Chapter 1: Vascular Diagnosis

Questions From the 2008 Case-Based Review Monograph

Please circle the best answer for each question and return to your VIR fellowship
director.

Name ________________________________

Case 1: Calf Claudication, Albert A. Nemcek Jr., MD, FSIR, and Scott Resnick, MD
Question: Which of the following statements regarding popliteal artery entrapment
syndrome is false?

A) More commonly discovered in men than women

B) Accounts for over 90% of cases of claudication in individuals less than 40
years of age
C) Most often unilateral
D) Can be associated with popliteal aneurysms
E) Can be associated with distal emboli

Case 2: Swollen Leg, Albert A. Nemcek Jr., MD, FSIR, and Scott Resnick, MD
Question: All of the following features are typical of leiomyosarcomas arising from
peripheral veins except:

A) Metastasize early
B) Grow rapidly
C) Delay in diagnosis common
D) Great saphenous vein the most commonly affected site

Case 3: Uncontrolled Hypertension, Albert A. Nemcek Jr., MD, FSIR

Question: Which of the following statements regarding pheochromocytoma or
functional paraganglioma is false?

A) CT scanning in suspected cases should be performed without intravenous

contrast, due to the likelihood of contrast administration resulting in a
hypertensive crisis.
B) Hypertensive crises may be precipitated by percutaneous biopsy, adrenal
venography or adrenal arteriography.
C) Beta-blockers may be useful adjuncts for the control of blood pressure and
cardiac tachyarrhythmias.
 D) Spontaneous reversal of renal artery stenosis has been described following
pharmacologic treatment of pheochromocytoma.

Case 4: AAA Endograft Planning, Brian Funaki, MD

Question: If no preceding intervention is performed, what is the most likely
complication after EVAR in this patient?

A) Rupture
B) Infection
C) Bowel ischemia
D) Renal failure

Case 5: Incidental Arteriopathy, Brian Funaki, MD

Question: What is the most likely diagnosis in this patient?

A) Segmental arterial mediolysis

B) Polyarteritis nodosa
C) Bacterial endocarditis
D) Takayasus arteritis

Case 6: Abdominal Pain Workup, Brian Funaki, MD

Question: What is the most likely etiology of the abnormality in this patient?

A) Segmental arterial mediolysis

B) Polyarteritis nodosa
C) Bacterial endocarditis
D) Collateral blood flow

Case 7: Evaluation of Renal Calculus, Charles E. Ray Jr., MD, FSIR

Question: Complications of IVC filters that can be noted on a single non-contrast
enhanced CT include:

A) Filter thrombosis
B) IVC penetration
C) Recurrent PE
D) None of the above

Case 8: Lower Extremity Swelling, Charles E. Ray Jr., MD, FSIR

Question: Venography of the lower extremities:

A) Should be performed with ionic contrast agents to maximize accuracy

B) Is best performed with the patient in a reverse Trendelenberg position (head
down) is order to facilitate contrast opacification of the more central veins
C) May visualize the central veins better than duplex US
D) Can be performed just prior to CTA of the pulmonary vessels with the same
contrast bolus
 E) Requires placement of at least an 18-gauge IV catheter

Case 9: Superior Vena Cava Syndrome, Charles E. Ray Jr., MD, FSIR
Question: Clinical examination of patients with superior vena cava (SVC) syndrome
reveals:

A) Headache leading to coma, caused by intravascular hemorrhage

B) Elevation of cervical venous pressure to 5080 mm Hg.
C) Nonmalignant causes account for 35% of cases in the US
D) Symptoms develop acutely (< 2 weeks) in the majority of patients
E) Of the malignant causes, small cell lung cancer is diagnosed in the majority of
patients.

Case 10: Shortness of Breath After Ceserean Section, Mark Montgomery, MD

Question: Which of the following is true regarding the entity depicted on the images?

A) Prompt surgical intervention is necessary in most cases.

B) Cyanosis is uncommon with this entity.
C) Brain abscess is a potential lethal complication.
D) Chest radiographs would likely show increased pulmonary vascularity.

Case 11: 15-Year-Old With Syncope, Mark Montgomery, MD

Question: Based upon the anatomy depicted on the CT scan, the patient would be
considered at high risk for sudden death because:

A) The vessel depicted arising from the aorta will cross the base of the heart
posteriorly which predisposes it to impingement.
B) There is a high association of the entity depicted on the CT scan with
pulmonary embolism.
C) There is a marked increase risk of atrial fibrillation with the entity depicted.
D) Potential impingement of the coronary artery by the aorta and pulmonary
artery

Case 12: Blunt Chest Trauma, Mark Montgomery, MD

Question: Which of the following would be the best treatment option for the entity
depicted?

A) Percutaneous catheter directed coil or Amplazter device embolization

B) Alcohol embolization
C) High dose indomethacin
D) Surgical bypass graft placement