Angio and interventional chest mcqs

regarding the puncture sites in arteriography

a) if entry through an axillary approach is required , entry from the left side minimises the risk of stroke
b) a translumbar approach is NOT contra-indicated out in a patient with a blood pressure of 180/110
c) in a translumbar approach the needle should be aimed at the L1 level if an aortic aneurysm is suspected
d) the vessel most commonly used for arterial access is the superficial femoral artery
e) infrainguinal arterial puncture may lead to retoperitoneal haemmorhage

The correct answer is T F F F T

Explanation

NO EXPLANATION

regarding guide wires in arteriography

a) 0.018 inch guidewires are suitable for general aortography

b) standard wires are 145 cm long
c) J-wires are more likely than straight wires to produce arterial dissection
d) teflon coatings decrease the thrombogenicity of wires
e) wires coated with hydrophilic polymers are are liable to increased resistance to manipulation

The correct answer is F T F T F no exp

regarding the use of contrast in angiography

a) Iothalamate has anticoagulant properties

b) ionic contrast media have five to seven times the osmolality of blood in the concentration injected
c) carbon dioxide is the vascular contrast agent of choice in patients who give a history of urticaria following
an iodinated media injection
d) lidocaine may be added to non-ionic contrast media when lower extremity arteriography is performed
e) iohexol is a non-ionic contrast media

The correct answer is T T F F T

Explanation

NO EXPLANATION

embolization of pulmonary AVMs

a) general anaesthesia is usually required

b) the use of steel coils is contraindicated
c) the use of detachable balloons usually requires multiple catheter exchanges
d) the presence of pleuritic chest pain 48hours after the prrocedure is an ominous sign
e) following successful embolization prophylactic antibiotics are no longer required

Your answer is N N N N N

The correct answer is F F T F F

Explanation

A. NO EXP B. the use of coils of the correct size is relatively safe C. this is a major disadvantage of their use
D. this occurs in 10 % of patients and is self limiting E. complete obliteration of shunting is rare due to the
presence of small occult malformations.Patients should therefore continue to be prescribed antibiotics before
any procedure asscoiated with a risk of bacteraemia

regarding the use of catheters in arteriography

a) brachiocephalic arteries approached from the femoral artery may be approached vy a Headhunter
b) Simmons catheters are useful for hooking sharply angled vessels
c) flushing of catheters should take place every 2-3 minutes
d) an occluded catheter should never be opened by passage of a guide wire
e) when a guide wire is inserted into a catheter it may be allowed to exit the catheter tip if the catheter tip is
within the arch of the aorta

Your answer is N N N N N

The correct answer is T T T T T

Explanation

NO EXPLANATION

in cerebral angiography

a) only the anterior wall of the common carotid artery is punctured in the direct technique of carotid
angiography
b) 6ml iopamidol 300 at 4 ml per second is suitable for vertebral angiography
c) direct vertebral puncture is best performed with a short bevel needle
d) direct puncture of the vertebral artery is performed with the patient's head extended and the carotid artery
displaced laterally
e) cortical blindness is a complication of carotid angiography

The correct answer is F T F T F

regarding DSA

a) it allows more dilute contrast to be used

b) motion artefacts may be compensated for
c) is particularly useful in studies of the vessels of the foot
d) is useful when searching for the source of a gastro-intestinal bleed
e) intravenous DSA requires relatively higher doses of contrast than intra-arterial DSA

Your answer is N N N N N

The correct answer is T T T F T

Explanation

NO EXPLANATION

regarding the role of angioplasty in intermittent claudication

a) an ankle-brachial pressure gradient of 0.3 is normal

b) 5-year patency rates after iliac artery angioplasty are over 50%
c) the incidence of complications in a patient with intermittent claudication is lower than angioplasty in a
patient with rest pain
d) daily aspirin has been established as the best non-interventional form of therapy
e) patients with multiple level stenoses should be treated conservatively

The correct answer is F T T F F

Explanation

A. an ankle-brachial pressure gradient of less than 0.5 confers a poor prognosis B. the 5-year patency rates
after iliac artery angioplasty vary between 60 and 90%. The 5-year patency rates for femoro-popliteal lesions
is mostly over 50% C. 0.7% vs 2.8% D. pahramcological benefits are only minimal. the main non-
interventional form of therapy is exercise E. patients with multiple level stenoses generally do poorly with
conservative treatment and usually require angioplasty

the following are true of arterial access in arteriography

a) local anaesthesia with 8ml of lidocaine should be sufficient

b) if the needle is removed after successful arterial puncture but unsuccessful guide wire insertion
compression for 5-10 minutes is required before retrying
c) dilators may be safely used for entries within a synthetic Dacron vascular graft
d) a vascular sheath is recomended when multiple changes of catheters are anticipated
e) puncture of the common femoral artery at a level at the middle of the femoral head would probably be
above the inguinal ligament

The correct answer is T T T T F

Combination. 3312 Question number 3

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aortic dissection is associated with

a) Ehler's Danlos syndrome

b) co-arctation of the aorta
c) polyarteritis nodosa
d) Systemic lupus erythematosus
e) relapsing polychondritis

The correct answer is T T F F T

Explanation

NO EXP
regarding guide wires in arteriography

a) 0.018 inch guidewires are suitable for general aortography

b) standard wires are 145 cm long
c) J-wires are more likely than straight wires to produce arterial dissection
d) teflon coatings decrease the thrombogenicity of wires
e) wires coated with hydrophilic polymers are are liable to increased resistance to manipulation

Your answer is N N N N N

The correct answer is F T F T F

Explanation

NO EXPLANATION