Registered Physician in Vascular Interpretation (RPVI) Practice Exam

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• How can an examiner be certain a vein is thrombosed on duplex examination?
• Which artery is the only vessel that courses posterior to the inferior vena cava?
• CW Doppler waveform for multilevel arterial disease?
• Which option correctly lists the three arterial collateral pathways in the brain when the right internal carotid artery is occluded?
• Which PSV and EDV thresholds indicate flow-reducing stenosis in the superior mesenteric artery (SMA)?
• In collateral flow via ECA to the brain, what happens to ophthalmic artery flow?
• In fibromuscular dysplasia, which artery is most commonly affected?
• Bruit is more likely to be heard when flow velocity is very high. Which velocity is given as an example?
• In color Doppler, if the internal carotid artery (ICA) is directed upward toward the transducer and appears blue while the external carotid and common carotid deeper appear red, is there reversal flow in the ICA?
• In popliteal entrapment syndrome, foot flexion affects the systolic peak by:
• Popliteal entrapment syndrome is commonly found in which population, and is bilateral in approximately what fraction?
• During inspiration, which of the following occurs?
• Which statement about celiac artery velocity during median arcuate ligament compression is true?
• A reflection from a large smooth surface is most accurately described as which type of reflection?
• The normal flow of the renal vein at the hilum is:
• Which maneuver negates the effect of deep inspiration on arcuate ligament compression?
• In venous duplex, which feature helps determine DVT when the vein does not fully collapse?
• What cuff size should be at least what percent greater than limb diameter?
• An ABI value of 1.2 is suspicious for false elevation particularly in which patient condition?
• Compliance is defined as which of the following?
• For a transducer with a lateral focus at 3 cm depth, at what depth is lateral resolution best?
• Minimal spectral broadening in minimal stenosis is:
• In resistive index calculation, which formula defines RI?
• Photoplethysmography uses infrared light to quantify which component of blood?
• What is spectral mirroring artifact?
• Under Washington's ICA stenosis criteria, PSV>125 cm/s and EDV>140 cm/s with spectral broadening correspond to what percent diameter reduction?
• What is the normal flow pattern of the hepatic veins?
• If a thrombus is non-obstructive, how might Doppler signals appear?
• Pseudoaneurysm spectral Doppler at pedicle?
• If compression is set too high and transmit power is too low, what are the expected imaging consequences?
• Which waveform features are commonly seen with severe turbulence following high-grade stenosis?
• What calf circumference difference is considered significant in pretest probability assessment for acute DVT?
• Carotid steal phenomenon occurs on which side?
• In endoleak evaluation, a vessel communicating with the residual aneurysm sac demonstrates flow patterns similar to which feature?
• In Poiseuille's law, how does resistance relate to radius?
• What is a key advantage of pulsed-wave Doppler over continuous-wave Doppler?
• What are typical PRFs for venous and arterial Doppler flow?
• The principal source of attenuation for diagnostic ultrasound in soft tissues is:
• An ultrasound note states the Doppler angle was taken in the sagittal plane. Which plane is this?
• Which statement best describes why the superior vena cava can show pulsatility on Doppler in relation to anatomy?
• What is the wavelength equation in ultrasound physics?
• Endotension is defined as which of the following?
• Popliteal entrapment syndrome is caused by compression of which artery by which muscle?
• Which PSV and EDV thresholds indicate flow-reducing stenosis in the celiac artery?
• What is the effect of increasing PRF (color scale) on color Doppler?
• Which color Doppler velocity setting is commonly used to detect low-velocity Type II endoleaks?
• What is the characteristic color Doppler appearance of fibromuscular dysplasia in carotid arteries?
• Which velocity pattern would you expect to see across a truly occluded vessel?
• Imaging the innominate veins and the subclavian vein requires which transducer characteristics?
• What waveform characteristics in CCA with distal disease?
• In ICA stenosis with ipsilateral ECA internalization, how does the ECA appear on Doppler?
• In vascular grafts, which graft abnormality most commonly requires correction?
• Which statement describes a low-resistance celiac artery waveform?
• What is the effect of median arcuate ligament compression on celiac artery velocity during normal respiration?
• Which material is commonly used for a bypass graft and would appear as woven material on ultrasound?
• High internal carotid artery velocity can be a normal finding in which condition?
• Plethysmography measures which of the following?
• Flow in the subclavian vein may increase when the patient is supine due to what reason?
• During inspiration, what happens to upper-extremity venous flow velocity?
• Which statement best describes carotid bulb color flow?
• Transmit power reduced by factor 100; how many decibels?
• As flow disturbance increases, spectral broadening
• Toe pressure is typically used when ankle pressure is falsely elevated. What toe-brachial index value is considered abnormal?
• In photoplethysmography tracing, when is the toe systolic pressure determined?
• Which vessel is described as fasting when evaluating mesenteric arteries?
• Spectral window absence can be caused by which combination of factors?
• Normal flow direction in duplex
• Which vessel wall layer contributes to plaque lumen formation?
• Carotid body tumor is typically supplied primarily by which artery?
• Severe turbulence post-stenosis can show a reverse flow component below the systolic peak. True or false?
• Which Doppler control has the greatest impact on accuracy of pulsatility or resistive index measurements?
• In color Doppler imaging, what is a color packet?
• What is the normal toe-brachial index range?
• After exercise, peripheral arteries typically show which change in resistance?
• What is the effect of increasing color packet size on frame rate and signal-to-noise ratio?
• What explains color speckling on Doppler color flow imaging?
• What does color Doppler estimate?
• Which vessel courses posterior to the inferior vena cava?
• To optimize detection of low-velocity endoleaks on color Doppler, which velocity setting is commonly used?
• On an ultrasound of the right side, where is the axillary vein typically positioned on the screen?
• Which position is best for performing venous reflux testing?
• During expiration, how does the flow in the subclavian veins typically change?
• Which imaging finding is most consistent with collateral flow into an aneurysm sac?
• Power Doppler color encoding uses which property to signal flow color?
• During inspiration, how does intrathoracic pressure change and how does this affect venous return?
• Which equation best represents Poiseuille's law for pressure drop in a vessel in terms of pressure P, flow Q, and resistance R?
• How is acceleration time defined on Doppler waveforms?
• Power Doppler encodes color based on which property?
• Which of the following lists the three types of ultrasound reflections described?
• What ultrasound characteristic helps distinguish a bypass graft from a stent?
• If the left ankle pressure is 150 and the highest brachial pressure is 180, what is the left ABI?
• How does patient motion typically appear on color Doppler imaging?
• In color Doppler, negative Doppler shift colorized as which color?
• Which finding is most consistent with collateral flow into a limb?
• Speed of sound depends on what properties?
• Which angles require no angle correction in Doppler?
• What does a negative Doppler shift indicate about flow direction relative to the transducer?
• In vascular imaging, an intimal flap is best described as?
• Have velocity measurements or velocity ratios been validated for carotid artery disease stenosis greater than 50%?
• Which statement is true about wall filters in Doppler ultrasound?
• Do wall filters affect the accurate detection of spectral Doppler peak velocity?
• Which statement best describes the relationship among sensitivity, accuracy, and specificity?
• Which combination of footprint size and frequency is recommended for imaging the innominate veins and subclavian vein?
• If carotid color Doppler shows excessive color bleed and aliasing with a PRF of 7, which adjustment is likely beneficial?
• A color Doppler appearance shows the ICA directed toward the transducer with blue color; what does this indicate about flow?
• The flow pattern of a vessel communicating with the residual aneurysm sac is typically characterized by which directionality?
• Which Doppler pattern is typical for ECA when it assumes ICA-like flow in collateral channels?
• Which vessel would most likely produce a venous Doppler waveform in the axillary region?
• Capacitance in hemodynamics is defined as what?
• Which velocity parameter is most commonly used to assess ICA stenosis?
• How is plaque ulceration best assessed with ultrasound?
• Which aneurysm type is characterized by a tapered morphology with no well-defined neck?
• Beaded appearance of the arterial wall in the mid-to-distal renal artery is most characteristic of which disease?
• What is the minimal acceptable size for an arteriovenous fistula?
• Why might flow from the foot vessels be absent in a resting patient when examining tibial veins?
• Dropout color artifact occurs at what Doppler angle?
• In Doppler ultrasound, high resistance distal to the insonation is most consistent with what upstream condition?
• What indicates laminar flow on spectral Doppler?
• Turbulence is more likely to develop in which type of vessel diameter?
• Endoleak Type II is diagnosed by detecting retrograde flow into the aneurysm sac from which sources?
• In the spectral Doppler of the superior mesenteric artery, flow reversal would most likely be indicated by which finding?
• Why might thrombus be missed when compression doesn't reveal it?
• Which breathing maneuver helps distinguish median arcuate ligament compression of the celiac artery from intrinsic disease when measuring PSV?
• Using multiple transmit foci in ultrasound imaging affects which two aspects of resolution?
• Carotid bulb color flow is best described as?
• Which ultrasound technique has the worst temporal resolution?
• What is the arterial Doppler pattern characteristic of hyperemic flow?
• Laminar flow features
• Fibromuscular dysplasia arteries beyond renal
• Vein compression testing is impossible and difficult in which regions?
• If spectral window is not present in the common carotid artery Doppler study, what is the most accurate conclusion?
• Incomplete stent deployment during endovascular aneurysm repair is most likely to cause which type of endoleak?
• Mirror image artifacts in color Doppler imaging most commonly occur when what condition is present?
• Which waveform finding most strongly suggests collateral flow with low peripheral resistance?
• Which statement describes a normal right kidney on ultrasound?
• How does the celiac artery waveform behave during fasting and postprandial states?
• PW Doppler aliasing occurs when?
• In Doppler imaging of an intimal flap, what does a longitudinal view typically reveal?
• Incomplete stent deployment during endovascular aneurysm repair is most likely to cause which endoleak type?
• Which test is commonly used to evaluate venous reflux when the patient can tolerate standing?
• To differentiate median arcuate ligament compression from intrinsic disease of the celiac artery, interrogation should be performed during which breathing states?
• In ultrasound assessment of arterial plaque ulceration, which finding supports the presence of a true ulcer?
• Which region is most affected by overcolor gain in color Doppler imaging?
• Endoleak Type II is most commonly due to retrograde flow from which vessels into the aneurysm sac?
• Where are the interlobar arteries located?
• Which factors increase ultrasound bioeffects?
• In ultrasound physics, which phenomenon describes bending of waves as they pass between media with different propagation speeds?
• In graft hemodynamics, inflow obstruction generally refers to a blockage located where?
• During color flow imaging, which phase is typically best to capture color flow, and what color change is observed toward the black bar?
• Where is the greatest turbulence observed relative to a vascular stenosis?
• Which statement is NOT typical of severe turbulence post-stenosis waveform?
• Which statement about carotid body tumors is most accurate?
• Spectral mirroring artifact is exaggerated by:
• In a patient with congestive heart failure, what is typically seen in calf vein Doppler flow?
• In the systemic circulation, which segment has the highest vascular resistance?
• Which factor can disturb the spectral window aside from stenosis?
• What causes a Doppler shift?
• How is the left ankle-brachial index (LABI) calculated?
• In congestive heart failure, what happens to the pulsatility of the subclavian vein?
• During inspiration, which best describes the change in flow from the upper extremity to the subclavian vein?
• What finding on color Doppler would indicate an ulcerated plaque?
• Occlusion should always be confirmed with which method?
• What Doppler pattern suggests collateral flow compensating contralateral ICA stenosis?
• In SMA Doppler, a rapid upstroke is a characteristic of which condition?
• In pulsed-wave Doppler, the sampling rate is determined by which quantity?
• Which characteristic best describes a normal photoplethysmography (PPG) waveform?
• What happens to frame time as more color packets are transmitted?
• How does a plaque ulceration appear on color Doppler imaging compared with grayscale?
• Fibromuscular dysplasia most commonly involves which segment of the renal artery?
• Budd-Chiari syndrome involves thrombosis of which vascular structure?
• The carotid body tumor is most commonly found in which geographic context?
• Which statement correctly describes a condition that avoids aliasing in Doppler sampling?
• If an ABI reads 1.2 in a patient who is not diabetic and has stiff vessels, what is the most likely explanation?
• Specular reflections are produced by surfaces with which characteristics?
• Which proximal renal artery angle is correct if the artery runs parallel to the vessel and is associated with a lower peak systolic velocity reading?
• In a patient with congestive heart failure, what would you expect in calf veins on Doppler?
• Which description best defines a saccular aneurysm?
• Where along a vessel is aliasing more likely to occur and why?