ARDMS RVT URR PHYSIOLOGICAL
EXAMS WITH 100% CORRECT
ANSWERS { GRADED A+}
A patient complains of left arm numbness and pain that increases in
severity when it is cold outside. An upper extremity arterial duplex exam
demonstrated a >50% stenosis in the distal subclavian artery. The PPG
...
A patient complains of left arm numbness and pain that increases in
severity when it is cold outside. An upper extremity arterial duplex exam
demonstrated a >50% stenosis in the distal subclavian artery. The PPG
exam demonstrates additional decrease in digital flow with cold
exposure. What explains these findings?
A. Buergers Disease
B. secondary Raynaud phenomenon
C. primary Raynaud Syndrome
D. thoracic outlet syndrome - ✔✔B. secondary Raynaud phenomenon
,A double peaked waveform obtained during PPG evaluation of the digits
of the left hand is indicative of:
A. thoracic outlet syndrome
B. Raynaud syndrome
C. subclavian stenosis
D. palmer arch stenosis - ✔✔B. Raynaud syndrome
The double peaked PPG tracing is indicative of vasospasm seen with
Raynaud syndrome
Which of the following is a contraindication for a lower extremity
segmental pressure exam?
A. ulceration on the 3rd and 4th toes
B. current anticoagulant treatment
C. diabetes mellitus
D. ulceration on the distal calf - ✔✔D. ulceration on the distal calf
,Contraindications:
suspected or known acute DVT- use waveform analysis only or use of a
toe/brachial index (TBI)
recent surgery, trauma site or ulcers that cannot/should not be
compressed by pressure cuffs
patients with incompressible arteries due to medial calcification- TBI
may be used instead
morbidly obese patients- high-thigh pressure may be unobtained or
inaccurate due to limb girth
patients with significant tremors or involuntary movements that may
cause waveforms to be suboptimal or unreliable.
Ulcerations on the 3rd and 4th toes would not be compressed by cuffs.
While DM can cause medial calcification which could inhibit the exam,
not every patient with DM has medial calcification.
When a patient performs exercise on a treadmill what will be the normal
change in arterial flow in the legs?
, A. increased peripheral resistance
B. unchanged flow pattern
C. decreased antegrate flow in diastole
D. increased antegrade flow in diastole - ✔✔D. increased antegrade
flow in diastole
When the patient exercises, the leg muscles require more blood flow for
proper operation. The resistance will drop at the ankle to allow the
increased flow in diastole.
A patient presents with HTN, DM and left lower extremity pain that
occurs only as he walks. He usually begins to have pain after he walks to
his mailbox with increasing pain as he returns to the house. The pain is
relieved by resting his legs for a few minutes. What would the predicted
ABI value be for the left leg?
A. 0.9
B. 0..6
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