Aorta Quiz

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Aorta Quiz

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You are performing a bedside ultrasound on your 70 year old patient with flank pain, as you scan cephalad to caudad you recall the structures that should be apparent include: *

A. Celiac trunk, SMA, aortic bifurcation

B. Hepatic artery, splenic artery, SVC

C. Mesenteric fat, portal triad, SMA

D. Portal triad, celiac trunk, renal artery

You have four patients in whom you suspect an abdominal aortic aneurysm, in which patient may a CT scan be an appropriate test to further evaluate? *

A. A patient with an abdominal aorta with a maximal diameter of 1.9 cm, use CT to rule out rupture

B. A patient with diffuse abdominal tenderness to palpation on physical exam

C. A patient with an abdominal aorta of 5.6 cm on ultrasound, and hemodynamically unstable, obtain CT for operative planning

D. A stable patient with an ultrasound exam severely limited by body habitus and profound bowel gas

You have a hemodynamically unstable who has an abdominal aortic aneurysm on ultrasound exam, but you do not identify free fluid on your FAST exam, you next step in management should include: *

A. Call vascular surgery and prepare for operative management, as ultrasound is not sensitive for rupture of a AAA

B. Obtain a CT scan to rule out a likely false positive ultrasound exam

C. Perform serial FAST exams, as specificity for rupture increases with subsequent exams

D. Rule out rupture as the cause of this patient's hemodynamic instability

What pathological finding is likely to be missed by not appropriately dynamically scanning the full length of the abdominal aorta? *

A. Celiac artery dissection

B. Fusiform aneurysm

C. Saccular aneurysm

D. Transposition of the inferior vena cava and abdominal aorta

Which of these findings on an abdominal aorta ultrasound are abnormal? *

A. Absence of a dissection flap in the proximal portion of the aorta

B. Bifurcation of the caudal aorta below the umbilicus

C. Diameter of the abdominal aorta gradually increasing as you scan cephalad to caudad

D. Transverse cut of the aorta measuring less than 3 cm

Which of these mistakes in the performance of an abdominal aorta ultrasound if likely to result in an overestimation of the diameter? *

A. An off-axis or tangential cut of the aorta in long axis

B. Applying excess pressure to the patients abdomen during the exam

C. Measuring from the inner lumen to inner lumen of the abdominal aorta

D. Mistakenly measuring a dilated inferior vena cava in the long axis view

You are performing an abdominal aortic ultrasound on a patient with multiple finding on your exam, which of these findings is a normal variant? *

A. A dissection flap

B. A fusiform aneurysm

C. A saccular aneurysm

D. An ectatic aorta

While performing your ultrasound to evaluate your patient's aorta, you remember to keep in mind that you can potentially get a false positive result (you may mistakenly identify an aortic aneurysm) if: *

A. A dissection flap is identified

B. A saccular aneurysm is identified as opposed to a fusiform aneurysm

C. The measurement is made from the inner wall to the inner wall of the lumen in the setting of a mural thrombus

D. The transverse measurement is made on a cut that is angled and not perpendicular to the vessel

Your patient is a 61 year old hypertensive smoker whose chief complaint is back pain. You decide to ultrasound his aorta to evaluate for an abdominal aortic aneurysm. Your scan area will encompass: *

A. Ascending aorta at the sternal notch, through to the femoral arteries bilaterally at the inguinal creases

B. Below the costal margin to above the pubic symphisus

C. Aorta anterior to the lumbar spine

D. Below the xiphoid, through the bifurcation of the iliacs

A key component in an adequate evaluation for an abdominal aortic aneurysm involves: *

A. Make frequent measurements in the longitudinal axis

B. Obtain a comparison view with a CT (with contrast if no renal impairment)

C. Obtain both angled transverse cuts as well as tangential longitudinal cuts of the aorta

D. Perform a dynamic scan while adjusting for changes in vessel angle

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