Fall'23 Cardiac Final Flashcards by Julia Han

The left anterior descending coronary artery supplies blood to all of the following EXCEPT: Anterior wall of the left ventricle, Inferior wall of the left ventricle, Anterior interventricular septum, Apical cap

Inferior wall of the left ventricle

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The moderator band is always located in the:

right ventricle

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The most likely explanation of main pulmonary artery dilatation is: Pulmonary hypertension, Bicuspid aortic valve, Carcinoid heart disease, Truncus arteriosus

pulmonary hypertension

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The name of the aortic segment located between the left subclavian artery and the insertion of the ligamentum arteriosum is the: Aortic root, Sino-tubular junction, Transverse aorta, Aortic isthmus

Aortic isthmus

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The most common etiology of pulmonary regurgitation is: Rheumatic heart disease, Infective endocarditis, Pulmonary hypertension, Carcinoid heart disease

pulmonary hypertension

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The most common etiology of tricuspid stenosis is: Carcinoid heart disease, Right atrial myxoma, Infective endocarditis, Rheumatic fever

Rheumatic fever

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The murmur of tricuspid regurgitation is best described as a: Pansystolic murmur heard best at the cardiac apex with radiation to the axilla, Pansystolic murmur heard best at the lower left sternal border, Holodiastolic murmur heard best at the lower left sternal border, Systolic ejection murmur heard best at the upper right sternal border

Pansystolic murmur heard best at the lower left sternal border

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The pulmonary vein atrial reversal wave may be _______ in peak velocity and duration in a patient with severe acute aortic regurgitation.

increased

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The severity of aortic regurgitation may best be determined with color flow Doppler by all of the following methods EXCEPT: Comparing the aortic regurgitation jet width with the left ventricular outflow tract width in the parasternal long-axis view, Measuring the aortic regurgitation jet aliasing area in the parasternal long-axis view, Determining the presence of holodiastolic flow reversal in the descending thoracic aorta and/or abdominal aorta, Measuring the vena contracta in the parasternal long-axis view

Measuring the aortic regurgitation jet aliasing area in the parasternal long-axis view

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The typical two-dimensional echocardiographic findings in rheumatic tricuspid stenosis include all of the following EXCEPT: Systolic bowing of the posterior tricuspid valve leaflet, Right atrial dilatation, Diastolic doming of the anterior tricuspid valve leaflet, Leaflet thickening especially at the leaflet tips and chordae tendineae

Systolic bowing of the posterior tricuspid valve leaflet

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When two-dimensional evaluation of a systolic ejection murmur reveals a thickened aortic valve with normal systolic excursion and a peak velocity across the aortic valve of 1.5 m/s. The diagnosis is most likely aortic valve: Stenosis, Regurgitation, Sclerosis, Prolapse

sclerosis

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A tricuspid regurgitation peak velocity of 3.0 m/s is obtained. This indicates: Severe tricuspid regurgitation, Mild tricuspid regurgitation, Moderate tricuspid regurgitation, Pulmonary hypertension

pulmonary hypertension

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All of the following are considered useful quantitative measurements to determine the severity of aortic regurgitation EXCEPT: Peak velocity of aortic regurgitation, Regurgitant volume, Regurgitant fraction, Effective regurgitant orifice

peak velocity of aortic regurgitation

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All of the following are dilated in significant chronic tricuspid regurgitation EXCEPT: Pulmonary veins, Right atrium, Inferior vena cava, Hepatic veins

Pulmonary veins

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All of the following color flow Doppler findings indicate significant pulmonary regurgitation EXCEPT: Holodiastolic flow reversal in the main pulmonary artery, Jet width/Right ventricular outflow tract width > 70%Wide jet width at origin, Peak velocity of < 1.0 m/s

Peak velocity of < 1.0 m/s

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According to the electrocardiogram (EKG), electrical systole is:

Onset of the QRS complex to the end of the T wave

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All of the following are components of a pulsed-wave Doppler of a pulmonary vein EXCEPT (AR, S2. E, AR, S1):

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All of the following are considered a part of normal ventricular diastole EXCEPT: Early passive filling, Isovolumic relaxation, Ventricular depolarization, Atrial systole

Ventricular depolarization

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All of the following are true statements concerning the left ventricle EXCEPT: Contains two papillary muscle groups, Heavily trabeculated, Bullet shaped (truncated ellipsoid), Top normal thickness is approximately 1.0 cm

Heavily trabeculated

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All of the following are true statements concerning the right ventricle EXCEPT :Normal wall thickness is 0.3 to 0.5 cm, Most anterior positioned cardiac chamber, Normally forms the cardiac apex, Heavily trabeculated

Normally forms the cardiac apex

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All of the following left ventricular wall segments may be evaluated in the parasternal long-axis view EXCEPT: Basal anterior interventricular septum, Cardiac apex, Mid-anterior interventricular septum

Cardiac apex

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All of the following left ventricular wall segments may be evaluated in the parasternal short-axis of the left ventricle at the level of the papillary muscles EXCEPT: Anterior wall, Anterior interventricular septum, Cardiac apex, Anterolateral

Cardiac Apex

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All of the following structures are located in the right atrium EXCEPT: Crista terminalis, Eustachian valve, Thebesian valve, Moderator band

Moderator band

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All of the following ventricular wall segments may be supplied by the right coronary artery EXCEPT: Basal and mid-inferolateral walls of the left ventricle, Basal and mid-anterior interventricular septum, Basal and mid-inferior walls of the left ventricle, Lateral wall of the right ventricle

Basal and mid-anterior interventricular septum

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All of the following wall segments may be visualized in the apical two-chamber view EXCEPT: Right ventricular outflow tract, Anterior wall, Inferior wall, Cardiac apex

Right ventricular outflow tract

All of the following wall segments may be visualized in the apical four-chamber view EXCEPT: Cardiac apex, Lateral wall of the right ventricle, Anterior interventricular septum, Anterolateral wall

Anterior interventricular septum

Normal pressure values in millimeters of mercury (mm Hg) for the listed cardiac chambers or great vessels include all of the following EXCEPT: Right ventricle: 15 to 30 systolic; 2 to 8 diastolic Pulmonary artery: 15 to 30 systolic; 2 to 12 mean diastolic Right atrial pressure: 2 to 8 mean Aorta: 100 to 140 systolic; 3 to 12 end-diastolic

Aorta: 100 to 140 systolic; 3 to 12 end-diastolic

Structures of the mitral valve apparatus include all of the following EXCEPT: Sinuses of Valsalva, Papillary muscles, Chordae tendineae, Mitral valve annulus

Sinuses of Valsalva

The Chiari network is found in the:

Right atrium

The boundaries of the functional left ventricular outflow tract are best described as extending from the:

Free edge of the anterior mitral valve leaflet to the aortic valve annulus

The coronary sinus can be differentiated from the descending thoracic aorta with pulsed-wave Doppler because coronary sinus flow is predominantly diastolic while aortic flow is:

Predominantly systolic

The correct order for the branches of the transverse aorta (aortic arch) is:

Right brachiocephalic, left common carotid, left subclavian

The crista terminalis is found in the:

Right atrium

The eustachian valve is found in the:

Right atrium

The imaginary boundaries that define the mid-left ventricle are the:

Tip of the papillary muscles to the base of the papillary muscles

The names of the two left ventricular papillary muscle groups are: Anterior; posterior Superior; inferior Medial; lateral Antero lateral; posteromedial

Anterolateral, posteromedial

The most common cause of chronic tricuspid regurgitation is: Rheumatic heart disease, Pulmonary hypertension, Tricuspid valve prolapse, Ebstein's anomaly

Pulmonary hypertension

All of the following are cardiac Doppler findings for tricuspid valve stenosis EXCEPT: Increased mean pressure gradient. Decreased tricuspid valve area, Decreased pressure half-time, Increased tricuspid valve E wave velocity

decreased pressure half-time

An intracardiac pressure that may be determined from the continuous-wave Doppler tricuspid regurgitation signal is: Systemic vascular resistance, Mean pulmonary artery pressure, Pulmonary artery end-diastolic pressure, Systolic pulmonary artery pressure

systolic pulmonary artery pressure

Cardiac Doppler findings associated with significant chronic tricuspid regurgitation include all of the following EXCEPT: Concave late systolic configuration of the regurgitation signal, Systolic flow reversal in the hepatic vein, Systolic flow reversal in the pulmonary vein, Increased E velocity of the tricuspid valve

Systolic flow reversal in the pulmonary vein

Echocardiographic evidence of severe acute aortic regurgitation includes all of the following EXCEPT: Premature opening of the aortic valve, Premature closure of the mitral valve, Reverse doming of the anterior mitral valve leaflet, Premature opening of the mitral valve

Premature opening of the mitral valve

Holodiastolic flow reversal in the descending thoracic aorta and/or the abdominal aorta may be present in each of the following EXCEPT: Severe mitral regurgitation, Aortopulmonary window, Severe aortic regurgitation, Patent ductus arteriosus

severe mitral regurgitation

In a patient with severe acute aortic regurgitation the left ventricular end-diastolic pressure increases rapidly. This pathophysiology will affect which of the following? Closure of the pulmonary valve, Closure of the mitral valve, Systolic ejection period, Left ventricular dimension

closure of the mitral valve

In significant chronic aortic regurgitation, M-mode and two-dimensional evidence includes all of the following EXCEPT: Left ventricular dilatation, Hyperkinesis of the interventricular septum, Paradoxical interventricular septal motion, Hyperkinesis of the posterior (inferolateral) wall of the left ventricle

Paradoxical interventricular septal motion

M-mode and two-dimensional echocardiographic findings for chronic tricuspid regurgitation include: Protected right ventricle, Paradoxical interventricular septal motion, Left ventricular volume overload, Right ventricular hypertrophy

Paradoxical interventricular septal motion

Methods for determining the severity of tricuspid regurgitation with pulsed-wave Doppler include all of the following EXCEPT: Peak velocity of the tricuspid regurgitant jet, Laminar flow of the tricuspid regurgitant jet, Increased E wave velocity of the tricuspid valve, Holosystolic flow reversal of the hepatic vein

Peak velocity of the tricuspid regurgitant jet

Possible echocardiographic and cardiac Doppler findings in a patient with carcinoid heart disease include all of the following EXCEPT: Pulmonary regurgitation, Tricuspid stenosis, Tricuspid valve prolapse, Tricuspid regurgitation

Tricuspid valve prolapse

Posterior displacement of the aortic valve leaflet(s) into the left ventricle outflow tract during ventricular diastole is called aortic valve: Prolapse Sclerosis Stenosis Perforation

Prolapse

Premature closure of the mitral valve is associated with all of the following EXCEPT: First-degree atrioventricular block Acute severe aortic regurgitation Acute severe mitral regurgitation Loss of sinus rhythm

Acute severe mitral regurgitation

Severe aortic regurgitation is diagnosed with continuous-wave Doppler by all of the following criteria EXCEPT: Steep deceleration slope A maximum velocity of 4 m/s Increased jet density A pressure half-time of < 200 msec

A maximum velocity of 4m/s

Significant chronic pulmonary regurgitation is associated with: Left ventricular volume overload Right ventricular hypertrophy Right ventricular volume overload Right atrial hypertrophy

Right ventricular volume overload

Signs of significant tricuspid regurgitation include all of the following EXCEPT: Hepatomegaly Jugular venous distention Pulsus paradoxus Right ventricular heart failure

Pulsus paradoxus

The M-mode finding that indicates severe acute aortic regurgitation is premature aortic valve: Closure Mid-systolic closure Opening Systolic flutter

Opening

The M-mode/two-dimensional echocardiography parameters that have been proposed as an indicator for aortic valve replacement in severe chronic aortic regurgitation are left ventricular: End-diastolic dimension ≥ 55 mm and fractional shortening ≤ 25% End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25% End-diastolic dimension ≤ 55 mm and fractional shortening of ≥ 25% End-diastolic dimension ≥ 70 mm and left atrial dimension ≥ 55 mm

End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%

The continuous-wave Doppler signal of aortic regurgitation may be differentiated from the continuous-wave Doppler signal of mitral stenosis by the following guideline: If the diastolic flow pattern commences after mitral valve opening then the signal is due to aortic regurgitation The Doppler flow velocity pattern of mitral valve stenosis is laminar while the Doppler flow pattern of aortic regurgitation is turbulent. Cannot be differentiated by continuous-wave Doppler. If the diastolic flow pattern commences before mitral valve opening then the signal is due to aortic regurgitation

If the diastolic flow pattern commences before mitral valve opening then the signal is due to aortic regurgitation

The mitral valve pulsed-wave Doppler flow pattern often associated with severe acute aortic regurgitation is grade: II (pseudonormal) Normal for age III or IV (restrictive) I (impaired relaxation)

III or IV (restrictive)

All of the following represents possible etiologies for acute aortic regurgitation EXCEPT: Aortic dissection Aortic valve sclerosis Trauma Infective endocarditis

Aortic valve sclerosis

An effect of significant aortic valve stenosis on the left ventricle is: Protected in significant aortic valve stenosis Asymmetrical septal hypertrophy Eccentric left ventricular hypertrophy Concentric left ventricular hypertrophy

concentric left ventricular hypertrophy

Aortic valve with reduced systolic excursion. On physical examination there was a crescendo-decrescendo systolic ejection murmur and a diastolic decrescendo murmur heard. The most likely diagnosis is aortic valve: Flail Stenosis and mitral valve prolapse Regurgitation Stenosis and regurgitation

stenosis and regurgitation

Cardiac magnetic resonance imaging provides all of the following information in a patient with aortic regurgitation EXCEPT: Detailed resolution of the aortic valve Left ventricular volumes Regurgitant volume Effective regurgitant orifice

Detailed resolution of the aortic valve

Cardiac Doppler parameters used to assess the severity of valvular aortic stenosis include all the following EXCEPT: Peak aortic valve velocity Mean pressure gradient Aortic pressure half-time Aortic velocity ratio

Aortic pressure half-time

Detailed resolution of the aortic valve

In the parasternal long-axis view, severe aortic valve stenosis is defined as an aortic valve leaflet separation that measures: ≤ 12 mm ≤ 8 mm ≤ 10 mm ≥ 14 mm

≤ 8 mm

Of the transvalvular pressure gradients that can be measured in the echocardiography laboratory, the most useful in examining aortic valve stenosis is probably: Peak-to-peak gradient Mean systolic gradient Mean diastolic gradient Peak instantaneous pressure gradient

Mean systolic gradient

Pathologies that may result in a left ventricular pressure overload include all the following EXCEPT: Mitral valve stenosis Systemic hypertension Valvular aortic stenosis Discrete subaortic stenosis

Mitral valve stenosis

Possible two-dimensional echocardiographic findings in significant aortic valve stenosis include all the following EXCEPT: Left ventricular hypertrophy Post-stenotic dilatation of the ascending aorta Post-stenotic dilatation of the descending aorta Aortic valve calcification

Post-stenotic dilatation of the descending aorta

Reverse diastolic doming of the anterior mitral valve leaflet is associated with: Severe aortic regurgitation Rheumatic mitral valve stenosis Papillary muscle dysfunction Flail mitral valve

severe aortic regurgitation

Secondary echocardiographic findings associated with severe valvular aortic stenosis include all the following EXCEPT: Right ventricular hypertrophy Left ventricular hypertrophy Decreased left ventricular systolic function (late in course) Post-stenotic dilatation of the ascending aorta

right ventricular hypertrophy

The Doppler maximum peak instantaneous pressure gradient in a patient with aortic stenosis is 100 mm Hg. The cardiac catheterization peak-to-peak pressure gradient will most likely be: Dependent upon respiration Higher than 100 mm Hg Lower than 100 mm Hg Equal to 100 mm Hg

lower than 100mmHg

The LEAST common valve regurgitation found in normal patients is: Pulmonary regurgitation Mitral regurgitation Aortic regurgitation Tricuspid regurgitation

Aortic regurgitation

The aortic valve area considered severe aortic valve stenosis is: < 3 cm^2 < 1.5 cm^2 < 2 cm^2 ≤ 1.0 cm^2

≤ 1.0 cm^2

The characteristic M-mode findings for aortic valve stenosis include all the following EXCEPT: A lack of systolic flutter of the aortic valve leaflets Thickening of the aortic valve leaflets Diastolic flutter of the aortic valve leaflets Reduced leaflet separation in systole

Diastolic flutter of the aortic valve leaflets

The characteristic feature of the murmur of chronic aortic regurgitation is a: Diastolic rumble following an opening snap Diastolic crescendo-decrescendo murmur heard best along the left upper sternal border Harsh systolic ejection murmur heard best at the right upper sternal border Diastolic decrescendo murmur heard best along the left sternal border

Diastolic decrescendo murmur heard best along the left sternal border

The echocardiographer may differentiate between the similar systolic flow patterns seen in coexisting severe aortic valve stenosis and mitral regurgitation by all the following EXCEPT: Aortic ejection time is shorter that the mitral regurgitation time Mitral regurgitation flow always lasts until mitral valve opening, whereas aortic valve stenosis flow does not. Mitral diastolic filling profile should be present during recording of the mitral regurgitation, whereas no diastolic flow is observed in aortic valve stenosis. Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis.

Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis.

The hallmark M-mode finding for aortic regurgitation is: Fine diastolic flutter of the anterior mitral valve leaflet Coarse diastolic flutter of the anterior mitral valve leaflet Chaotic diastolic flutter of the mitral valve Systolic flutter of the aortic valve

Fine diastolic flutter of the anterior mitral valve leaflet

The most common etiology of chronic aortic regurgitation is: Marfan's syndrome Dilatation of the aortic root and aortic annulus Trauma Infective endocarditis

Dilatation of the aortic root and aortic annulus

The murmur associated with severe aortic regurgitation is: Still's Graham-Steell Austin-Flint Carvallo's

Austin-Flint

The murmur of aortic stenosis is described as: Diastolic rumble Holosystolic murmur heard best at the cardiac apex Holodiastolic decrescendo murmur heard best at the right sternal border Systolic ejection murmur heard best at the right upper sternal border

Systolic ejection murmur heard best at the right upper sternal border

The onset of flow to peak aortic velocity continuous-wave Doppler tracing in severe valvular aortic stenosis is: Decreased Increased Decreased with expiration Increased with inspiration

increased

The pulse that is characteristic of significant valvular aortic stenosis is: Pulsus alternans Pulsus paradoxus Pulsus bisferiens Pulsus parvus et tardus

Pulsus parvus et tardus

Fall'23 Cardiac Final Flashcards

(80 cards)