10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The RPhS exam has 170 questions and runs 2 hours 50 minutes.
These 10 free RPhS questions are organized by exam domain, so you can see how each part of the Registered Phlebology Sonographer blueprint is tested. Reveal the answer and explanation under each question.
During tumescent lidocaine infiltration for endovenous treatment, an awake patient develops tinnitus and a metallic taste, then becomes agitated and has a generalized seizure. The injection is stopped, emergency help is called, and airway and seizure care begin. Which cause-specific emergency pathway is indicated?
Correct answer: B - Local-anesthetic toxicity management with 20% intravenous lipid emulsion
A woman describes years of symmetric enlargement of her thighs and calves that began around puberty. The tissue is tender, she bruises easily, and there is an abrupt cuff above each ankle with sparing of the feet. Duplex shows no significant venous reflux or obstruction. Which diagnosis best brings these findings together?
Correct answer: D - Lipedema
Examination reveals a dense, fan-shaped network of small intradermal veins around the medial ankle and onto the foot. There is no edema, pigmentation, eczema, induration, or ulcer history. Which 2020 CEAP clinical class captures this ankle-flare pattern?
Correct answer: D - C4c
An ambulatory adult with new unilateral leg swelling has a two-level DVT Wells score of 3. A technically adequate proximal compression ultrasound is negative; calf veins were not examined. The D-dimer is positive. Under NICE NG158, what follow-up is required to complete the diagnostic pathway?
Correct answer: D - Repeat proximal leg vein ultrasound in 6 to 8 days.
A standing reflux examination records reproducible retrograde flow lasting 0.8 seconds in the great saphenous vein, 0.7 seconds in the deep femoral vein, and 0.8 seconds in the femoral vein after appropriate provocation. Using SVS/AVF/AVLS definitions, which veins meet the duration criterion for reflux?
Correct answer: B - The great saphenous and deep femoral veins
At mid-thigh, the femoral vein divides into two parallel channels that reunite above and below the segment. One channel collapses completely. The other is enlarged, contains hypoechoic material, and remains noncompressible with adequate transverse pressure. Color flow is seen only in the compressible channel. What belongs in the interpretation?
Correct answer: C - Deep venous thrombosis in one channel of a duplicated femoral vein
Duplex for right-arm swelling in a patient with a PICC shows compressible brachial and axillary veins. With symmetric arm positioning, the right subclavian waveform is continuous and damped, while the left retains normal respiratory variation. The medial right subclavian and brachiocephalic segments are obscured by bone. Which conclusion is justified?
Correct answer: A - Central venous outflow obstruction remains a concern despite peripheral patency.
A 72-year-old with an active medial-ankle ulcer has superficial venous reflux and peripheral arterial disease, without rest pain or foot necrosis. Systolic pressures are 160 mmHg in the right arm, 140 mmHg in the left arm, 104 mmHg at the affected dorsalis pedis artery, and 112 mmHg at the affected posterior tibial artery; toe pressure is 52 mmHg. Under the ESVS 2022 approach to mixed arterial-venous ulcers, which ABI and compression plan are supported?
Correct answer: C - ABI 0.70; consider supervised modified compression below 40 mmHg
Following thermal treatment of the below-knee great saphenous vein, a patient notices new numbness along the medial calf extending toward the medial ankle. Ankle dorsiflexion and plantar flexion remain normal. The sensory distribution most strongly implicates which nerve?
Correct answer: A - Saphenous nerve
During ultrasound-guided foam sclerotherapy, a transverse image shows a bright needle echo centered in a tributary. Blood returns through the needle, but its distal tip has not been separately identified. Which maneuver resolves the remaining uncertainty before injection?
Correct answer: C - Track the needle tip by sweeping the imaging plane.
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