RVT study plan

Sketch the aortic arch, carotid bifurcation, and vertebral artery anatomy from memory, labeling ECA versus ICA differentiating features

Recite the velocity and spectral criteria for <50%, 50-69%, 70-99% ICA stenosis and complete occlusion without notes

Identify the technical pitfalls (Doppler angle, sample volume placement, wall filter, gain) that can falsely elevate or lower carotid velocities

Practice 30 minutes of hands-on or simulated knobology, changing scale, baseline, and color box to eliminate aliasing

Explain the hemodynamic rationale for parvus-tardus and tardus waveforms distal to a high-grade stenosis

Interpret vertebral artery spectral waveforms and describe the waveform sequence in subclavian steal

Contrast the expected duplex findings of carotid dissection, fibromuscular dysplasia, and carotid body tumor in writing

Summarize indications, limitations, and typical findings of transcranial Doppler in sickle cell screening and vasospasm monitoring

Classify lower-extremity arterial waveforms as triphasic, biphasic, or monophasic and match each to a physiologic cause

Compare normal, dampened, and absent Doppler signals across proximal, mid, and distal limb segments

Calculate ankle-brachial index, toe-brachial index, and segmental pressure gradients from raw numbers and state the diagnostic category for each

Sequence the cuff placement and limb-position steps for a segmental pressure study and explain how to avoid cuff artifact

Describe the exercise and reactive hyperemia protocols, including indications and contraindications

State duplex velocity criteria for 50% and 70% peripheral arterial stenosis and identify when criteria do not apply (e.g., native versus graft, tandem lesions)

Outline a graft surveillance schedule and the duplex parameters that trigger intervention

Measure and document aortic diameter using outer-wall-to-outer-wall technique and state surveillance intervals by size

Interpret renal artery duplex using the renal-aortic ratio and direct velocity thresholds, and differentiate intrinsic from extrinsic compression

Evaluate celiac and SMA waveforms for stenosis, including the median arcuate ligament pattern

Explain portal vein waveform changes in portal hypertension and the expected findings after TIPS placement

Review the peripheral arterial material from weeks 2-3 and correct every error from the previous deliverable

Describe renal transplant waveforms, resistive index interpretation, and the signs of rejection, stenosis, and thrombosis

Detail mesenteric ischemia duplex findings, including the difference between acute and chronic presentations

Explain hemodialysis access surveillance: flow volume calculation, stenosis criteria, and the causes of access recirculation

Compare duplex appearance of true aneurysm, pseudoaneurysm, and endoleak following endovascular repair

Assemble a one-page summary of visceral and aortic normal values used in reporting

Sequence the lower-extremity venous duplex protocol, including patient positioning, augmentation maneuvers, and the calf vein approach

Differentiate acute from chronic deep vein thrombosis using vein caliber, echogenicity, collapsibility, and flow characteristics

Describe upper-extremity venous protocols, including effort thrombosis and central catheter-related evaluation

Interpret venous insufficiency studies by applying reflux time cutoffs for the great, small, and perforating veins and describing the provocation maneuvers

Outline vein mapping measurements required before bypass or ablation

Explain transducer selection, frequency trade-offs, and ALARA principles including thermal and mechanical indices

Describe routine quality assurance of the ultrasound system: phantom uniformity, sensitivity, axial and lateral resolution, and depth of penetration checks

List the elements of a vascular laboratory quality program including accreditation standards, credentialing, and reporting requirements

Explain specialized testing indications and findings for plethysmography, thoracic outlet maneuvers, cold sensitivity, and photoplethysmographic reflux

Review infection control, ergonomics, and patient safety practices relevant to vascular testing

Complete two full-length timed practice exams under exam-day conditions

Rank performance by domain and re-study the two lowest-scoring domains until scores reach 80% or higher

Rehearse written interpretation templates for the highest-frequency case types across all five domains

Practice single-best-answer strategy: eliminating distractors, identifying absolute words, and pacing 90 seconds per item

Consolidate all cheat sheets into a single final review document