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Vendor: Cisco Exam Code: 200-125 Exam Name: CCNA Cisco Certified Network Associate CCNA (v3.0) Version: DemoDEMO

QUESTION 1 A network administrator needs to configure a serial link between the main office and a remote location. The router at the remote office is a non-Cisco 200-125 dumps router. How should the network administrator configure the serial interface of the main office router to make the connection? A. Main(config)# interface serial 0/0 Main(config-if)# ip address Main(config-if)# no shut B. Main(config)# interface serial 0/0 Main(config-if)# ip address Main(config-if)# encapsulation ppp Main(config-if)# no shut C. Main(config)# interface serial 0/0 Main(config-if)# ip address Main(config-if)# encapsulation frame-relay Main(config-if)# authentication chap Main(config-if)# no shut D. Main(config)# interface serial 0/0 Main(config-if)#ip address Main(config-if)#encapsulation ietf Main(config-if)# no shut Correct Answer: B

QUESTION 2 Which Layer 2 protocol encapsulation type supports synchronous and asynchronous circuits and has built- in security mechanisms? A. HDLC B. PPP C. X.25 D. Frame Relay Correct Answer: B

QUESTION 3 Refer to the exhibit. The two connected ports cissp dumps on the switch are not turning orange or green. What would be the most effective steps to troubleshoot this physical layer problem? (Choose three.)A. Ensure that the Ethernet encapsulations match on the interconnected router and switch ports. B. Ensure that cables A and B are straight-through cables. C. Ensure cable A is plugged into a trunk port. D. Ensure the switch has power. E. Reboot all of the devices. F. Reseat all cables. Correct Answer: BDF

QUESTION 4 A network administrator is troubleshooting the OSPF 100-105 dumps configuration of routers R1 and R2. The routers cannot establish an adjacency relationship on their common Ethernet link. The graphic shows the output of the show ip ospf interface e0 command for routers R1 and R2. Based on the information in the graphic, what is the cause of this problem? A. The OSPF area is not configured properly. B. The priority on R1 should be set higher. C. The cost on R1 should be set higher. D. The hello and dead timers are not configured properly. E. A backup designated router needs to be added to the network. F. The OSPF process ID numbers must match. Correct Answer: D

QUESTION 5 Standard industrialized protocol of etherchannel? A. LACP B. PAGP C. PRP D. REP Correct Answer: A

210-260 dumps QUESTION 6 Two features of the extended ping command? (Choose two.) A. It can send a specific number of packet B. It can send packet from specified interface of IP address C. It can resolve the destination host nameD. It can ping multiple host at the same time Correct Answer: AB

QUESTION 7 What command is used to configure a switch as authoritative NTP server? A. ntp master 3 B. ntp peer IP C. ntp server IP D. ntp source IP Correct Answer: A

QUESTION 8 Two statements about syslog loging? A. Syslog logging is disabled by default B. Messages are stored in the internal memory of device C. Messages can be erased when device reboots D. Messages are stored external to the device E. other F. other Correct Answer: AD

QUESTION 9 How to enable vlans automatically across multiple switches? A. Configure VLAN B. Confiture NTP C. Configure each VLAN D. Configure VTP Correct Answer: D

QUESTION 10 Refer to the exhibit. A network administrator is configuring an EtherChannel 300-101 dumps between SW1 and SW2. The SW1 configuration isshown. What is the correct configuration for SW2? A. interface FastEthernet 0/1 channel-group 1 mode active switchport trunk encapsulation dot1q switchport mode trunk interface FastEthernet 0/2 channel-group 1 mode active switchport trunk encapsulation dot1q switchport mode trunk B. interface FastEthernet 0/1 channel-group 2 mode auto switchport trunk encapsulation dot1q switchport mode trunk interface FastEthernet 0/2 channel-group 2 mode auto switchport trunk encapsulation dot1q switchport mode trunk C. interface FastEthernet 0/1 channel-group 1 mode desirable switchport trunk encapsulation dot1q switchport mode trunk interface FastEthernet 0/2 channel-group 1 mode 640-911 dumps desirable switchport trunk encapsulation dot1q switchport mode trunk D. interface FastEthernet 0/1 channel-group 1 mode passive switchport trunk encapsulation dot1q switchport mode trunk interface FastEthernet 0/2 channel-group 1 mode passive switchport trunk encapsulation dot1q switchport mode trunk Correct Answer: C

300-135 400-051 101 adm-201 1z0-808 CCA-500 1v0-621 mb2-707 70-980 70-483 2v0-621 nse4 1z0-434 9l0-012 101-400 300-085 og0-093 1z0-061 70-488 1z0-062 mb5-705 102-400 PEGACPBA71V1 70-463 mb2-704 PR000041 IIA-CIA-PART1 700-037 PEGACSA71V1 1z0-144 2v0-621d 1z0-051 070-461 a00-211 jn0-102 1z0-804 640-875 API-580 3002 400-151 98-365 712-50 9l0-066 ns0-506 156-215.77 70-466 lx0-104 9a0-385 642-980 og0-091 74-678 700-260 70-494 c_tfin52_66 lx0-103 m70-101 pmi-001 DEV-401 1z0-067 1K0-001 220-801 TB0-123 700-038 IIA-CIA-PART2 cwna-106 070-487 hp0-y50 070-483 mb2-708 C2010-595 1z0-883 c_tadm51_731 pk0-003 700-039 jn0-633 98-364 300-080 74-343 1z0-133 70-465 c_tscm62_66 PRINCE2-PRACTITIONER mb6-704 1v0-605 API-571 500-007 and-401 c_taw12_731 AX0-100 070-463 70-981 1z0-052 070-488 c_hanatec_10 010-111 mb6-700 700-270 600-455 600-460 1z0-533

Treatment Options for AVMs

Treatment options for AVMs have improved dramatically in the past decade. The goal of treating an AVM is to completely close off the abnormal vessels, thereby curing the patient. This can be achieved in a variety of ways and requires a team of highly experienced specialists to provide the safest methods available posing minimal risks for individuals with AVMs.

Types of Treatments Available for AVMs

Conventional Surgery

In many cases, surgery may be recommended to completely remove the AVM. This is appropriate when the AVM is small and located on the surface of the brain or spinal cord. When the AVM is deep in the brain, other minimally invasive techniques are used to prevent damage to surrounding tissue.


This procedure is done through a catheter temporarily inserted in the groin, places glue or other substances such as onyx right into the abnormal vessels of the AVM  to help close them off. Although several AVMs have been cured with this procedure alone, it is most often used in conjunction with surgery or radiation to reduce the size and flow of blood to an AVM, thereby making other treatments safer and more effective.  Liquid embolic products are used to treat both aneurysms (weakened balloon-like portions of a vessel) and arterio-venous malformations (the abnormal growing together for arteries and veins forming a web-like mass). The embolic material is injected in a liquid form through a small micro-catheter into the effected area, where it begins to solidify, reducing the pressure and likelihood of rupture. Unlike glues, Onyx Material is non-adhesive and provides a more controlled delivery and set up. The embolic agent used will depend totally on the rate of flow and size of the AVM.
The below image shows onyx being inserted into an AVM.

Absolute Ethanol

The history behind absolute ethanol as an intravascular embolic agent, its mechanism of action, and applications of its use.

By Wayne F. Yakes, MD, FSIR, FCIRSE

Embolotherapy is a burgeoning field developed by the subspecialties of interventional radiology and interventional neuroradiology and is rapidly being embraced by neurosurgeons, neurologists, vascular surgeons, and cardiologists who began performing minimally invasive catheter-directed procedures in recent years. The vast array of embolic agents that can be superselectively delivered with multiple catheter systems and direct puncture needles has blossomed due to the innovative ideas of numerous investigators and has led to improved quality and lower costs of care, quicker patient recuperation times, and the better outcomes that our patients deserve. This article describes the current uses of absolute ethanol as an embolic agent.


Particulate agents, coils, and detachable balloons dominated the early years of embolotherapy. Prof. Plinio Rossi was the first to develop selective catheter arteriography of the brachiocephalic arteries. In the late 1960s, Prof. Rossi had a scientific exhibit at Karolinska University Hospital in Stockholm, Sweden (P. Rossi, oral communication, September 1994; later collaborated by T. H. Newton, oral communication, October 1997) where he described his pioneering selective catheter technique to Prof. Hans Newton. Previously, only a technique using direct carotid injections with 18-gauge needles was employed. This method of selective catheterization along the carotid artery distribution gave rise to the concept of selective catheter delivery of contrast and embolic agents in other arterial anatomies as well.

In the late 1960s, Prof. Fedor A. Serbinenko pioneered catheter systems to navigate the internal carotid artery to the level of the cavernous carotid artery to deliver his hand-made detachable balloons to treat carotid-cavernous fistulas, either resulting from trauma or aneurysm rupture.1 By the early 1970s, Prof. Charles Kerber began working with isobutyl cyanoacrylate (IBCA).2 When he finished his neuroradiology fellowship under Prof. Newton, he then became a staff neuroradiologist at the University of Oregon Health Sciences Center in Portland, Oregon (as an aside, Prof. Kerber performed the first carotid angioplasty). 3

Prof. Kerber took the next step and developed microcatheter systems to navigate the cerebral vasculature (a calibrated-leak balloon catheter system) and many other pioneering developments.4 Because the lumen size of the calibrated-leak balloon system was small (no wire system was developed for it yet), only liquid agents were able to be injected through this catheter system. Prof. Kerber then integrated his work with IBCA, making embolization of cerebral arteriovenous malformations (AVMs) possible. Prof. Charles Dotter broke into Prof. Kerber’s desk to use the IBCA to close pelvic vasculature trauma while Prof. Kerber was on vacation (C. Kerber, oral communication, July 1998).

Because the concept of selective catheterization in arterial systems was firmly in place, investigators aggressively pursued transcatheter delivery of many embolic agents. Dr. Brian Elman first developed preoperative transcatheter embolization of renal cell carcinomas with absolute ethanol.5 Absolute ethanol proved to be a superior embolic agent to particle and coil renal artery embolization due to the absence of any postembolization infarction syndrome. Other indications for the use of absolute ethanol soon came to light (see the Current Indications for the Use of Ethanol as an Embolic Agent sidebar).6


Before the etiology of postethanol injection-cardiopulmonary (CP) collapse was elucidated, it was a rare but dire complication. A bolus of ethanol reaches the pulmonary vascular bed, and pulmonary artery spasm can then occur. If the spasm becomes severe enough, it can lead to pulmonary hypertension and right heart failure, which causes decreased left heart filling and resultant systemic hypotension. Severe systemic hypotension causes decreased coronary artery perfusion. If severe enough, this can lead to cardiac arrhythmias such as electromechanical dissociation and asytole.

Prof. Young Soo Do and coinvestigators7 published an AVM treatment series showing that if the operator does not exceed 0.14 mL of ethanol/kg of body weight during a 10-minute period, CP collapse will not occur. I did a prospective in-house study of > 200 consecutive procedures in conjunction with my anesthesiologists. When treating high-flow lesions (AVMs/arteriovenous fistulas [congenital and acquired]), as well as low-flow lesions (venous malformations, lymphatic malformations, mixed lesions), with endovascular ethanol in doses of 0.1 mL/kg ideal body weight every 10 minutes, pulmonary pressures never increased to any significant degree, and CP collapse was obviated. Therefore, if one stays within these parameters for any intravascular ethanol procedure, CP collapse should not occur.

If a patient has pulmonary hypertension (whatever the etiology), they should have an arterial line placed and Swan-Ganz catheter monitoring of pulmonary pressures during the ethanol procedure. Small ethanol amounts can worsen their pulmonary hypertension and cause CP collapse.


Absolute ethanol is a liquid embolic agent that penetrates to the capillary bed levels. Because of the distal penetration to the capillary bed level, tissues are totally devitalized, and infarcted collateral flow cannot occur. Therefore, great care and vigilance must be maintained to prevent unwarranted, nontarget embolization of vascular territories with ethanol. When injected into any vascular space (arterial, venous, lymphatic), ethanol denudes the endothelial cell from the vascular wall and precipitates its protoplasm. The denuded vascular wall is then fractured to the level of the internal elastic lamina. Platelet aggregation then occurs on the fractured and denuded vascular wall. Thus, thrombosis occurs beginning at the vascular wall with more and more accumulation until it thromboses centrally in the vascular lumen.

In vascular malformations, the endothelial cell is the reason recurrences are so common with embolic agents other than ethanol. The acute thrombosis that occurs with any embolic agent (polyvinyl alcohol, coils, glues, etc.) produces an ischemic state that is sensed by the intact endothelial cell lining of all vascular surfaces. Reacting to the acute ischemic state caused by the thrombosis, the endothelial cell releases chemotactic cellular factor and angiogenesis factor. Chemotactic cellular factor causes the migration of macrophages that carries off the intravascular debris formed during the embolization procedure. After there is significant debris removal, the endothelial cell then re-endothelializes the “new” lumen, which recanalizes the vascular malformation, leading to recurrences. The angiogenesis factor secreted by the endothelial cell stimulates new vascularity to the thrombosed ischemic area of the vascular malformation. This is called the “neovascular stimulation phenomenon” or “neovascular recruitment phenomenon.”

By using ethanol as an embolic agent, you can destroy the endothelial cell, and these two phenomena of recanalization and neovascular recruitment are noticeably absent. Thus, there is a permanence of treatment, and cures are now possible.


Absolute ethanol as an intravascular embolic agent must be respected. Inadvertent nontarget ethanol embolization must be completely obviated or devitalization of tissues with resultant necrosis will invariably occur. Unopacified ethanol as an embolic agent can be challenging to use successfully when one is only used to visualizing embolic agents fluoroscopically. Adhering to an ethanol injection protocol that does not exceed 0.1 mL/kg ideal body weight every 10 minutes will obviate the need for Swan-Ganz catheter monitoring of pulmonary artery pressure and arterial line monitoring of systemic arterial pressures unless the patient suffers from chronic pulmonary artery hypertension. Absolute ethanol has many indications for the treatment of the previously listed pathologic conditions, and investigators will invariably develop more indications for its use in the future.

Wayne F. Yakes, MD, FSIR, FCIRSE, is the Founder and Director of the Vascular Malformation Center in Englewood, Colorado. He has disclosed that he has no financial interests related to this article. Dr. Yakes may be reached at wayne.yakes@vascularmalformationcenter.com.

To view in PDF Format
Sclerogel . Treatment for Venous Malfomations
While this is not yet approved by the FDA it’s being tested in other countries. It the documentation says that is being used  successfully for the treatment of low flow venous malformations .

See PDF Below



This is a non-invasive way of treating AVMs that cannot be safely removed with surgery. Radiation delivered in one dose as an outpatient works over several years to gradually clog off the flow of blood into the AVM. The CyberKnife method  has been a very effective tool to treat even the most difficult AVMs.
Novalis TX
There have been exciting recent advances in stereostatic radiosurgery treatments for cancer patients that have recently started being used for people with AVMs, take a look at the links below…
These treatments are now being offered at the following two centres in the UK, if you have an AVM and looking for a prospective treatment, you can contact the two hospitals below for more information
Western General Hospital
Crewe Road South
Edinburgh, EH4 2XU, Scotland
+44 131 537 1000
Clatterbridge Cancer Centre Liverpool
Lower Lane
Liverpool, L9 7BA, United Kingdom
+44 (0)151 514 2800


T Muir1, A Fall2, A Guhan3, G Kessell4, V Miller5

1 Plastic and Reconstructive Surgery Department, James Cook University Hospital, Middlesbrough, North Yorkshire, UK
2 Paediatric Department, James Cook University Hospital, Middlesbrough, North Yorkshire, UK
3 Medical Department, James Cook University Hospital, Middlesbrough, North Yorkshire, UK
4 Anaesthetic Department, James Cook University Hospital, Middlesbrough, North Yorkshire, UK
5 Psychology Department, James Cook University Hospital, Middlesbrough, North Yorkshire, UK

Introduction and aims: Intralesional bleomycin sclerotherapy has been offered to 63 of 238 patients presenting with haemangiomas and vascular malformations in our centre over the last three years.

Methods: Clinical response, administered dose, amount of sessions and complications were recorded. 42 of the 66 patients have completed their treatment thus far. Respiratory surveillance is provided by an adult and paediatric pulomonologist utilising the locally agreed Cleveland malformation surveillance protocol.

Results: Thirteen children and 29 adults completed treatment with a mean of 3.4 sclerotherapy sessions. 17% of children treated were under the age of 1. Treatment lasted for an average of 88 days. 43% of patients received prior treatment other than bleomycin. The following pathologies were treated: haemangioma 10, venous malformation 26, lymphatic malformation 4, capillary malformation 1, AVM 1. Complete resolution occurred in 66%, with an overall response rate of 98%. Skin ulceration occurred in 1 patient, minor blistering in 5, infection 1, swelling 1, headache 1, bruising, skin rash 1 and skin pigmentation occurred in 3 patients. The maximum administered dose was 3 mg/kg.

Conclusion: Predictable results were obtained with a high success rate. No systemic or pulmonary complications occurred. Secondary treatment, apart from bleomycin sclerotherapy was only needed in two patients with partially resoluted hemangiomas.