Question 1:
Patient presents with recent history of syncope. New onset of HTN and HX of smoking 1
pack per day (ppd) x 25 years.
Carotid ultrasound exam ordered. Considering following questions and please answer.
1. In patient presentation, which item is the symptom for carotid ultrasoound exam?
2. In patient presentation, identify the risk factors for atherosclerosis and carotid artery
disease.
3. Consider image, which vessel contain some blue colors?
4. Is the ‘blue’ pathological?
5. What is the color blue representing?
Question 2:
Patient presents to ultrasound department for preoperative work-up. Patient
scheduled to have coronary artery bypass graft (CABG) in two days. Patient has
HX of peripheral vascular disease, smoking, HTN and hyperlipidemia. You obtain
this image. Consider following questions.
1. Is it possible to have plaque producing stenosis without symptoms?
2. What are the risk factors for atherosclerosis in this patient presentation?
3. Is this image diagnostic for hemodynamically significant stenosis? Why or why
not.
Question 3:
Patient admitted with sudden onset of LT sided weakness and aphasia x 48 hours.
Carotid duplex ordered and you obtain this image of RT ICA.
1. Considering patient symptoms, is this a TIA? Why or why not?
2. Considering velocities, what does this image indicate?
3. Describe waveform down stream from this current location.
Question 4:
Consider this image.
1. Which vessel is is sample gate positioned?
2. Is the cursor parallel to vessel wall?
3. Is velocity measurement reliable? Why or why not?
4. How would you optimize image? List two items
Question 5:
Review ultrasound image and answer following questions:
1. The red arrows indicate what on grayscale?
2. How would you describe surface? How would you describe echogenicity?
3. Color is activated with image ‘B’, what is term used to describe color patterns
center of blood flow? Why is this happening?
4. At which locations will you sample blood flow to determine velocities with this
finding? Why will we sample blood flow in these locations?
Question 6:
The surface of this plaque is a potential source of emboli. True or False?
Question 7:
Is this a high resistant or low resistant waveform? Why? Please explain why the
CCA waveform.
Question 8:
Patient is 38 y/o female with stroke like symptoms. No risk factors or medical
history. You take this image of distal ICA.
1. What is the sonographic description of distal ICA?
2. What does this indicate or what is possible diagnosis?
3. Is this related to atherosclerosis?
4. What is important in patient clinical presentation for possible diagnosis?
5. Which other vessels most likely impacted by this?
Question 9:
You obtain these images of vertebral arteries.
1. What is this finding right side?
2. What does this indicate?
3. Where is obstruction?
4. Vertebral artery feeds which portion of brain?
5. The two vertebral arteries unite to form?

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