100+ Free RPVI Practice Questions

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On great saphenous vein (GSV) reflux mapping, Valsalva or distal compression-release shows reverse flow of 1.2 sec at the saphenofemoral junction. The GSV diameter at SFJ is 7 mm. Interpretation:

Perforator incompetence

Significant SFJ/GSV reflux meeting endovenous ablation candidacy threshold

Deep vein insufficiency

No reflux

to track

2026 Statistics

Key Facts: RPVI Exam

185

Total Items

Includes PACSim interpretation

4 hrs

Exam Time

APCA

Issuer (NOT CCI)

Alliance for Physician Cert (Inteleos)

ABS 2026

Required for

Vascular Surgery Certifying Exam

APCA RPVI is the physician credential for vascular ultrasound interpretation. 185 items including PACSim simulation, 4 hours. Issued by APCA (Inteleos), NOT CCI. Beginning 2026, ABS Vascular Surgery Certifying Exam candidates must hold RPVI. Master SRU 2003 ICA criteria, ABI/TBI, complete duplex DVT protocol, AAA SVS thresholds, RAS criteria (PSV >180, RAR >3.5), and IAC accreditation standards.

Sample RPVI Practice Questions

Try these sample questions to test your RPVI exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to the Doppler equation, the frequency shift detected by a duplex ultrasound system is directly proportional to all of the following EXCEPT:

A.Reflector velocity

B.Transmitted frequency

C.Cosine of the insonation angle

D.Speed of sound in tissue

Explanation: The Doppler equation is fD = (2 × fT × v × cos θ) / c. Frequency shift is directly proportional to velocity, transmitted frequency, and cosine θ, but inversely proportional to the propagation speed of sound (c).

2A vascular study uses a 5 MHz transducer at a pulse repetition frequency (PRF) of 8 kHz. What is the Nyquist limit for unambiguous Doppler velocity sampling?

A.2 kHz

B.4 kHz

C.8 kHz

D.16 kHz

Explanation: The Nyquist limit equals PRF/2. With PRF = 8 kHz, the maximum unambiguous Doppler shift is 4 kHz; shifts above this value alias.

3Which of the following adjustments will reliably reduce or eliminate color Doppler aliasing in a high-velocity ICA jet?

A.Decrease the PRF (velocity scale)

B.Increase the PRF (velocity scale)

C.Decrease the gain

D.Increase the wall filter

Explanation: Aliasing occurs when the Doppler shift exceeds the Nyquist limit (PRF/2). Increasing the PRF/scale raises the Nyquist limit and resolves aliasing. Other valid options include lowering the transducer frequency or increasing the angle (less ideal).

4Society of Radiologists in Ultrasound (SRU 2003) consensus recommends keeping the Doppler insonation angle at:

A.≤ 30 degrees

B.≤ 45 degrees

C.≤ 60 degrees

D.Exactly 90 degrees

Explanation: Velocity measurements should be obtained with the Doppler beam at an angle of 60 degrees or less to the vessel axis. Angles approaching 90 degrees yield no detectable shift; angles above 60 degrees magnify error from cosine variability.

5Power Doppler differs from color Doppler in that power Doppler:

A.Provides directional information about flow

B.Displays the integrated power of the Doppler signal independent of velocity or direction

C.Is more susceptible to aliasing

D.Requires the lowest gain settings to function

Explanation: Power Doppler encodes the amplitude (power) of the Doppler signal, giving better sensitivity to slow flow and being independent of angle, direction, and aliasing. It does not display directional or velocity information.

6Spectral broadening on a Doppler waveform reflects:

A.Excess transducer pressure

B.A widened range of velocities within the sample volume, often due to turbulence or stenosis

C.Improper angle correction above 60 degrees

D.Loss of low-frequency wall filter cutoff

Explanation: Spectral broadening represents simultaneous detection of a wide spectrum of velocities, classically seen with poststenotic turbulence or with an oversized sample volume in laminar flow.

7Continuous-wave (CW) Doppler differs from pulsed-wave (PW) Doppler in that CW Doppler:

A.Has range resolution along the beam path

B.Cannot measure very high velocities without aliasing

C.Has no Nyquist limit and can record very high velocities but lacks range resolution

D.Requires angle correction within 30 degrees

Explanation: CW Doppler uses two transducer elements (transmit and receive continuously), so there is no PRF and no Nyquist limit; it accurately captures very high velocities but cannot localize them to a specific depth.

8Which artifact appears as a mirror-image color signal beyond a strong specular reflector such as the pleura or diaphragm?

A.Mirror-image artifact

B.Twinkle artifact

C.Edge shadowing

D.Comet tail

Explanation: Mirror-image artifact creates a duplicated color/spectral signal on the deep side of a strong reflector because of multiple reflections; commonly seen with subclavian artery imaging beyond the pleura.

9Resistive index (RI) is calculated as:

A.(PSV − EDV) / PSV

B.PSV / EDV

C.(PSV + EDV) / 2

D.EDV / PSV

Explanation: RI = (peak systolic velocity − end-diastolic velocity) / peak systolic velocity. RI ranges from 0 to 1 and increases with downstream resistance.

10Which transducer frequency is most appropriate for evaluating the deep abdominal aorta in an average-sized adult?

A.2–5 MHz curvilinear

B.7–10 MHz linear

C.12–18 MHz linear (hockey stick)

D.1 MHz CW pencil probe

Explanation: Lower frequencies (2–5 MHz) provide adequate penetration for deep abdominal structures. Higher frequencies sacrifice depth for resolution.

About the RPVI Exam

APCA physician-level credential for interpreting vascular ultrasound studies. NOTE: APCA is the physician-credentialing arm of Inteleos (sister to ARDMS) — RPVI is NOT a CCI credential. The exam (PVI — Physicians' Vascular Interpretation) includes 185 items with PACSim interpretation simulation. Validates physician-level expertise in vascular physics, cerebrovascular duplex (NASCET/SRU criteria), peripheral arterial (ABI/segmental/waveforms), peripheral venous (DVT, reflux), abdominal vascular (AAA, renal, mesenteric, TIPS, transplant), and IAC accreditation/reporting standards. Beginning 2026, ABS Vascular Surgery Certifying Exam candidates MUST hold RPVI.

Questions

185 scored questions

Time Limit

4 hours

Passing Score

Scaled

Exam Fee

Per APCA (APCA (Alliance for Physician Certification & Advancement, Inteleos))

RPVI Exam Content Outline

15%

Vascular Physics & Instrumentation

Doppler equation, angle ≤60°, Nyquist (PRF/2), CW vs PW, color/power Doppler

25%

Cerebrovascular

SRU 2003 ICA criteria, NASCET/ECST, vertebral, subclavian steal, TCD windows + Lindegaard

20%

Peripheral Arterial

ABI/TBI, segmental pressures, waveforms, bypass surveillance Vr >3.5, pseudoaneurysm

15%

Peripheral Venous

Complete compression DVT, reflux thresholds, May-Thurner, EHIT, vein mapping

15%

Abdominal Vascular

AAA SVS thresholds, renal artery (PSV/RAR), mesenteric (Moneta), portal/TIPS, transplant

10%

Quality, Accreditation, Reporting

IAC vascular accreditation, ACR, reporting standards, physician interpretation

How to Pass the RPVI Exam

What You Need to Know

Passing score: Scaled
Exam length: 185 questions
Time limit: 4 hours
Exam fee: Per APCA

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

RPVI Study Tips from Top Performers

1Master SRU 2003 ICA stenosis criteria: PSV/EDV/ICA-CCA ratio thresholds for <50%, 50-69%, ≥70%, near-occlusion, occlusion

2Memorize ABI thresholds: >1.0 normal, 0.71-0.99 mild PAD, 0.41-0.70 moderate, ≤0.40 severe; >1.40 noncompressible → TBI

3Know AAA SVS repair thresholds: ≥5.5 cm men, ≥5.0 cm women, or rapid expansion >0.5 cm in 6 months

4Apply RAS duplex criteria: renal artery PSV >180-200 cm/s + RAR (renal-aortic ratio) >3.5 = ≥60% RAS; tardus parvus distally

5Understand renal transplant Doppler: intrarenal RI elevation suggests rejection/ATN; tardus parvus indicates artery stenosis

Frequently Asked Questions

Is RPVI a CCI or APCA credential?

RPVI is APCA-issued. APCA (Alliance for Physician Certification & Advancement) is the physician-credentialing arm of Inteleos — sister to ARDMS. RPVI is sometimes mistakenly listed as CCI but CCI's analogous physician credential is RPhS (Registered Phlebology Sonographer), not RPVI. RPVI is the exam most vascular surgeons and vascular medicine physicians pursue.

Why is RPVI required for ABS Vascular Surgery starting 2026?

Starting in 2026, the American Board of Surgery (ABS) Vascular Surgery Certifying Exam requires candidates to hold the APCA RPVI credential prior to sitting for the certifying exam. This change formalizes physician competency in vascular ultrasound interpretation as a prerequisite for vascular surgery board certification — a significant change for vascular surgery training programs.

What is PACSim?

PACSim is APCA's interpretation simulation component embedded in RPVI and other physician exams. Candidates view actual vascular ultrasound studies on a PACS-style interface and answer questions about the imaged anatomy and pathology — testing real-world interpretation skills beyond traditional MCQ recall. The format makes the RPVI exam meaningfully harder than purely text-based MCQs.

How should I study for RPVI?

Plan 100-160 hours over 16-20 weeks. Focus heaviest on Cerebrovascular (25%) and Peripheral Arterial (20%) — together nearly half the exam. Master SRU 2003 ICA stenosis criteria, ABI/TBI calculation, complete duplex DVT protocol, AAA management thresholds, and IAC accreditation standards. Get hands-on with PACS-style interpretation tools — review actual cases.