Congenital Flashcards by Kaitlyn Yeager

Following a peripheral (saline) contrast injection, bubbles appear in the left atrium within 3 cardiac cycles. This patient most likely has a:

A. Pulmonary shunt
B. AV fistula
C. Interventricular shunt
D. Interatrial shunt

Interatrial shunt

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Which of the following is NOT a defect found in tetralogy of Fallot?

A. Pulmonic stenosis
B. Large ventricular septal defect
C. Atrial septal defect
D. Right ventricular hypertrophy

Atrial septal defect

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The Hemodynamic effect of an atrial septal defect (ASD) depends on all of the following EXCEPT:

A. Response of the pulmonary vascular bed
B. Size and direction of the shunt
C. Degree of aortic regurgitation
D. Compliance of the ventricles

Degree of aortic regurgitation

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Patients with Ebstein’s anomaly often have an associated congenital abnormality. Which is the most common one?

A. Perimembranous ventricular septal defects
B. Secundum atrial septal defect
C. Primum atrial septal defect
D. Membranous ventricular septal defect

Secundum atrial septal defect (50%)

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When the anatomic ventricles are switched and there are no other defects, the patient is said to have:

A. Simple transposition
B. L-transposition
C. Double-outlet right ventricle
D. D-transposition

L-transposition

(Or ventricular inversion)

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Which is the best view to diagnose a sinus venosus ASD?

A. Parasternal short axis
B. Modified subcostal four chamber
C. Modified subcostal short axis
D. Apical four chamber

Modified subcostal four chamber

(Aimed at better aligning the beam with direction of blood flow through the LVOT)

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Systemic hypertension is when the:

A. Systolic pressure is over 100 mmHg
B. Systolic pressure is over 120 mmHg
C. Systolic pressure is over 140 mmHg
D. Systolic pressure is over 130 mmHg

Systolic pressure is over 140 mmHg

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Peripheral (saline) contrast normally appears in which cardiac chamber first?

A. Left ventricle
B. Left atrium
C. Right atrium
D. Right ventricle

Right atrium

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Which 2D view is best for identifying Ebstein’s anomaly?

A. Parasternal short axis
B. Parasternal long axis
C. Apical 4 chamber
D. Apical 2 chamber

Apical 4 chamber

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A supracristal ventricular septal defect (VSD) is also referred to as a:

A. Outlet
B. Muscular
C. Subvalvular
D. Inlet

Outlet

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Pulmonic stenosis involving stenosis in the right ventricular outflow tract creating a right ventricular outflow tract obstruction is called:

A. Supravalvular
B. Valvular
C. Right ventricular hypertrophy
D. Infundibular

Infundibular

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A patient with a Secundum ASD has a saline contrast study. It shows all of the following EXCEPT:

A. Bubbles from RV to LV
B. Bubbles in the pulmonary artery
C. Negative contrast jet in the RA
D. Bubbles from RA to LA

Bubbles from RV to LV

(This would indicate a VSD)

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When using continuous wave Doppler estimation of tricuspid regurgitation gradient for predicting pulmonary artery pressure, which final step is required?

A. Documenting that there is no pulmonic stenosis
B. Adding the TR gradient to the estimated right atrial pressure
C. Looking at the hepatic vein for systolic flow reversal
D. Adding the TR gradient to the estimated left atrial pressure

Documenting that there is no pulmonic stenosis

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Which of the following statements are true about tetralogy of Fallot defects?

A. Pulmonary stenosis is valvular
B. Made up of 5 defects
C. VSD with R to L shunting
D. Has an atrial septal defect

VSD with R to L shunting

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Peripheral (saline) contrast is NOT useful in:

A. Tricuspid regurgitation
B. Atrial septal defects
C. Aortic regurgitation
D. Ventricular septal defects

Aortic regurgitation

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In patients with suspected pulmonary hypertension, the right ventricular systolic pressure may be predicted:

A. When the pulmonary artery pressure is low by precise correlation of pulmonary valve closure times
B. With continuous wave Doppler detection of tricuspid regurgitation
C. By accurate measurement of end systolic and end diastolic anterior right ventricular wall thickness
D. With pulsed Doppler interrogation of the left pulmonary artery

With continuous wave Doppler detection of tricuspid valve insufficiency

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All of the following are echo findings for pulmonary hypertension EXCEPT:

A. Flattening of the interventricular septum
B. Right ventricular hypertrophy
C. Dilated right ventricle
D. Dilated left atrium

Dilated left atrium

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When using continuous wave Doppler estimation of tricuspid regurgitation gradient for predicting right ventricular systolic pressure, which final step is required?

A. Adding the TR gradient to the estimated right atrial pressure
B. Adding the TR gradient to the estimated left atrial pressure
C. Looking at the hepatic vein for systolic flow reversal
D. Documenting that there is no pulmonic stenosis

Adding the TR gradient to the estimated right atrial pressure

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Infundibular pulmonary stenosis is uncommon as an isolated lesion and is usually associated with:

A. Atrial septal defects
B. Tricuspid atresia
C. Ventricular septal defects
D. Coarctation of the aorta

Ventricular septal defects

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Pulmonary hypertension is when the:

A. Pulmonary artery pressure is over 20 mmHg
B. Pulmonary artery pressure is over 30 mmHg
C. Pulmonary artery pressure is over 28 mmHg
D. Pulmonary artery pressure is over 22 mmHg

Pulmonary artery pressure is over 30 mmHg

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If the IVC is dilated and doesn’t collapse when the patient sniffs, the RA pressure is estimated to be:

A. 15 mmHg
B. 5 mmHg
C. 10 mmHg
D. 20 mmHg

15 mmHg

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A pressure overload of the right ventricle may produce all of the following 2D findings EXCEPT:

A. Large right ventricle
B. Flattened interventricular septum
C. Small right ventricle
D. Right ventricular hypertrophy

Small right ventricle

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Following a peripheral (saline) contrast injection, bubbles appear in the left atrium in 5 cardiac cycles. This patient most likely has a:

A. Interatrial shunt
B. AV fistula
C. Interventricular shunt
D. Pulmonary shunt

Pulmonary shunt

(*5 cardiac cycles)

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The major development of the heart is complete by the end of the week:

A. 4
B. 10
C. 3
D. 7

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The severity of this anomaly’s symptoms depends on the size of the ventricular septal defect, the degree of pulmonic stenosis, and the position of the aorta. A. Cor triatriatum B. Tetralogy of Fallot C. Truncus arteriosus D. Infundibular pulmonic stenosis

Tetralogy of Fallot

Which of the following is most often associated with Primum ASDs? A. Muscular VSDs B. Coarctation of the aorta C. Cleft mitral valve D. Bicuspid aortic valve

Cleft mitral valve

What is the most common type of atrial septal defect (ASD)? A. Coronary sinus B. Primum C. Sinus venosus D. Secundum

Secundum

The most common form of cyanotic congenital heart disease is: A. Atrial septal defects B. Pulmonary stenosis C. Tetralogy of Fallot D. Coarctation of the aorta

Tetralogy of Fallot

In patients that develop Eisenmenger’s syndrome, what happens? A. The shunt reverses direction and now is R to L B. Spontaneous closure of the shunt C. The shunt suddenly becomes worse D. The shunt reverses direction and now is L to R

The shunt reverses direction and now is R to L

A patient with a patent ductus arteriosus (PDA) commonly has what type of murmur? A. Systolic B. Blowing C. Diastolic D. Continuous

Continuous (Systolic and diastolic)

Surgically what happens during a Mustard procedure? A. Baffles at the atrial level redirect blood flow into the ventricles B. The right ventricle is connected to the pulmonary artery via a conduit C. The SVC is connected to the right pulmonary artery D. A valved conduit is positioned between the RV and Pulmonary artery

Baffles are placed at the atrial level to redirect blood flow into the proper ventricles since these patients have D-transposition of the great arteries

The communication between the aorta and pulmonary artery that may persist after birth is called: A. Persistent ductus arteriosus B. Patent Foramen ovale C. Patent ductus arteriosus D. Persistent fetal circulation

Patent ductus arteriosus

Early in cardiac development, what is the name of the one great vessel leaving the heart? A. Pulmonary Truncus B. Bulbous venosus C. Aorta Truncus D. Truncus arteriosus

Truncus arteriosus

Where should saline contrast be injected in order to diagnose a persistent left superior vena cava? A. Right arm B. Left arm C. Subclavian vein D. Subclavian artery

Left arm

After birth, if the ductus arteriosus fails to close, the result is a communication between the: A. Right atrium/left atrium B. Ductus venosus/placenta C. Aorta/pulmonary artery D. Ductus venosus/inferior vena cava

Aorta/pulmonary artery

Which of the following best represents the normal range for systemic diastolic pressure? A. 70-105 mmHg B. 60-90 mmHg C. 15-30 mmHg D. 100-140 mmHg

60-90 mmHg

The most common cause of valvular pulmonic stenosis is: A. Degenerative B. Bicuspid C. Congenital D. Rheumatic

Congenital

Given tricuspid regurgitation with a 64 mmHg gradient, grade the severity of pulmonary hypertension: A. Moderate B. None C. Mild D. Severe

Severe The RV systolic pressure would be at least 74 mmHg

The abnormal displacement of the tricuspid valve downward with atrialization of the right ventricle is: A. Cleft tricuspid valve B. Ebstein’s anomaly C. Tricuspid atresia D. Noonan syndrome

Ebstein’s anomaly

The classic M-mode finding in patients with pulmonary hypertension is: A. Absent “a” wave on the pulmonic valve B. Normal “a” wave on the pulmonic valve C. Mid-diastolic closure on the pulmonic valve D. Right atrial enlargement

Absent “a” wave on the pulmonic valve

Reversal of a long standing left to right shunt is referred to as: A. Paradoxical emboli B. Eisenmenger’s syndrome C. Noonan syndrome D. Edelman syndrome

Eisenmenger’s syndrome

Which of the following statements are true regarding coarctation of the aorta? A. Majority are located before the left common carotid artery B. Partial obstruction of the aorta C. Often associated with cleft mitral valve D. Often associated with aortic regurgitation

Partial obstruction of the aorta

After a baby is born, which of the following causes the Foramen ovale to close? A. Increased left atrial pressure B. Increased right atrial pressure C. Decreased right atrial pressure D. Decreased left atrial pressure

Increased left atrial pressure

Which one of the following anomalies is most likely associated with a sinus venosus ASD? A. Partial anomalous pulmonary venous return B. Deformed mitral valve C. Cleft mitral valve D. Ebsteins anomaly

Partial anomalous pulmonary venous return

While performing an echo on a premature baby, what two findings are to be expected? A. Patent ductus arteriosus and patent Foramen ovale B. Patent ductus arteriosus and atrial septal defect C. Patent Foramen ovale and ventricular septal defect D. Patent Foramen ovale and atrial septal defect

Patent ductus arteriosus and patent Foramen ovale

Which of the following best represents the normal range for systemic systolic pressure? A. 3-12 mmHg B. 15-30 mmHg C. 100-140 mmHg D. 70-105 mmHg

100-140 mmHg

Patients develop Eisenmenger’s syndrome because: A. Tricuspid regurgitation is now severe B. Systemic pressures now exceed pulmonary C. Pulmonary pressures now exceed systemic D. They have a ventricular septal defect

Pulmonary pressures now exceed systemic (Higher than the patients systolic BP)

The remnant of the fetal ductus arteriosus is called the: A. Ligamentum venosus B. Patent ductus arteriosus C. Ligamentum ateriosum D. Fossa ovalis

Ligamentum ateriosum

A patient has undergone a Mustard procedure. What was their most likely original diagnosis? A. Tetralogy of Fallot B. D-transposition of the great arteries C. Truncus arteriosus D. L-transposition of the great arteries

D-transposition of the great arteries

In patients with large ventricular septal defects and left to right shunting which chamber or vessel is least likely to be dilated? A. Pulmonary arteries B. Right atrium C. Left atrium D. Left ventricle

Right atrium

A 22 year old patient with Down Syndrome is referred to the echo lab. The most common cardiac problem with these patients is: A. Tetralogy of Fallot B. AV septal defect C. Bicuspid aortic valve D. Transposition of the great arteries

AV septal defect

A sinus venosus ASD is located in the superior portion of the interatrial septum near the junction of the: A. IVC and SVC B. IVC and RA C. SVC and RA D. SVC and right pulmonary artery

SVC and RA

Which 2D view is best for identifying an atrial septal defect? A. Parasternal long axis B. Subcostal 4 chamber C. Apical 4 chamber D. Parasternal short axis

Subcostal 4 chamber

A pressure overload of the right ventricle may produce which of the following 2D findings? A. Normal left ventricular short axis B. Left ventricular hypertrophy C. Right ventricular hypertrophy D. Dilated pulmonary veins

Right ventricular hypertrophy

A patient with enlargement of the right side should have other echo study? A. Peripheral (saline) contrast B. 2D study C. Stress echo D. Transesophageal echo (TEE)

Peripheral (saline) contrast

The 2 most frequently encountered congenital heart lesions diagnosed in adults are: A. ASD and PDA B. VSD and bicuspid aortic valve C. ASD and bicuspid aortic valve D. ASD and VSD

ASD and bicuspid aortic valve

Ebstein’s anomaly involves the downward displacement of the tricuspid valve leaflets into the right ventricle, a portion of the right ventricle becomes: A. A VSD B. An ASD C. Atrialized D. A patent Foramen ovale

Atrialized

A patient with a Secundum ASD has a saline contrast study. It shows all the following EXCEPT: A. Bubbles from RA to LA B. Negative contrast jet in the RA C. Bubbles in the pulmonary artery D. Bubbles from RV to LV

Bubbles from RV to LV (This would indicate a VSD)

Systemic hypertension is when the: A. Diastolic pressure is over 80 mmHg B. Diastolic pressure is over 70 mmHg C. Diastolic pressure is over 90 mmHg D. Diastolic pressure is over 60 mmHg

Diastolic pressure is over 90 mmHg

All of the following are classified as ventricular septal defects (VSDs) EXCEPT: A. Primum B. Muscular C. Subpulmonic D. Subvalvular

Primum (These are ASDs)

Where should saline contrast be injected in order to diagnose a persistent left superior vena cava? A. Subclavian vein B. Left arm C. Right arm D. Subclavian artery

Left arm

When the anatomic ventricles are switched and there are no other defects, the patient is said to have: A. Simple transposition B. Double-outlet right ventricle C. L-transposition D. D-transposition

L-transposition

Which of the following is most often associated with Primum ASDs? A. Coarctation of the aorta B. Bicuspid aortic valve C. Muscular VSDs D. Cleft mitral valve

Cleft mitral valve

If a patient presents with Cor pulmonale, the echo might show: A. Hyperdynamic left ventricle B. Hyperdynamic right ventricle C. Dilated right ventricle D. Dilated left ventricle

Dilated right ventricle (Cor pulmonale is right ventricular failure from pulmonary hypertension)

Which of the following statements are true regarding coarctation of the aorta? A. Majority are located before the left common carotid artery B. Often associated with cleft mitral valve C. Partial obstruction of the aorta D. Often associated with aortic regurgitation

Partial obstruction of the aorta

All of the following are etiologies for pulmonary hypertension EXCEPT: A. Mitral stenosis B. Pulmonary embolism C. Aortic coarctation D. Mitral regurgitation

Aortic coarctation

Which is the best standard 2D echo view for saline contrast studies to detect atrial septal defects? A. Apical long axis B. Subcostal 4 ch C. Apical 4 ch D. Parasternal long axis

Apical 4 ch

A dilated pulmonary artery, severe tricuspid regurgitation, and RV enlargement best describes? A. Pulmonary hypertension B. Mitral regurgitation C. Myocardial infarction D. Pulmonary emboli

Pulmonary hypertension

The remnant of the fetal ductus arteriosus is called the: A. Ligamentum venosus B. Patent ductus arteriosus C. Ligamentum arteriosum D. Fossa ovalis

Ligamentum ateriosum

If a large patent ductus arteriosus (PDA) is not corrected, what might develop? A. Pulmonary edema B. Eisenmenger’s syndrome C. Pericardial effusion D. Pulmonary hypertension

Eisenmenger’s syndrome

The atrial septal defect that affects the upper portion of the interatrial septum is: A. Coronary sinus B. Ostium Secundum C. Sinus venosus D. Ostium Primum

Sinus venosus

If the IVC is dilated but collapses 50% when the patient sniffs, the RA pressure is estimated to be: A. 20 mmHg B. 8 mmHg C. 10 mmHg D. 5 mmHg

8 mmHg

A common etiology for pulmonary hypertension is: A. Pulmonic stenosis B. Mitral stenosis C. Idiopathic D. Mitral regurgitation

Idiopathic

Congenital Flashcards

(73 cards)