenic veins
*It also receives blood from the inferior mesenteric, gastric, and cystic veins
Portals walls/waveforma - ANSWER- echogenic walls & phasic waveforms
Renal veins are formed by - ANSWER- renal tributaries
Left Renal Vein - ANSWER- Longer than Rt.; Receives suprarenal/Gonadal vein
Left Renal pathway - ANSWER- Anterior to AO; Posterior to SMA
Right Renal Vein - ANSWER- No tributaries; shorter
Hepatic Veins - ANSWER- Hepatofugal flow; from liver to IVC
Patient status for Abdominal Vascular Imaging - ANSWER- NPO 8-12 hours
Ectasia - ANSWER- Local diameter increase with small bulge
(20% increase for Ao <3cm)
AAA growth rate - ANSWER- 1-2mm/year until 3-4cm; 5 mm/yr >4cm
Aneurysm classification - ANSWER- 2-3cm; 3-4cm for AAA
AAA Intervention - ANSWER- 5.5cm (high risk for rupture-catastrophic)
Fusiform - ANSWER- Concentric enlargement; All 3 layers intact
Saccular - ANSWER- Eccentric enlargement; All 3 layers compromised; Less common
(<1%); Usually in Thoracic Ao
Types of Saccular AAA - ANSWER- 1-Cannula Placement
,2-Mycotic aneurysm (bacterial infection Ao wall)
3-Vasculitis (Inflammatory process)
4-Penetrating ulcer rupture into media
Vasculitis/Aortitis - ANSWER- Inflammatory process in wall of Ao beginning with outer
(adventitia) layer and moving inward; ie: Takayasu's
Dissection - ANSWER- Intimal wall compromised resulting in 2 lumens
false>true; flow reversal
Type 1 (a/b) endoleak - ANSWER- Leak in anastamosis of graft at (a) prox or (b) distal
end
Type 2 endoleak - ANSWER- Aorta branch vessel; exhibits retrograde flow; more
dangerous b/c internally bleeding
Type 3/4 endoleak - ANSWER- (3) Junction of modular components; (4) Trans graft
flow-graft defect
Chronic Mesenteric Ischemia - ANSWER- "Fear of Food" 95% of Bowel Ischemia cases
Atherosclerotic stenosis/occlusion in main mesenteric arteries: >70% stenosis in 2/3 of
principle mesenteric arteries
Ischemia diagnosis criteria via Moneta - ANSWER- Celiac >200cm/s
SMA >275cm/s
Median Arcuate Ligament Syndrome (MALS) - ANSWER- Arch impedes on Celiac
during EXPIRATION (non-compressed during inhalation)
Measurement(s) of Splenic Vein - ANSWER- 7-17 cm long; 5-10mm diameter
Portal vein diameter - ANSWER- <13mm
Blood supply to liver - ANSWER- 75% from Portal VEIN; 25% from Hepatic ARTERY
Portal vein carries ____________ to the liver - ANSWER- Nutrients
, Hepatic artery carries ______________ to the liver - ANSWER- Oxygen
Portal Hypertension - ANSWER- Extrahepatic, Hyperdynamic, Intrahepatic (more
common)
Extrahepatic Portal HTN - ANSWER- Prehepatic (Portal/splenic vein thrombus,
Extrinsic compression of Potral vein)
Posthepatic (IVC/Hepatic vein obstruction)
Hyperdynamic Portal HTN - ANSWER- AV malformation causing arterial portal fistulas
Intrahepatic (within liver) - ANSWER- Presinusodial (less common)
Postsinusoidial (more common)
Cirrhosis/Venoclusive disease
Small liver, large spleen, ascites
LaPlace's law - ANSWER- Larger vessel radius, larger wall tension to compensate for
extra pressure
Hydrostatic pressure - ANSWER- Gravitational
Large vessels serve as - ANSWER- Pressure reservoirs
Vasodilation - ANSWER- Stretch to absorb
Vasoconstriction - ANSWER- shrink/squeeze
Energy and stenosis - ANSWER- Prox- PE↑, KE↓(highest total energy)
Within-PE↓, KE↑ (lower TE, Bernouille's)
Distal-PE↑, KE↓ (lowest total energy)
A-Early Systole (Forward flow to periphery)
B-Peak Systole (Store PE)
C-Late Systole (Temporary reversal-Peripheral resistance)
D-Early Diastole (Forward-reduced resistance)
E-Late Diastole (Vessel Recoil/Vasoconstrict/PE turns KE) - ANSWER-
PRACTICE EXAM QUESTIONS, LATEST 400+
QUESTIONS AND CORRECT DETAILED
ANSW ERS W ITH RATIOALES, ALREADY
GRADED A+
Abdominal Aorta waveform(s) - ANSWER- Low resistance proximal, Higher resistance
beyond renals
Celiac Artery supplies - ANSWER- Liver, spleen, stomach, & proximal small bowel
Branches of the Abdominal AO - ANSWER- 1st major-Celiac artery (trunk/axis)
2nd major-SMA
Renals
3rd major-IMA (after renals)
Celiac Axis - ANSWER- Branches into Common Hepatic (to right), Splenic, & Left
Gastric (off left)
Common Hepatic Arteries - ANSWER- Gives rise to the Gastroduodenal artery in PANC
head & divides into Rt & Lt Hepatics
Splenic Artery - ANSWER- Branches left and posteriosuperior to PANC body/tail
SMA/IMA waveforms - ANSWER- High resistance preprandial/Low resistance
postprandial
SMA supplies - ANSWER- Bowel from duodenum to prox small bowel
IMA supplies - ANSWER- Bowel descending & rectosigmoid colon
Right Renal Artery - ANSWER- Branches anterolateral, posterior to IVC
,Left Renal Artery - ANSWER- Branches posterolateral
Renal Artery waveform - ANSWER- Low resistance
Portal vein is usually formed by the confluence of - ANSWER- SMV & Splenic veins
*It also receives blood from the inferior mesenteric, gastric, and cystic veins
Portals walls/waveforma - ANSWER- echogenic walls & phasic waveforms
Renal veins are formed by - ANSWER- renal tributaries
Left Renal Vein - ANSWER- Longer than Rt.; Receives suprarenal/Gonadal vein
Left Renal pathway - ANSWER- Anterior to AO; Posterior to SMA
Right Renal Vein - ANSWER- No tributaries; shorter
Hepatic Veins - ANSWER- Hepatofugal flow; from liver to IVC
Patient status for Abdominal Vascular Imaging - ANSWER- NPO 8-12 hours
Ectasia - ANSWER- Local diameter increase with small bulge
(20% increase for Ao <3cm)
AAA growth rate - ANSWER- 1-2mm/year until 3-4cm; 5 mm/yr >4cm
Aneurysm classification - ANSWER- 2-3cm; 3-4cm for AAA
AAA Intervention - ANSWER- 5.5cm (high risk for rupture-catastrophic)
Fusiform - ANSWER- Concentric enlargement; All 3 layers intact
Saccular - ANSWER- Eccentric enlargement; All 3 layers compromised; Less common
(<1%); Usually in Thoracic Ao
Types of Saccular AAA - ANSWER- 1-Cannula Placement
,2-Mycotic aneurysm (bacterial infection Ao wall)
3-Vasculitis (Inflammatory process)
4-Penetrating ulcer rupture into media
Vasculitis/Aortitis - ANSWER- Inflammatory process in wall of Ao beginning with outer
(adventitia) layer and moving inward; ie: Takayasu's
Dissection - ANSWER- Intimal wall compromised resulting in 2 lumens
false>true; flow reversal
Type 1 (a/b) endoleak - ANSWER- Leak in anastamosis of graft at (a) prox or (b) distal
end
Type 2 endoleak - ANSWER- Aorta branch vessel; exhibits retrograde flow; more
dangerous b/c internally bleeding
Type 3/4 endoleak - ANSWER- (3) Junction of modular components; (4) Trans graft
flow-graft defect
Chronic Mesenteric Ischemia - ANSWER- "Fear of Food" 95% of Bowel Ischemia cases
Atherosclerotic stenosis/occlusion in main mesenteric arteries: >70% stenosis in 2/3 of
principle mesenteric arteries
Ischemia diagnosis criteria via Moneta - ANSWER- Celiac >200cm/s
SMA >275cm/s
Median Arcuate Ligament Syndrome (MALS) - ANSWER- Arch impedes on Celiac
during EXPIRATION (non-compressed during inhalation)
Measurement(s) of Splenic Vein - ANSWER- 7-17 cm long; 5-10mm diameter
Portal vein diameter - ANSWER- <13mm
Blood supply to liver - ANSWER- 75% from Portal VEIN; 25% from Hepatic ARTERY
Portal vein carries ____________ to the liver - ANSWER- Nutrients
, Hepatic artery carries ______________ to the liver - ANSWER- Oxygen
Portal Hypertension - ANSWER- Extrahepatic, Hyperdynamic, Intrahepatic (more
common)
Extrahepatic Portal HTN - ANSWER- Prehepatic (Portal/splenic vein thrombus,
Extrinsic compression of Potral vein)
Posthepatic (IVC/Hepatic vein obstruction)
Hyperdynamic Portal HTN - ANSWER- AV malformation causing arterial portal fistulas
Intrahepatic (within liver) - ANSWER- Presinusodial (less common)
Postsinusoidial (more common)
Cirrhosis/Venoclusive disease
Small liver, large spleen, ascites
LaPlace's law - ANSWER- Larger vessel radius, larger wall tension to compensate for
extra pressure
Hydrostatic pressure - ANSWER- Gravitational
Large vessels serve as - ANSWER- Pressure reservoirs
Vasodilation - ANSWER- Stretch to absorb
Vasoconstriction - ANSWER- shrink/squeeze
Energy and stenosis - ANSWER- Prox- PE↑, KE↓(highest total energy)
Within-PE↓, KE↑ (lower TE, Bernouille's)
Distal-PE↑, KE↓ (lowest total energy)
A-Early Systole (Forward flow to periphery)
B-Peak Systole (Store PE)
C-Late Systole (Temporary reversal-Peripheral resistance)
D-Early Diastole (Forward-reduced resistance)
E-Late Diastole (Vessel Recoil/Vasoconstrict/PE turns KE) - ANSWER-
