Semester Pool Flashcards by Lindsey Kaminski

A communication between the ascending aorta and the main pulmonary artery is called:
-Patent ductus arteriosus
-Coarctation of the aorta
-Aortopulmonary window
-Supracristal ventricular septal defect

Aortopulmonary window

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A complete atrioventricular septal defect is ostium primum atrial septal defect with:
- Canal (inlet)-type ventricular septal defect, common atrioventricular valve
-Cleft mitral valve
-Canal (inlet)-type ventricular septal defect, patent ductus arteriosus
-Coarctation of the aorta

Canal (inlet)-type ventricular septal defect, common atrioventricular valve

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A congenital malformation of the tricuspid valve in which one, two or all three leaflets are displaced downward from the annulus with right ventricular dysplasia (atrialization) is known as:
-Tricuspid stenosis
-Tricuspid atresia
-Epstein-Barr anomaly
-Ebstein’s anomaly

Ebstein’s anomaly

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A defect is found in the central portion of the inter-atrial septum. The type of atrial septal defect present is:
-Coronary sinus
-Sinus venosus
-Ostium secundum
-Ostium primum

Ostium secundum

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A membrane stretching from the left side of the interventricular septum to the right side of the anterior leaflet of the mitral valve is called:
-Aortic dissection
-Hourglass aortic stenosis
-“Strand” aorta
-Discrete subaortic stenosis

Discrete subaortic stenosis

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A patient with a long-standing history of systemic hypertension is sent to the emergency room after developing chest pain that radiated to the back. The electrocardiogram demonstrated left ventricular hypertrophy and the chest roentgenogram revealed a widening of the superior mediastinum. A possible diagnosis is:
-Pericarditis
-Acute severe mitral regurgitation
-Mitral stenosis
-Aortic dissection

Aortic dissection

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A possible etiology for aortic aneurysm is:
-Marfan syndrome
-Coronary artery disease
-Dilated cardiomyopathy
-Aortic regurgitation

Marfan syndrome

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A potential complication of patent foramen ovale is:
-Congestive heart failure
-Mitral valve stenosis
-Valvular stenosis
-Paradoxical embolus

Paradoxical embolus

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A redundancy of the mid-portion of the atrial septum which may result in an inter-atrial shunt is called:
-SAM
-DSS
-ASH
-ASA

ASA

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A two-dimensional echocardiographic finding for an aortic intimal flap indicates aortic:
-Stenosis
-Regurgitation
-Aneurysm
-Dissection

Dissection

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All of the following are associated echocardiographic findings for atrial septal defect EXCEPT:
-Paradoxical interventricular septal motion
-Left ventricular enlargement
-Right ventricular enlargement
-Right atrial enlargement

Left ventricular enlargement

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All of the following are associated with pulmonary stenosis EXCEPT:
-Systolic doming of the pulmonary valve
-Right ventricular hypertrophy
-Pulmonary regurgitation
-Coarctation of the aorta

Coarctation of the aorta

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All of the following are true concerning supravalvular aortic stenosis EXCEPT:
-Left ventricular volume overload
-Hourglass type associated with Williams syndrome
-Parasternal long-axis view allows visualization
-Associated with proximal coronary artery dilatation

Left ventricular volume overload

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All of the following surgical repairs for congenital heart disease are correctly matched EXCEPT:
-Fontan: Single ventricle repair
-Modified Glenn: Superior vena cava to the right pulmonary artery
-Blalock-Taussig: Right subclavian artery to the right
pulmonary artery
-Ross: Surgical ligation of a patent ductus arteriosus

Ross: Surgical ligation of a patent ductus arteriosus

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An intimal flap in the aorta is discovered in the parasternal long-axis view, suprasternal long-axis view of the aorta and subcostal long-axis of the abdominal aorta. The type of aortic dissection is DeBakey type:
II
I
B
III

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Associated anomalies of sinus of Valsalva aneurysm include all of the following EXCEPT:
-Coarctation of the aorta
-Atrial septal defect
-Bicuspid aortic valve
-Ventricular septal defect

Atrial septal defect

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Congenital heart defects strongly associated with Ebstein’s anomaly include:
-Parachute mitral valve
-Atrial septal defect
-Coarctation of the aorta
-Discrete subaortic stenosis

Atrial septal defect

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Defects associated with tetralogy of Fallot in approximately 30% of cases include:
-Overriding pulmonary artery
-Right aortic arch
-Tricuspid atresia
-Bicuspid aortic valve

Right aortic arch

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Echocardiographic criteria for the diagnosis of aortic dissection include all of the following EXCEPT:
-Pericardial effusion
-Pleural effusion
-Recognition of an intimal flap within the aorta
-Decrease in aortic dimension

Decrease in aortic dimension

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Eisenmenger’s syndrome may be associated with all of the following EXCEPT:
-Bicuspid aortic valve
-Atrial septal defect
-Patent ductus arteriosus
-Ventricular septal defect

Bicuspid aortic valve

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For an agitated saline contrast exam, where will contrast appear proving the patient has an atrial septal defect?
-Main pulmonary artery
-Right ventricle
-Left atrium
-Right atrium

Left atrium

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Important factors in evaluating post-surgical repair of tetralogy of Fallot include all of the following EXCEPT:
-Evaluate right and left ventricular function
-Rule out shunting at the margins of the ventricular septal defect repair
-Rule out residual right ventricular outflow tract obstruction
-Rule out residual shunting at the margins of the atrial septal defect repair

Rule out residual shunting at the margins of the atrial septal defect repair

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In a patient with ventricular septal defect the blood pressure is 120/80 mm Hg and the peak systolic velocity of the ventricular septal defect is 5 m/s. The right ventricular systolic pressure and systolic pulmonary artery pressure is:
120 mm Hg
110 mm Hg
30 mm Hg
20 mm Hg

20 mm Hg

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In coarctation of the aorta blood pressure in the legs:
-Is higher than in the right arm
-Is lower than the right arm
-Is equal to blood pressure in the right arm
-Cannot be compared with blood pressure in the right arm

Is lower than the right arm

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Narrowing of the aortic isthmus is:
-Patent ductus arteriosus
-Aortic arch aneurysm
-Coarctation of the aorta
-Aortic dissection

Coarctation of the aorta

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Patent ductus arteriosus results in
-Left ventricular pressure overload
-Right ventricular pressure overload
-Right ventricular volume overload
-Left ventricular volume overload

Left ventricular volume overload

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Possible complications of aortic dissection include all of the following EXCEPT:
-Pericardial effusion
-Progressive enlargement of the aorta
-Left ventricular inflow tract obstruction
-Aortic regurgitation

Left ventricular inflow tract obstruction

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Prime characteristics of tetralogy of Fallot include all of the following EXCEPT:
-Right ventricular outflow tract obstruction
-Right ventricular hypertrophy
-Atrial septal defect
-Malalignment ventricular septal defect

Atrial septal defect

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The Doppler finding associated with patent ductus arteriosus is:
-Decreased pressure half-time of the mitral valve
-Holodiastolic flow reversal in the descending thoracic aorta
-Increased flow velocity at the aortic isthmus
-Systolic flow reversal in the pulmonary veins

Holodiastolic flow reversal in the descending thoracic aorta

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The _____________ sinus of Valsalva is the most common sinus involved in sinus of Valsalva aneurysm.
-Right
-All three are equally involved in sinus of Valsalva aneurysm
-Non-coronary
-Left

Right

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The cardiac chambers that are enlarged in ventricular septal defect initially are:
-Left atrium; left ventricle
-Right atrium; left atrium
-Right ventricle; left ventricle
-Right atrium; right ventricle

Left atrium; left ventricle

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The cardiovascular abnormalities seen with Marfan syndrome include all of the following EXCEPT:
-Aortic dissection
-Dilatation of the aortic root, sinuses of Valsalva, ascending aorta
-Mitral valve prolapse
-Mitral supravalvular ring

Mitral supravalvular ring

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The congenital heart defect most often associated with Down syndrome (trisomy 21) is:
-Atrioventricular septal defect
-Coarctation of the aorta
-Peripheral pulmonary stenosis
-Tetralogy of Fallot

Atrioventricular septal defect

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The four defects that make up tetralogy of Fallot are right ventricular outflow tract obstruction (e.g., pulmonary stenosis), ventricular septal defect, right ventricular hypertrophy and:
-Deviation of the aorta
-Coarctation of the aorta
-Cleft mitral valve
-Atrial septal defect

Deviation of the aorta

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The most common location for aneurysm of the aorta is the:
-Ascending aorta
-Transverse aorta
-Descending thoracic aorta
-Abdominal aorta

Abdominal Aorta

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The most common type of ventricular septal defect is:
-Outlet (supracristal)
-Trabecular
-Perimembranous
-Inlet

Perimembranous

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The normal Qp/Qs ratio is:
50%
1:1
1:2
2:1

1:1

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The peak velocity across a patent ductus arteriosus is 4 m/s and the blood pressure is 90/60 mm Hg. The systolic pulmonary artery pressure is:
36 mm Hg
26 mm Hg
64 mm Hg
4 mm Hg

26 mm Hg

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The physical finding of cyanosis is most common in:
-Patent foramen ovale
-Pulmonary regurgitation
-Mitral valve prolapse
-Eisenmenger’s syndrome

Eisenmenger’s syndrome

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The type of ventricular septal defect most often associated with ventricular septal aneurysm is:
-Perimembranous
-Outlet
-Trabecular
-Inlet

Perimembranous

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The typical murmur associated with patent ductus arteriosus is:
-Continuous murmur
-Holosystolic murmur
-Decrescendo diastolic murmur
-Late systolic murmur

Continuous murmur

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The view of choice when examining a patient with secundum atrial septal defect is:
-Apical four-chamber
-Parasternal long-axis
-Parasternal short-axis of the aortic valve
-Subcostal four-chamber

Subcostal four-chamber

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Types of supravalvular aortic stenosis include all of the following EXCEPT:
-Hypertrophic
-Dissected
-Tunnel
-Hourglass

Dissected

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Uhl’s anomaly is:
-Right ventricular dysplasia
-Ostium primum atrial septal defect with cleft mitral valve
-Abnormal displacement of the tricuspid valve
-Left atrium aneurysm

Right ventricular dysplasia

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Valvular lesions with which coarctation of the aorta is strongly associated include:
-Bicuspid aortic valve
-Tricuspid atresia
-Aortic valve vegetation
-Aortic valve flail

Bicuspid aortic valve

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When evaluating atrial septal defect flow with color Doppler, the sonographer should:
-Reduce the color velocity scale
-Increase the color Doppler filter
-Invert the color flow map
-Invert the color flow map

Reduce the color velocity scale

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A common echocardiographic finding in a cardiac surgery patient is:
-Paradoxical interventricular septal motion
-Valvular stenosis
-Valvular prolapse
-Pleural effusion

Paradoxical interventricular septal motion

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A common two-dimensional echocardiographic finding in patients with chronic renal failure is:
-Aortic dissection
-Mitral valve prolapse
-Pulmonary hypertension
-Pericardial effusion

Pericardial effusion

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A dilated coronary sinus is visualized in the parasternal long-axis. An agitated saline contrast study is performed and contrast is noted to appear in the coronary sinus before entering the right atrium. The diagnosis is most likely:
-Inlet ventricular septal defect
-Persistent left superior vena cava
-Normal
-Inlet ventricular septal defect

Persistent left superior vena cava

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A left atrial volume is determined to be 44 ml/m^2. The left atrium is:
-Enlarged
-Thrombosed
-Hyperdynamic
-Normal

Enlarged

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A membrane is visualized in the left atrium and appears to be superior to the fossa ovalis. This finding suggests:
-Supravalvular mitral ring
-Tetralogy of Fallot
-Cor triatriatum
-Mitral stenosis

Cor triatriatum

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A membrane located at the level of the mitral valve annulus is mitral valve:
-Ring
-Flail
-Annular calcification
-Prolapse

Ring

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A string-like structure is seen in the apex of the left ventricle. This finding may be called all of the following EXCEPT:
-False tendon
-Ectopic chordae
-Moderator band
-Chordal web

Moderator band

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All of the following are associated echocardiographic/Doppler finding for the Marfan syndrome EXCEPT:
-Aortic root dilatation
-Aortic dissection
-Mitral stenosis
-Valvular regurgitation

Mitral stenosis

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All of the following are associated findings for pulmonary embolism EXCEPT:
-Tricuspid regurgitation
-D-shaped left ventricle
-Left ventricular hypertrophy
-Right ventricular dilatation

Left ventricular hypertrophy

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All of the following are expected echocardiographic/Doppler finding in the elderly EXCEPT:
-Mitral annular calcification
-Mitral valve E/A ratio of 1.5
-Aortic valve sclerosis
-Mild left atrial dilatation

Mitral valve E/A ratio of 1.5

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All of the following are expected echocardiographic/Doppler findings for atrial fibrillation EXCEPT:
-Normal mitral valve E/A ratio
-Pulmonary vein absent atrial reversal wave
-Reduced left atrial appendage peak velocity
-Biatrial dilatation

Normal mitral valve E/A ratio

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All of the following are findings for ankylosing spondylitis EXCEPT:
-Acute myocardial infarction
-formula
-Dilatation of the sinuses of Valsalva
-Dilatation of the aortic annulus

Acute myocardial infarction

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All of the following are most likely to mimic the findings of mitral stenosis EXCEPT:
-Cor triatriatum
-Parachute mitral valve
-Infective endocarditis
-Left atrial myxoma

Infective endocarditis

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All of the following are normal characteristics of a normal athlete’s heart EXCEPT:
-Tissue Doppler E’ peak velocity > 8 cm/s
-Normal E/A mitral ratio
-Concentric hypertrophy (< 17 mm)
-Left atrial dilatation

Left atrial dilatation

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All of the following are normal findings in cardiac transplantation patients EXCEPT:
-Biatrial dilatation
-Paradoxical interventricular septal motion
-Reduced global ventricular systolic function
-Mild tricuspid regurgitation

Reduced global ventricular systolic function

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All of the following are possible echocardiographic/Doppler findings for Ehlers-Danlos EXCEPT:
-Ventricular septal defect
-Ascending aortic aneurysm
-Valvular prolapse
-Mitral stenosis

Mitral stenosis

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All of the following are possible sources of systemic embolism EXCEPT:
-Left atrial myxoma
-Left ventricular apical thrombus
-Aortic atherosclerotic plaque
-Aortic regurgitation

Aortic regurgitation

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An aortic arteritis associated with marked intimal proliferation and fibrous scarring is:
-Marfan’s syndrome
-Libman-Sacks
-Takayasu’s disease
-Shone’s complex

Takayasu’s disease

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Dilated coronary sinus has been associated with all of the following EXCEPT:
-Coronary atrioventricular fistula with drainage into the coronary sinus
-Right atrial hypertension
-Mitral regurgitation
-Persistent left superior vena cava

Mitral regurgitation

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Electrical pacing of the right ventricle mimics the electrocardiographic and echocardiography findings of:
-Right bundle branch block
-Wolff-Parkinson-White syndrome
-Complete atrioventricular block
-Left bundle branch block

Left bundle branch block

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In normal young patients most ventricular filling occurs during:
-During the PR interval
-Diastasis
-Early ventricular diastole
-Atrial systole

Early ventricular diastole

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In the parasternal short-axis of the mitral valve two separate mitral valve orifices are seen during ventricular diastole. This suggests:
-Double orifice mitral valve
-Flail mitral valve
-Cleft mitral valve
-Mitral valve prolapse

Double orifice mitral valve

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Osler-Weber-Rendu disease is associated with pulmonary arteriovenous fistula. The preferred echocardiographic/Doppler technique to determine the presence of this finding is:
-M-mode
-Color flow Doppler
-Agitated saline contrast
-Two-dimensional

Agitated saline contrast

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Papillary muscle dysfunction usually results from:
-Rheumatic heart disease
-Infective endocarditis
-Ischemic heart disease
-Dressler’s syndrome

Ischemic heart disease

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Penetrating aortic ulcer is considered to be:
-Congenital
-Aortopulmonary window
-Idiopathic
-Aortic dissection

Aortic dissection

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Pulmonary vein stenosis may result in:
-Left atrial enlargement
-Mitral regurgitation
-Pulmonary hypertension
-Left ventricular hypertrophy

Pulmonary hypertension

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Rupture of the vasa vasorum into the media of the aortic wall may result in:
-Aortic aneurysm
-Coarctation of the aorta
-Supravalvular aortic stenosis
-Intramural hematoma

Intramural hematoma

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The classic echocardiographic finding for Pompe’s disease is:
-Aortic stenosis
-Mitral stenosis
-Left ventricular hypertrophy
-Coarctation of the aorta

Left ventricular hypertrophy

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The classic echocardiographic findings for Noonan syndrome is:
-Dysplastic pulmonary valve
-Bicuspid aortic valve
-Dilated cardiomyopathy
-Ventricular septal defect

Dysplastic pulmonary valve

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The combination of left ventricular inflow tract obstruction and left ventricular outflow tract obstruction is called:
-Takayasu’s disease
-Uhl’s anomaly
-Shone’s complex
-Ebstein’s anomaly

Shone’s complex

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The echocardiographic/Doppler findings for Friedreich ataxia include:
-Left ventricular hypertrophy
-Thickened mitral valve
-Libman-Sacks endocarditis
-Aortic stenosis

Left ventricular hypertrophy

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The echocardiographic/Doppler findings for cor pulmonale are very similar to:
-Hypertrophic cardiomyopathy
-Ischemic heart disease
-Pulmonary hypertension
-Hemochromatosis

Pulmonary hypertension

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The echocardiographic/Doppler findings for diabetes include:
-Dilated cardiomyopathy
-Restrictive cardiomyopathy
-Arrhythmogenic right ventricular cardiomyopathy
-Hypertrophic cardiomyopathy

Dilated cardiomyopathy

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The echocardiographic/Doppler findings for hyperthyroidism is:
-Enhanced global left ventricular systolic function
-Significant valvular regurgitation
-Mitral stenosis
-Aortic stenosis

Enhanced global left ventricular systolic function

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The echocardiographic/Doppler findings for pheochromocytoma include all of the following EXCEPT:
-Segmental wall motion abnormalities
-Aortic aneurysm
-Acute myocarditis
-Concentric left ventricular hypertrophy

Aortic aneurysm

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The echocardiographic/Doppler findings in hypothyroidism include:
-Thickened mitral valve
-Reduced global left ventricular systolic function
-Pericardial effusion
-Coarctation of the aorta

Reduced global left ventricular systolic function

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The expected echocardiographic finding for Fabry’s disease is mitral valve:
-Prolapse
-Stenosis
-Flail
-Vegetation

Prolapse

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The expected echocardiographic/Doppler findings for cocaine ingestion include all of the following EXCEPT:
-Hypertrophic cardiomyopathy
-Reduced global ventricular systolic function
-Acute aortic dissection
-Acute myocardial infarction

Hypertrophic cardiomyopathy

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The most common echocardiographic/Doppler finding for scleroderma is:
-Mitral stenosis
-Pericardial effusion
-Pulmonary stenosis
-Ebstein’s anomaly

Pericardial effusion

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The most common echocardiographic/Doppler finding in systemic lupus erythematosus is:
-Pericardial effusion
-Left atrial myxoma
-Aortic stenosis
-Coarctation of the aorta

Pericardial effusion

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The most common reason for congestive heart failure in the United States is:
-Reduced global systolic function due to coronary artery disease
-Volume overload (e.g., significant mitral regurgitation)
-Diastolic dysfunction
-Pressure overload (e.g., systemic hypertension)

Reduced global systolic function due to coronary artery disease

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The motion of a congenitally stenotic aortic valve can be described as:
-Fluttering
-Doming
-Hypokinetic
-Flail

Doming

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The principal echocardiographic feature of left bundle branch block is:
-Hyperkinesis of the lateral wall of the left ventricle
-Early systolic dip of the interventricular septum
-Posterior motion of the interventricular septum
-Hyperkinesis of the interventricular septum

Early systolic dip of the interventricular septum

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Thickening of the aortic valve leaflets with normal systolic excursion with a Doppler peak velocity of less than 2 m/s is the definition for aortic valve:
-Prolapse
-Sclerosis
-Stenosis
-Flail

Sclerosis

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Tuberous sclerosis is associated with:
-Rhabdomyoma
-Myxoma
-Fibroma
-Angiosarcoma

Rhabdomyoma

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Turner syndrome is associated with:
-Coarctation of the aorta
-Rhabdomyoma
-Aortic dissection
-Mitral valve prolapse

Coarctation of the aorta

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Two ventricular pacing wires are implanted with one placed in the right ventricle and one placed at the left ventricular free wall region via the coronary sinus. This is a description of (a):
-Holter monitor
-Left ventricular assist device
-Conventional pacemaker therapy
-Cardiac resynchronization therapy

Cardiac resynchronization therapy

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Which of the following is NOT associated with concentric left ventricular hypertrophy?
-Aortic stenosis
-Discrete subaortic stenosis
-Supravalvular aortic stenosis
-Cor pulmonale

Cor pulmonale

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Which of the following is strongly associated with syncope?
-Carcinoid heart disease
-Rheumatic fever
-Left ventricular outflow tract obstruction
-Perimembranous ventricular septal defect

Left ventricular outflow tract obstruction

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Which of the following is the most likely finding in Chagas disease?
-Aortic stenosis
-Mitral stenosis
-Dilated cardiomyopathy
-Hypertrophic cardiomyopathy

Dilated cardiomyopathy

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Which of the following mitral valve PW Doppler parameters suggests increased left heart filling pressures in a patient with atrial fibrillation?
-Decreased mitral valve E velocity
-Reduced mitral valve deceleration time (< 130 msec)
-Absent mitral valve A wave
-Increased mitral valve A duration

Reduced mitral valve deceleration time (< 130 msec)

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A 44 year old female presents with dyspnea, no history of smoking or cardiac disease and significantly increased pulmonary artery pressures. The most likely explanation is:
-Pulmonary regurgitation
-Primary pulmonary hypertension
-Grade I diastolic dysfunction
-Tricuspid regulation

Primary pulmonary hypertension

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A dumbbell-shaped configuration of the inter-atrial septum is associated with
-Lipomatous hypertrophy
-Amyloidosis
-Sarcoidosis
-Sarcoma

Lipomatous hypertrophy

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A late peaking dagger shaped left ventricular outflow tract continuous-wave Doppler flow pattern is obtained in a patient with systemic hypertension. The most likely explanation is:
-Hypertrophic obstructive cardiomyopathy
-Left ventricular systolic gradient
-Coarctation of the aorta
-Discrete subaortic stenosis

Left ventricular systolic gradient

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A patient with chronic systemic hypertension presents to the echocardiography laboratory. The following pulsed-wave Doppler mitral inflow data is acquired: E:A ratio 0.66, deceleration time 290 msec, isovolumic relaxation time 132 msec. The Doppler data suggests the diastolic filling grade of Grade:
I
IV
II
III

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A posterior echo-free space is detected during the systolic phase only by M-mode/two-dimensional echocardiography. This is considered a:
-Large pericardial effusion
-Small pericardial effusion
-Moderate pericardial effusion
-Normal finding

Normal finding

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A thickened, inflamed, adherent or calcific pericardium is associated with:
-Pulmonary embolism
-Cardiac tamponade
-Constrictive pericarditis
-Mitral stenosis

Constrictive pericarditis

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A two-dimensional echocardiographic finding associated with pulmonary hypertension is:
-Atrial septal aneurysm
-Flattening of the interventricular septum during ventricular systole
-Interventricular myocardial infarction
-Hyperkinetic interventricular septal motion

Flattening of the interventricular septum during ventricular systole

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Air in the pericardial sac is known as:
-Effusive-constrictive pericardium
-Cardiac tamponade
-Pneumopericardium
-Hemopericardium

Pneumopericardium

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All of the following are associated M-mode/two-dimensional echocardiography findings for cardiac tamponade EXCEPT:
-Right ventricular systolic collapse
-Inferior vena cava plethora
-Right atrial diastolic collapse
-Pericardial effusion (usually moderate to large)

Right ventricular systolic collapse

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All of the following are associated findings for pericarditis EXCEPT:
-Fever
-Pericardial effusion by echocardiography
-Pericardial friction rub
-Tachycardia

Pericardial effusion by echocardiography

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All of the following are possible etiologies of constrictive pericarditis EXCEPT:
-Atherosclerosis
-Radiation therapy to the chest region
-Tuberculosis
-Prior pericardiotomy

Atherosclerosis

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All of the following may be used to calculate pulmonary artery pressure by cardiac Doppler EXCEPT:
-Right ventricular outflow tract acceleration time
-Mitral regurgitation
-Pulmonary regurgitation
-Tricuspid regurgitation

Mitral regurgitation

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All of the following may result in secondary pulmonary hypertension EXCEPT:
-Tricuspid regurgitation
-Coronary artery disease
-Mitral stenosis
-Left ventricular failure

Tricuspid regurgitation

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An anterior clear space is noted in the parasternal long-axis view. The diagnosis is most likely:
-Adipose tissue
-Constrictive pericarditis
-Pericardial effusion
-Cardiac tamponade

Adipose tissue

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An echocardiographic finding for congenital absence of the pericardium is volume overload of the:
-Right ventricle
-Left ventricle
-Right atrium
-Left atrium

Right ventricle

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An unattached freely moving thrombus within the left atrium is referred to as a:
-Myxoma
-Pedunculated thrombus
-Ball-valve thrombus
-Sessile thrombus

Ball-valve thrombus

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As the mean pulmonary artery pressure increases, the right ventricular outflow tract acceleration time:
-Decreases
-Depends upon patient age
-Remains unchanged
-Increases

Decreases

Cardiac catheterization findings for constrictive pericarditis include:
-Increased peak-to-peak pressure gradient
-Absent “a” wave
-Dip-and-plateau
-Increased “v” wave

Dip-and-plateau

Complications of a right atrial thrombus include:
-Pulmonary embolism
-Patent foramen ovale
-Valvular prolapse
-Interatrial septal aneurysm

Pulmonary embolism

Doppler evidence of constrictive pericarditis from diastolic hepatic vein flow is:
-Inspiratory increase
-Systolic flow reversal
-Expiratory increase
-Expiratory decrease

Expiratory decrease

Echocardiographic signs associated with constrictive pericarditis include all of the following EXCEPT:
-Septal bound
-Inferior vena cava plethora
-Increased EPSS
-Railroad track sign

Increased EPSS

Fibrin within the pericardial effusion most likely indicates:
-Long-standing pericardial effusion
-Cardiac tamponade
-Acute myocardial infarction
-Constrictive pericarditis

Long-standing pericardial effusion

M-mode findings associated with pulmonary hypertension include:
-Absent or shallow “a” dip of the pulmonary valve
-Deep “a” dip of the pulmonic valve
-Paradoxical “a” dip of the pulmonic valve
-Reverse “a” dip of the pulmonic valve

Absent or shallow “a” dip of the pulmonary valve

Possible echocardiographic findings for pulmonary hypertension include all of the following EXCEPT:
-Abdominal aortic aneurysm
-Tricuspid regulation
-Right ventricular hypertrophy
-Dilated main pulmonary artery

Abdominal aortic aneurysm

Pulsed-wave Doppler evidence of cardiac tamponade from diastolic hepatic vein flow is:
-Inspiratory reversal
-Expiratory increase
-Inspiratory increase
-Expiratory decrease

-Expiratory decrease

Pulsed-wave Doppler evidence of cardiac tamponade includes:
-Inspiratory decrease in peak velocity across the mitral valve with an inspiratory increase in peak velocity across the tricuspid valve
-Inspiratory increase in peak velocity across the mitral valve with an inspiratory decrease in the tricuspid valve
-Systolic flow reversal in the hepatic veins
-Systolic flow reversal in the pulmonary veins

Inspiratory decrease in peak velocity across the mitral valve with an inspiratory increase in peak velocity across the tricuspid valve

Pulsed-wave Doppler evidence of constrictive pericarditis includes:
-Increased peak velocity across the mitral valve with expiration
-Increased peak velocity across the aortic valve with inspiration
-Increased peak velocity across the mitral valve with inspiration
-Increased peak velocity across the tricuspid valve with expiration

Increased peak velocity across the mitral valve with expiration

Secondary findings associated with systemic hypertension include all of the following EXCEPT:
-Increased main pulmonary artery
-Increased left ventricular mass
-Left atrial enlargement
-Left ventricular hypertrophy

Increased main pulmonary artery

The best guideline for differentiating pericardial effusion from pleural effusion by two-dimensional echocardiography is:
-Pericardial effusion is usually seen as a posterior clear space; pleural effusion is usually seen as an anterior clear space.
-Pericardial effusion is usually seen as an anterior clear space; pleural effusion is usually seen as a posterior clear space.
-Pericardial effusion is present posterior to the descending aorta; pleural effusion is located anterior to the descending aorta.
-Pericardial effusion is located anterior to the descending aorta; pleural effusion is present posterior to the descending aorta.

Pericardial effusion is located anterior to the descending aorta; pleural effusion is present posterior to the descending aorta.

The combination of pericardial effusion and constrictive pericarditis is called:
-Cardiac tamponade
-Libman-Sacks
-Pericardial cyst
-Effusive-constrictive pericarditis

Effusive-constrictive pericarditis

The most common etiology of systemic hypertension is:
-Coarctation of the aorta
-Idiopathic processes
-Renal disease
-Pheochromocytoma

Idiopathic processes

The most common intracardiac tumor in adults is (the):
-Rhabdomyoma
-Metastatic
-Angiosarcoma
-Myxoma

Metastatic

The most common location for a pericardial cyst is the:
-Hilum
-Left costophrenic angle
-Right costophrenic angle
-Superior mediastinum

Right costophrenic angle

The most common presenting symptom of acute pericarditis is:
-Chest pain
-Fatigue
-Cachexia
-Hemoptysis

Chest pain

The most common primary benign intracardiac tumor found in children is:
-Rhabdomyoma
-Myxoma
-Papilloma
-Rhabdomyosarcoma

Rhabdomyoma

The most common primary benign valvular tumor in adults is the:
-Angiosarcoma
-Myxoma
-Rhabdomyoma
-Fibroelastoma

Fibroelastoma

The most common primary malignant intracardiac tumor in adults is the:
-Angiosarcoma
-Fibroma
-Myxoma
-Papillary fibroelastoma

Angiosarcoma

The most effective treatment for cardiac tamponade is:
-Pericardiocentesis
-Aspirin
-Bed rest
-Pericardiectomy

Pericardiocentesis

The most likely pulsed-wave Doppler mitral flow pattern in constrictive pericarditis is:
-Restrictive
-Pseudonormal
-Normal for age
-Impaired relaxation

Restrictive

The primary pulsed-wave Doppler mitral valve flow pattern associated with systemic hypertension is Grade:
IV
II
I
III

The pulse associated with cardiac tamponade is:
-Pulsus alternans
-Pulsus parvus et tardus
-Pulsus bisferiens
-Pulsus paradoxus

Pulsus paradoxus

The swinging heart syndrome is associated with:
-Constrictive pericarditis
-Pericardial effusion
-Cardiac trauma
-Mitral valve prolapse

Pericardial effusion

The tissue Doppler finding for constrictive pericarditis is mitral valve annulus:
-Increased S’ wave peak velocity
-Normal E’ wave peak velocity
-Absent A’ wave
-E’/A’ ratio reversal

Normal E’ wave peak velocity

The tissue Doppler finding of the mitral annulus in constrictive pericarditis is called:
-Pulsus paradoxus
-Annulus paradoxus
-Beck’s triad
-Kussmaul’s sign

Annulus paradoxus

The two layers of the pericardium are:
-Myocardium; parietal pericardium
-Epicardium; fibrous pericardium
-Visceral pericardium; myocardium
-Epicardium; endocardium

Epicardium; fibrous pericardium

A common late complication associated with dilated cardiomyopathy is:
-Infective endocarditis
-Mitral regurgitation
-Ventricular gallop
-Systemic emboli

Systemic emboli

A common mitral valve finding in dilated cardiomyopathy in two-dimensional echocardiography is:
-Decreased E-septal separation
-Incomplete closure of the mitral valve
-Reversed diastolic doming
-Premature closure of the mitral valve

Incomplete closure of the mitral valve

A hallmark M-mode aortic valve finding in patients with hypertrophic obstructive cardiomyopathy is aortic valve:
-Diastolic flutter
-Fine systolic flutter
-Vegetation
-Mid-systolic notching

Mid-systolic notching

A more appropriate name for idiopathic hypertrophic cardiomyopathy (IHSS) is:
-Subaortic hourglass deformity
-Discrete subaortic stenosis (DSS)
-Hypertrophic cardiomyopathy
-Aortic tunnel disease (ATD)

Hypertrophic cardiomyopathy

A speckled or ground-glass appearance of the interventricular septum seen on two-dimensional echocardiography is found is:
-Dilated cardiomyopathy
-Mitral stenosis
-Constrictive pericarditis
-Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy

A systolic high-velocity, late-peaking, dagger-shaped continuous-wave Doppler signal is obtained. The most likely diagnosis is:
-Hypertrophic obstructive cardiomyopathy
-Mitral regurgitation
-Tricuspid regurgitation
-Valvular aortic stenosis

Hypertrophic obstructive cardiomyopathy

All of the following are considered possible pharmacologic treatment for hypertrophic obstructive cardiomyopathy EXCEPT:
-Disopyramide
-Calcium-channel blocker (e.g., Verapamil)
-Digitalis
-Beta-blockers

Digitalis

All of the following maneuvers may induce or enhance the obstruction in hypertrophic cardiomyopathy EXCEPT:
-Leg raising
-Inhalation of amyl nitrate
-Supine to standing
-v

Leg raising

All of the following may be used to treat hypertrophic obstructive cardiomyopathy EXCEPT:
-Septal myectomy
-Aspirin
-Dual chamber pacemaker
-Alcohol-induced septal ablation

Aspirin

Characteristic findings in patients with dilated cardiomyopathy include all of the following EXCEPT:
-Dilated, poorly contracting left ventricle
-Low cardiac output
-Asymmetric septal hypertrophy
-Increased intracardiac pressures

Asymmetric septal hypertrophy

Common two-dimensional echocardiographic findings in hypertrophic obstructive cardiomyopathy include all of the following EXCEPT:
-Asymmetric interventricular septal hypertrophy
-Left ventricular enlargement
-Systolic anterior motion of the mitral valve
-Left atrial enlargement

Left ventricular enlargement

Early in the disease stage the usual pulsed-wave Doppler flow of the mitral valve in patients with dilated cardiomyopathy demonstrates a Grade:
II
IV
III
I

Echocardiographic findings in dilated cardiomyopathy include all of the following EXCEPT:
-Preserved ejection fraction
-Enlarged atrial cavities
-Apical mural thrombus
-Dilated ventricular cavities

Preserved ejection fraction

Functional classifications of cardiomyopathy include all the following EXCEPT:
-Restrictive
-Dilated
-Non-dilated
-Hypertrophic

Non-dilated

M-mode findings associated with hypertrophic cardiomyopathy include all of the following EXCEPT:
-Systolic anterior motion of the mitral valve (SAM)
-Asymmetric septal hypertrophy (ASH)
-Mid-systolic notching of the pulmonary valve
-Mid-systolic notching of the aortic valve

Mid-systolic notching of the pulmonary valve

Persistent intramyocardial sinusoids located in the left ventricle are found in:
-Noncompaction cardiomyopathy
-Hypertrophic cardiomyopathy
-Dilated cardiomyopathy
-Restrictive cardiomyopathy

Noncompaction cardiomyopathy

Possible causes of restrictive cardiomyopathy include all of the following EXCEPT:
-Hemochromatosis
-Sarcoidosis
-Amyloidosis
-Alcohol

Alcohol

Possible echocardiographic findings for sarcoid heart disease include:
-Asymmetric septal hypertrophy
-Concentric left ventricular hypertrophy
-Infero-basal aneurysm
-Dilatation of the ascending aorta

Infero-basal aneurysm

Pulsed-wave Doppler and color flow Doppler are useful in hypertrophic cardiomyopathy in all of the following ways EXCEPT:
-Quantitate the severity of the left ventricular outflow tract obstruction
-Help distinguish left ventricular outflow tract flow from mitral regurgitation
-Aid in guiding the continuous-wave Doppler beam
-Determine the presence and severity of mitral regurgitation

Quantitate the severity of the left ventricular outflow tract obstruction

The cardiac involvement associated with acquired immunodeficiency syndrome (AIDS) is:
-Hypertrophic cardiomyopathy
-Dilated cardiomyopathy
-Arrhythmogenic right ventricular cardiomyopathy
-Restrictive cardiomyopathy

Dilated cardiomyopathy

The cardiomyopathy described as presenting with four-chamber enlargement with poor global ventricular systolic function is:
-Hypertrophic
-Uhl’s
-Dilated
-Restrictive

Dilated

The cardiomyopathy with which cardiac hemochromatosis is most commonly associated with is:
-Idiopathic
-Hypertrophic
-Arrhythmogenic right ventricular cardiomyopathy
-Dilated

Dilated

The echocardiographic features of amyloidosis include all of the following EXCEPT:
-Increased ventricular wall thickness
-Dilatation of the ascending aorta
-Multivalvular regurgitation
-Pericardial effusion

Dilatation of the ascending aorta

The mitral valve finding most strongly associated with hypertrophic obstructive cardiomyopathy is mitral valve:
-Flail leaflet
-Aneurysm
-Fenestration
-Systolic anterior motion

Systolic anterior motion

The most common regurgitation found in patients with dilated cardiomyopathy is:
-Pulmonary regurgitation
-Aortic regurgitation
-Tricuspid regurgitation
-Mitral regurgitation

Mitral regurgitation

The primary cause of endomyocardial fibrosis is:
-Hypereosinophilia
-Alcohol
-Intravenous drug abuse
-Chemotherapy

Hypereosinophilia

The progressive replacement of right ventricular myocardium with fatty and fibrous tissue is called
-ARVC
-HCM
-DSS
-IHSS

ARVC

The pulsed-wave Doppler mitral flow pattern most often associated with hypertrophic cardiomyopathy is grade:
II
III
IV
I

All of the following are true statements concerning pulsed-wave (PW) Doppler EXCEPT:
-Aliasing is a primary disadvantage
-Preferred modality to evaluate diastolic function
-Range resolution (range discrimination) is the primary advantage
-Utilizes two elements

Utilizes two elements

A maneuver that will result in tachycardia and a transient decrease in blood pressure is:
-Inhalation of amyl nitrite
-Straight leg raising
-Standing to supine
-Squatting

Inhalation of amyl nitrite

A maneuver which results in a decrease in venous return is:
-Straight leg raising
-Squatting
-Valsalva
-Inspiration

Valsalva

A swirling of transpulmonary contrast is noted at the apex of the left ventricle. The sonographer should:
-Call the nurse
-Decrease the transmit gain
-Inject the contrast at a slower rate
-Use respiratory maneuvers

Decrease the transmit gain

Agitated saline contrast may be used to evaluate all of the following EXCEPT:
-Tricuspid regurgitation
-Patent foramen ovale
-Left to right atrial septal defect
-Aortic regurgitation

Aortic regurgitation

All of the following are primary advantages of transesophageal echocardiography EXCEPT:
-Preferred test for infective endocarditis
-Absence of lung and rib artifact
-Preferred test for mitral valve stenosis
-Superior resolution with high transmit frequencies

Preferred test for mitral valve stenosis

All of the following are true statements concerning M-mode echocardiography EXCEPT:
-Excellent axial resolution
-Standard sweep speed is 50 mm/s
-Primary method currently of determining the presence and severity of cardiac pathology
-Excellent temporal resolution

Primary method currently of determining the presence and severity of cardiac pathology

All of the following are true statements concerning color flow Doppler EXCEPT:
-Pulsed-wave Doppler technique
-Mean velocity displayed
-Normal flow does not alias
-Multigate

Normal flow does not alias

All of the following are ways in which the sonographer can improve the lateral resolution while imaging EXCEPT:
-Increase the number of focuses
-Increase the transducer diameter
-Utilize harmonic imaging
-Increase the transmit frequency

Increase the transducer diameter

All of the following are ways to increase the color flow Doppler frame rate and improve temporal resolution EXCEPT decrease:
-Line density
-Image depth
-Color gain
-Field of view

Color gain

All of the following cardiac pathologies are best evaluated with cardiac Doppler in the apical views EXCEPT:
-Atrial septal defect
-Aortic stenosis
-Mitral stenosis
-Mitral regurgitation

Atrial septal defect

All of the following decrease with increasing transmit frequency EXCEPT:
-Depth of penetration
-Attenuation
-Beam width
-Spatial pulse length and pulse duration

Attenuation

All of the following may be evaluated using the apical window EXCEPT:
-Mitral valve prolapse
-Left atrial volume
-Pulmonary vein flow
-Isovolumic relaxation time

Mitral valve prolapse

All of the following may be evaluated with cardiac Doppler in the apical five-chamber view EXCEPT:
-Valvular aortic stenosis
-Discrete subaortic stenosis
-Hypertrophic cardiomyopathy
-Patent foramen ovale

Patent foramen ovale

All of the following two-dimensional views may be useful when evaluating for the presence of perimembranous ventricular septal defect EXCEPT:
-Subcostal four-chamber
-Apical five-chamber
-Parasternal long-axis
-Parasternal short-axis of the aortic valve

Subcostal four-chamber

All of the following will increase the frame rate and improve temporal resolution EXCEPT decreasing the:
-Field of view
-Image depth
-Transmit gain
-Number of focuses

Transmit gain

Increasing the pulsed-wave Doppler sample gate length will result in:
-Increased peak velocity
-Better determination of laminar flow
-Lower frame rates
-Increased spectral broadening

Increased spectral broadening

Left ventricular opacification may be accomplished by all of the following contrast agents EXCEPT:
-Optison
-Definity
-Agitated saline
-Imagent

Agitated saline

Multiple echoes equally spaced are called:
-Refraction
-Side lobes
-Propagation speed error
-Reverberation

Reverberation

Of all of the resolutions, which resolution is most difficult for the sonographer to improve during an examination?
-Contrast
-Elevational
-Temporal
-Spatial (axis resolution; lateral resolution)

Elevational

Possible pharmacologic treatments for hypertrophic obstructive cardiomyopathy include:
-Dobutamine
-Epinephrine
-Lasix
-Propranolol

Propranolol

The Doppler high-pass filter eliminates:
-Peak velocity flow
-Spectral broadening
-Window fill-in
-Strong amplitude signals

Strong amplitude signals

The four acoustic windows for transthoracic echocardiography are:
-Parasternal, long-axis, short-axis, subcostal
-Apical, subcostal, short-axis, parasternal
-Parasternal, apical, subcostal, suprasternal
-Long-axis, short-axis, four-chamber, suprasternal

Parasternal, apical, subcostal, suprasternal

The image artifact associated with displaying double images of a structure due to the change in the direction of the sound beam is called:
-Reverberation
-Acoustic shadowing
-Range ambiguity
-Refraction

Refraction

The image artifact which may cause the sonographer to fail to detect prosthetic mitral valve regurgitation from the apical window is:
-Enhancement
-Comet tail
-Grating lobes
-Shadowing (flow masking)

Shadowing (flow masking)

The measurement of the left ventricular outflow tract diameter during early ventricular systole is an important measurement in all of the following calculations EXCEPT:
-Right ventricular systolic pressure
-Mitral valve area
-Stroke volume
-Aortic valve area

Right ventricular systolic pressure

The preferred two-dimensional view for determining the presence of bicuspid aortic valve is the:
-Apical five-chamber
-Apical long-axis
-Parasternal long-axis
-Parasternal short-axis of the aortic valve

Parasternal short-axis of the aortic valve

The primary advantage of continuous-wave (CW) Doppler is:
-Range resolution
-Aliasing will not occur
-Range discrimination
-Range ambiguity

Aliasing will not occur

The sonographer may avoid pulsed-wave Doppler aliasing by all of the following techniques EXCEPT:
-Decrease the Doppler transmit gain
-Decrease the image depth
-Increase the velocity scale
-Shift the zero baseline

Decrease the Doppler transmit gain

The three two-dimensional planes used to examine the heart with transthoracic echocardiography are:
-Long-axis, short-axis, four-chamber
-Long-axis, short-axis, apical
-Long-axis, short-axis, five-chamber
-Parasternal, apical, subcostal

Long-axis, short-axis, four-chamber

The two-dimensional view of choice for evaluating the inferior vena cava and hepatic veins is the:
-Parasternal long-axis
-Apical four-chamber
-Parasternal short-axis of the aortic valve
-Subcostal four-chamber

Subcostal four-chamber

The two-dimensional view of choice for the evaluation of coarctation of the aorta is the:
-Apical five-chamber
-Parasternal long-axis
-Suprasternal long-axis of the aorta
-Parasternal short-axis of the aortic valve

Suprasternal long-axis of the aorta

Tissue harmonic imaging improves all of the following EXCEPT:
-Frame rate
-Side lobe artifacts
-Depth of penetration
-Beam width

Frame rate

What is the standard sweep speed for M-mode echocardiography and cardiac Doppler?
25 mm/s
100 mm/s
50 mm/s
150 mm/s

50 mm/s

Which Doppler intercept angle will result in the maximum flow velocity?
30
0
90
60

Which color flow Doppler map will display the color green to indicate turbulent flow?
-Variance
-Directional
-Intensity
-Hue

Variance

Which instrument control directly affects the dynamic range?
-Compression
-Transmit gain
-Image depth
-TGC

Compression

Which of the following may lead to a misdiagnosis for the presence of aortic dissection with transesophageal echocardiography?
-Linear Artifact
-Thickened mitral valve
-Mirror-Image
-Aberrant right subclavian artery

Linear Artifact
Mirror-Image
Aberrant right subclavian artery

Which transmit frequency would most likely be useful for an adult echocardiogram?
7.5 MHz
2.5 MHz
5.0 MHz
3.5 MHz

2.5 MHz

Which two-dimensional view is likely to be LEAST useful when evaluating for atrial septal defect with cardiac Doppler?
-Subcostal four-chamber
-Apical two-chamber view
-Apical four-chamber with color flow Doppler
-Parasternal short-axis of the aortic valve with color flow Doppler

Apical two-chamber view

Which two-dimensional view would be most useful to use when evaluating pulmonary stenosis and pulmonary regurgitation?
-Parasternal short-axis at the aortic valve
-Suprasternal long-axis
-Parasternal long-axis of the left ventricle
-Apical four-chamber

Parasternal short-axis at the aortic valve

A patient with a history of intravenous drug abuse presents to the echocardiography laboratory with complaints of fever, night sweats and weight loss. The most likely explanation is:
-Coronary artery disease
-Kawasaki disease
-Congestive heart failure
-Infective endocarditis

Infective endocarditis

A prosthetic heart valve that is associated with a relatively high rate of outlet strut fracture and disc embolism is the:
-Carpentier-Edwards
-Starr-Edwards
-Bjork-Shiley
-Omniscience

Bjork-Shiley

A pulmonic valve relocated to the aortic valve position is called a(n):
-Autograft
-Allograft
-Xenograft
-Heterograft

Autograft

Abnormal rocking motion of a prosthetic valve by two-dimensional echocardiography indicates prosthetic valve:
-Dehiscence
-Vegetation
-Thrombus
-Stenosis

Dehiscence

All of the following are bioprosthetic (tissue) valves EXCEPT:
-Hancock
-Edwards Perimount
-Medtronic Intact
-Starr-Edwards

Starr-Edwards

All of the following are mechanical valves EXCEPT:
-Hancock
-Starr-Edwards
-CarboMedics
-St. Jude

Hancock

All of the following are true statements concerning prosthetic valves EXCEPT:
-Prosthetic valve peak velocities are generally higher as compared to normal native valves
-A baseline study should be obtained post-surgery
-Prosthetic valve regurgitation is always abnormal
-Velocities depend upon the size and type of prosthetic valve

Prosthetic valve regurgitation is always abnormal

All of the following are types of prosthetic valve types EXCEPT:
-Bioprosthetic (tissue)
-Homograft (allograft)
-Mechanical (metal)
-Native

Native

All of the following should be determined when evaluating a prosthetic valve with cardiac Doppler EXCEPT:
-Peak velocity
-Mean pressure gradient
-Shunt ratio
-Effective orifice area

Shunt ratio

Cardiac Doppler evaluation of a prosthetic mitral valve should include all of the following EXCEPT:
-Pressure half-time
-Peak mitral valve A wave velocity
-Peak and mean pressure gradients
-Effective orifice area

Peak mitral valve A wave velocity

Complications associated with prosthetic valve dysfunction include all of the following EXCEPT:
-Thrombosis
-Dehiscence
-Tumor
-Leaflet degeneration

Tumor

Infective endocarditis is a greater risk in patients with:
-Coronary artery disease
-Atrial fibrillation
-Prosthetic heart valve
-Left ventricular aneurysm

Prosthetic heart valve

The best Doppler formula for calculating the effective orifice area (EOA) in a patient with mitral valve replacement is:
4 x (V2)2
4 x (V22 – V12)
220 ÷ pressure half-time
(CSALVOT x VTILVOT) ÷ VTIMV

(CSALVOT x VTILVOT) ÷ VTIMV

The best Doppler method for evaluating aortic valve replacement is probably:
-Maximum peak instantaneous pressure gradient
-Deceleration slope
-Pressure half-time
-Velocity ratio

Velocity ratio

The classic manifestation of infective endocarditis is cardiac valve:
-Doming
-Tumor
-Vegetation
-Sclerosis

Vegetation

The complications of infective endocarditis include all of the following EXCEPT:
-Valve ring abscess
-Congestive heart failure
-Embolization
-Annular calcification

Annular calcification

The determination of prosthetic mitral valve regurgitation and prosthetic tricuspid valve regurgitation is made difficult by the artifact called:
-Enhancement
-Shadowing
-Mirroring
-Slice thickness

Shadowing

The essential two-dimensional echocardiographic finding of valve ring abscess secondary to infective endocarditis may be best described as:
-Mural
-Pedunculated
-Echolucent
-Sessile

Echolucent

The excessive ingrowth of tissue for a prosthetic valve is called:
-Vegetation
-Dehiscence
-Pannus
-Thrombus

Pannus

The most common ball and cage valve is the:
-Medtronic-Hall
-St. Jude
-Starr-Edwards
-Omniscience

Starr-Edwards

The most common bileaflet tilting disc valve is the:
-St. Jude
-Medtronic-Hall
-Starr-Edwards
-Omniscience

St. Jude

The most common symptom of infective endocarditis is:
-Chest pain
-Dyspnea
-Orthopnea
-Fever

Fever

The primary disadvantage of the bioprosthetic (tissue) valve is:
-Lack of durability
-Pannus formation
-Dehiscence
-Thrombus formation

Lack of durability

The primary disadvantage of the mechanical valve is:
-Thrombogenicity
-Durability
-Dehiscence
-Pannus ingrowth

Thrombogenicity

The test of choice for diagnosing the presence of vegetation and the complications of infective endocarditis is:
-Transthoracic echocardiography
-Transesophageal echocardiography
-Cardiac catheterization
-Cardiac magnetic resonance imaging

Transesophageal echocardiography

The usual site of attachment for vegetations on the mitral valve and tricuspid valve is the:
-Ventricular surface of the valve leaflets
-Papillary muscles
-Annulus
-Atrial side of the valve leaflets

Atrial side of the valve leaflets

The vegetation diameter as determined by two-dimensional echocardiography that is most often associated with systemic emboli is:
5 mm
3 mm
7 mm
10 mm

10 mm

Valve ring abscess is usually caused by:
-Infective endocarditis
-Valvular regurgitation
-Rheumatic fever
-Valvular prolapse

Infective endocarditis

Which of the following pressures can be predicted when measuring the pulmonary regurgitation end-diastolic velocity?
-Mean pulmonary artery pressure
-Systolic pulmonary artery pressure
-Pulmonary artery end-diastolic pressure
-Right ventricular systolic pressure

Pulmonary artery end-diastolic pressure

Which of the following pressures may be calculated when measuring the peak velocity of pulmonary regurgitation?
-Systolic pulmonary artery pressure
-Pulmonary wedge pressure
-Right ventricular systolic pressure
-Mean pulmonary artery pressure

Mean pulmonary artery pressure

Which two cardiac valves need to be evaluated carefully in a patient with the Ross procedure?
-Mitral valve; aortic valve
-Aortic valve; pulmonary valve
-Mitral valve; tricuspid valve
-Aortic valve; tricuspid valve

Aortic valve; pulmonary valve

A pericardial effusion develops in a patient two weeks post-myocardial infarction. This suggests ______ syndrome.
-Down
-Williams
-Dressler’s
-Marfan

Dressler’s

A positive stress echocardiogram consists of:
-Normal left atrial dimension peak exercise
-Normal wall motion to akinesis
-Normal wall motion pre and post exercise
-Improved ejection fraction

Normal wall motion to akinesis

A possible etiology for pericardial effusion is:
-Acute myocardial infarction
-Mitral valve stenosis
-Pulmonary regurgitation
-Mitral valve prolapse

Acute myocardial infarction

A pulsed-wave Doppler tracing of the mitral valve inflow at the leaflet tips is obtained with the following information: E/A ratio is 0.7; deceleration time is 320 msec; a tissue Doppler at the mitral annulus demonstrated an E’ peak velocity of 6 cm/s and an E/E’ ratio is calculated to be 7. The diastolic grade is:
Normal diastolic function
III or IV
I
II

A pulsed-wave Doppler tracing of the mitral valve inflow at the leaflet tips is obtained with the following information: E/A ratio is 2.3, deceleration time is 123 msec, Valsalva maneuver demonstrated no change in the E/A ratio, tissue Doppler of the mitral valve annulus demonstrates an E’ wave peak velocity of 3 cm/s and an E/E’ ratio of 33 is calculated. The diastolic grade is grade:
I
III
II
IV

A pulsed-wave Doppler tracing of the mitral valve inflow at the leaflet tips is obtained with the following information: E/A ratio is 1.2, deceleration time is 200 msec, tissue Doppler of the mitral annulus peak E’ wave velocity is 7 cm/s, E’/A’ ratio is .6 and a E/E’ ratio of 12 is calculated. The diastolic grade is Grade:
II
IV
I
III

A systolic wall motion score of 3 is assigned to a certain segment of left ventricular muscle indicates:
-Akinetic
-Hypokinetic
-Dyskinetic
-Normal

Akinetic

A thrombus shape that is associated with embolization is:
-Flat
-Spherical
-Pedunculated
-Eccentric

Pedunculated

A wall segment of the heart that is without systolic wall thickening is best described as:
-Akinetic
-Hypokinetic
-Hyperkinetic
-Dyskinetic

Akinetic

An ejection fraction of 42% is determined with two-dimensional echocardiography. This indicates _________ global left ventricular systolic function.
-Normal
-Mildly abnormal
-Severely abnormal
-Moderately abnormal

Moderately abnormal

An increased mitral valve E point to septal-separation (EPSS) may indicate:
-Reduced ejection fraction
-Pulmonary hypertension
-Left atrial myxoma
-Increased left ventricular end-diastolic pressure

Reduced ejection fraction

Echocardiographic findings in the post-myocardial infarction patient include:
-Mural thrombus
-Ventricular septal aneurysm
-Valvular stenosis
-Mitral annular calcification

Mural thrombus

Echocardiography differentiates a pseudoaneurysm from a true ventricular aneurysm by the:
-Diastolic motion of the aneurysm
-Width of the neck of the aneurysm
-Width of the border of the aneurysm
-Length of the aneurysm

Width of the neck of the aneurysm

For exercise echocardiography the images post-exercise need to be acquired within ______ from the time the patient exercise is completed.
-5 minutes
-3 hours
-60 minutes
-60 seconds

60 seconds

Hibernating myocardium is:
-Viable myocardium at rest but not functioning with exercise
-Viable myocardium that is nonfunctioning because of chronic ischemia
-Myocardium that is hyperkinetic post-myocardial infarction
-Reperfused viable myocardium that is functioning

Viable myocardium that is nonfunctioning because of chronic ischemia

In determining the size of myocardial infarction echocardiography generally:
-Predicts the exact size of infarct
-Underestimates recent myocardial infarction and overestimates old myocardial infarction
-Overestimates recent myocardial infarction and underestimates old myocardial infarction
-Is unpredictable

Overestimates recent myocardial infarction and underestimates old myocardial infarction

In patients with dilated cardiomyopathy, the index of myocardial performance (IMP) will be:
-Decreased
-Dependent on blood pressure
-Increased
-Normal

Increased

Patients with increased diastolic filling pressures post-exercise will demonstrate:
-Normal mitral E/A ratio
- E/E’ ratio > 10
-Increased mitral deceleration time
-Normal tricuspid regurgitation peak velocity

E/E’ ratio > 10

Possible mechanisms in the development of mitral regurgitation following acute myocardial infarction include all of the following EXCEPT:
-Papillary muscle rupture
-Incomplete closure of the mitral valve
-Fibrosis of the papillary muscle
-Mitral valve stenosis

Mitral valve stenosis

Stress echocardiography methods that may be used to detect hibernating myocardium include:
-Cold pressure
-Handgrip
-Treadmill
-Low-dose dobutamine

Low-dose dobutamine

The correct term for describing decreased ventricular systolic wall thickening is:
-Dyskinetic
-Hypokinetic
-Hyperkinetic
-Akinetic

Hypokinetic

The definition of stunned myocardium is:
-Myocardium after electrical cardioversion
-Reperfused viable myocardium that is not functioning
-Myocardium that is hyperkinetic post-myocardial infarction
-Myocardium after cardiopulmonary resuscitation

Reperfused viable myocardium that is not functioning

The echocardiographic appearance of necrotic myocardium secondary to myocardial infarction includes all of the following EXCEPT:
-Echogenic wall segment
-Wall motion score of 1
-Akinetic wall segment
-Thin ventricular wall

Wall motion score of 1

The expected Doppler finding in a patient with ventricular septal rupture is:
-Turbulent high-velocity flow in diastole on the right side of the septum
-Laminar high-velocity flow in diastole on the right side of the septum
-Turbulent high-velocity flow in systole on the right side of the interventricular septum
-Laminar low-velocity flow during diastole on the left side of the interventricular septum

Turbulent high-velocity flow in systole on the right side of the interventricular septum

The formula used to determine ejection fraction is:
(EDV – ESV) ÷ EDV x 100
EDV – ESV
CSA x VTI
(EDD – ESD) ÷ EDD x 100

(EDV – ESV) ÷ EDV x 100

The formula used to determine fractional shortening is:
EDV – ESV
(EDD – ESD) ÷ EDD x 100
CSA x VTI
(EDV – ESV) ÷ EDV x 100

(EDD – ESD) ÷ EDD x 100

The formula used to determine stroke volume by Doppler is:
(EDD – ESD) ÷ EDD x 100
(EDV – ESV) ÷ EDV x 100
EDV – ESV
CSA x VTI

CSA x VTI

The four most common two-dimensional views acquired during a stress echocardiogram are the parasternal long-axis, parasternal short-axis of the left ventricle at the level of the papillary muscles, the apical four-chamber view and the:
-Subcostal short-axis at the cardiac base
-Apical five-chamber
-Apical two-chamber
-Apical long-axis

Apical two-chamber

The infarction most commonly associated with left ventricular aneurysm is:
-True posterior
-Anterior
-Inferior
-Lateral

The most common etiology for ischemic heart disease is coronary artery:
-Atherosclerosis
-Spasm
-Embolus
-Aneurysm

Atherosclerosis

The most common medication used in performing pharmacological stress echocardiography is:
-Adenosine
-Dipyridamole
-Propranolol
-Dobutamine

Dobutamine

The most specific echocardiographic finding for ischemic heart muscle is:
-Abnormal diastolic wall motion at the ischemic segment
-Normal diastolic wall motion
-Alterations in systolic wall thickening
-Normal systolic wall motion

Alterations in systolic wall thickening

The normal response of non-infarcted myocardium in a patient with acute myocardial infarction is:
-Hypokinesis
-Hyperkinesis
-Dyskinesis
-Akinesis

Hyperkinesis

The primary indication for stress echocardiography is:
-Diagnosis of shunt lesions
-Assessment of cardiac valve abnormalities
-Evaluation of ejection fraction
-Evaluation for coronary artery disease

Evaluation for coronary artery disease

The principal echocardiographic/Doppler findings of right ventricular infarction include all of the following EXCEPT:
-Tricuspid regurgitation
-Right ventricular dilatation
-Right ventricular hypertrophy
-Abnormal motion of the right ventricular free wall

Right ventricular hypertrophy

The rate at which the left ventricular pressure rises in ventricular systole is referred to as:
dP/dt
dt/dP
dd/tP
dv/dt

dP/dt

The type of myocardial infarction which most often involves the right ventricle is:
-Inferior
-Lateral
-Anterior
-Anterolateral

Inferior

Which maneuver is most useful to use when trying to determine the presence of Grade II (pseudonormalization) or when determining between Grade III (reversible restrictive) and Grade IV (fixed restrictive):
-Squatting
-Valsalva
-Leg raising
-Mueller

Valsalva

Which of the following methods is recommended to determine left ventricular volumes?
-Teichholtz
-Biplane area-length
-Cubed
-Biplane Simpson’s method of discs

Biplane Simpson’s method of discs

Which of the following mitral valve flow patterns provides risk stratification post-myocardial infarction?
-Normal for age
-Pseudonormal (grade II)
-Restrictive (Grade III-IV)
-Impaired relaxation (Grade I)

Restrictive (Grade III-IV)

Which of the following pharmacologic agents increases contractility and increases heart rate?
-Propranolol
-Dobutamine
-Verapamil
-Digitalis

Dobutamine

________ is a direct measure of myocardial contractile function.
- E-F slope
-Strain
-Deceleration time
-EPSS

Strain

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