Semin intervent Radiol 2013; 30(04): C1-C6
DOI: 10.1055/s-0033-1359739
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Post-Test Questions

Further Information

Publication History

Publication Date:
20 November 2013 (online)

Article One (333–339)

  1. The most common cause of primary postpartum hemorrhage (PPH) is:

    • Genital tract lacerations

    • Coagulation defects

    • Uterine atony

    • Retained products of conception

  2. Ideally, uterine artery pseudoaneurysms should be treated with:

    • Gelfoam

    • Coils or vascular plugs

    • Medium sized particles

    • Autologous clot

  3. Which of the following statement is TRUE?

    • The incidence of placenta accreta is increasing

    • Major complications associated with uterine artery embolization (UAE) in the setting of PPH are common

    • Postprocedurally, it is never appropriate to leave arterial access in place

    • Gelfoam embolization must be performed through a 5-French catheter

    Article Two (340–346)

  4. Which of the following statements is TRUE when comparing myomectomy and uterine embolization?

    • The two procedures have never been studied directly in randomized controlled trials.

    • Nearly half of all patients who undergo myomectomy eventually require hysterectomy

    • About one-third of all patients who undergo uterine embolization eventually require definitive surgery

    • Quality of life following both procedures has favored myomectomy in one RCT and shown no preference between the procedures in another RCT

    • All are true.

  5. Long-term results from multiple studies demonstrate what percentage of patients who initially undergo uterine embolization for fibroids eventually need a hysterectomy?

    • 5%

    • 10%

    • 20%

    • 30%

    • 50%

  6. Approximately what percentages of patients have symptomatic control in the first 12 months following uterine embolization?

    • 50%

    • 66%

    • 75%

    • 80%

    • 90%

    Article Three (347–353)

  7. MR-HIFU treats uterine fibroids using which of the following mechanisms?

    • Cryoablation

    • Radiofrequency ablation

    • Embolization

    • Thermal ablation

  8. Which of the following is a definite contraindication to MR-HIFU treatment of uterine fibroids?

    • Prior MRgFUS treatment

    • Subserosal intracavitary fibroid

    • Current pregnancy

    • Adenomyosis

  9. All of the following structures must be manipulated out of the beam path except:

    • Bowel

    • Urine-filled urinary bladder

    • Abdominal cutaneous scar

    • Sacral nerves

    Article Four (354–363)

  10. What is the typical location of bupivacaine injection for a superior hypogastric nerve block?

    • Adjacent to the uterus on either side

    • Along the anterior aspect of the vertebral bodies just below the aortic bifurcation, typically L4 or L5

    • L4/5 and L5/S1 neuro foramen bilaterally

    • At the sciatic notch bilaterally

    • At the groin access site

  11. The suggested preprocedure medical regimen includes each of the following except:

    • Intramuscular ketorolac (Toradol)

    • Intravenous long-acting narcotics (such as hydromorphone hydrochloride [Dilaudid])

    • Implementation of a patient controlled anesthesia (PCA)

    • Intravenous Fentanyl citrate (Fentanyl)

    • Intravenous ondansetron (Zofran)

  12. Which of the following factors have been shown to predict postprocedure pain and efficacy?

    • Size of uterine fibroids

    • Number of uterine fibroids

    • Embolization endpoint

    • Age of the patient

    • Nature of preprocedural symptoms (bleeding, bulk, etc.)

    Article Five (364–371)

  13. Which of the following embolic agents should NOT be used during embolization of fast-flow vascular malformations?

    • N-butyl cyanoacrylate

    • Ethylene-vinyl alcohol copolymers

    • Polyvinyl alcohol particles

    • Gelfoam slurry

    • None of the above

  14. The following is NOT typically associated with Klippel-Trenaunay syndrome.

    • High-flow arteriovenous malformations

    • Soft tissue and osseous hypertrophy

    • Port-wine stain

    • Venous varicosities

    • All of the above

  15. MRI is a helpful imaging modality because it improves visualization of the:

    • Extension of a lesion into the adjacent soft tissues

    • Velocity measurements through the vascular anomalies

    • Small calcifications associated with phleboliths

    • All of the above

    Article Six (372–380)

  16. Pelvic varices can be caused by

    • Intrinsic pelvic pathology

    • Pelvic venous insufficiency

    • Lower extremity insufficiency

    • A and C

    • All of the above

  17. Presenting clinical findings of patients with pelvic congestion include:

    • Postural pelvic pain

    • Dyspareunia and post-coital ache

    • Ovarian point tenderness

    • Urinary frequency

    • All of the above

  18. A workup of patients with chronic pelvic pain that includes pelvic examination, laparoscopy, ultrasound, and venography may find PCS in what percent of patients?

    • 10%

    • 30%

    • 60%

  19. Which of the following statements is FALSE?

    • PCS has been treated successfully with the following strategies: (1) coil embolization of the left ovarian vein: (2) bilateral ovarian and internal iliac branch embolization; (3) sclerosis of the left ovarian vein and pelvic varicosities with 3% sodium tetradecyl sulfate foam

    • Embolization provides the same or better results than hysterectomy with bilateral oophorectomy

    • Recurrence rates of pelvic pain after treatment are 20%

    • A small percentage of patients get worse following treatment

    • PVI may be secondary to renal vein compression

    Article Seven (381–387)

  20. In the United States, the most popular form of contraception is:

    • Condom and other barrier methods

    • Oral contraceptives

    • Intrauterine device

    • Tubal ligation

  21. In fallopian tubes occluded proximally, fluoroscopic tubal catheterization is successful in establishing patency in:

    • 10 to15%

    • 30 to 40%

    • 50 to 60%

    • More than 90%

  22. Attempts to occlude fallopian tubes nonsurgically date back to:

    • The 1850s

    • Early 1900s

    • The 1950s

    • The 1980s

    Article Eight (388–393)

  23. What would be the basic CEAP classification for a woman with symptomatic varicose veins, leg edema, and healed venous ulcers? She undergoes Duplex evaluation, which demonstrates reflux of the great saphenous vein above and below the knee with incompetent thigh perforator veins. There is no current thrombus or evidence of chronic thrombus.

    • C2,3,5S Ep As,p, Pr2,3,17

    • C2,3,5S Ep As,p, Pr

    • C5S Ep As,p, Pr

    • C2s

  24. Which of the treatments for venous insufficiency would be contraindicated in the patient with right-to-left shunt, including patent foramen ovale?

    • Surgical venous stripping

    • Endovascular laser ablation

    • Endovascular radiofrequency ablation

    • Foam sclerotherapy

    • Conservative hemodynamic cure of venous insufficiency (CHIVA)

  25. Which therapy should be considered for a woman with varicose veins and no contraindications to therapy?

    • Compression stockings

    • Endovascular laser ablation

    • Sclerotherapy

    • Surgical venous stripping

    • Conservative medical management

    Article Nine (394–402)

  26. What is a strategy for reducing fluoroscopy dose?

    • Use of increased magnification to improve visualization

    • Decrease the distance between the patient and the X-ray tube

    • Increase the distance between the patient and image intensifier

    • Removal of the grid

  27. Which of the following is FALSE regarding the procedures commonly performed during pregnancy?

    • Pregnancy predisposes to development of deep venous thrombosis beginning in the first trimester

    • Nephrostomy changes should be scheduled every 10 to 12 weeks to reduce radiation to the fetus

    • Postpartum hemorrhage can occur secondary to uterine atony, uterine arterial injury or AV fistula, and placenta accreta or increta.

    • Pelvic trauma can lead to fracture of the pelvic ring, internal iliac artery injuries, and placental abruption, with high risk for fetal mortality.

  28. What medication is safe to use in pregnancy?

    • Diazepam

    • Doxycycline

    • Meperidine

    • Gadolinium

    Article Ten (403–407)

  29. Women interventional radiologists represent what percentage of all radiologists?

    • 6%

    • 22%

    • 30%

    • 46%

  30. Which of the following is a FALSE statement regarding radiation exposure during pregnancy?

    • The regulatory limit for fetal exposure is 500 mrem (5 mSv) over the duration of the pregnancy

    • The dose to the fetus of a pregnant interventional radiologist is likely to exceed the threshold doses for deterministic effects such as major malformations

    • The embryo is most sensitive to the effects of radiation during the period of organogenesis

    • The risk of childhood cancer is increased only slightly by a fetal radiation exposure below the regulatory limit

  31. Which of the following techniques reduce the radiation dose to the pregnant interventionalist?

    • Minimize fluoroscopy beam-on time

    • Collimate the beam to minimize scatter

    • Reduce patient dose by decreasing the frame rate to 7.5 frames per second.

    • All of the above.

    • A and C only