Practice Exam 1 Flashcards
(100 cards)
1
Q
The congenital cardiac anomaly seen most frequently in adults is?
- Epstein’s anomaly
- Bicuspid aortic valve
- Ventricular septal defect
- AV septal defect
A
Bicuspid aortic valve
2
Q
What is the number and location of the Papillion muscles of a normal mitral valve?
A
2: posterior medial & anterior lateral
3
Q
Clinically, prolapse of the Mitral valve is associated with what kind of murmur?
A
Midsystolic to late systolic murmur
4
Q
Papillary muscle dysfunction usually results from?
- Dresser syndrome
- ischemic heart disease
- Bacterial endocarditis
- Rheumatic heart disease
A
Ischemic heart disease
5
Q
How many veins connect the pulmonary vascular bed with the left atrium in the normal heart?
A
4
6
Q
What are aortic valve frenestrations?
A
An aperature or loss of tissue in the aortic leaflets
7
Q
Which M mode finding is considered to be a specific indicator of a fenestrated aortic valve ?
- Diastolic flutter of the mitral valve.
- Premature opening of the aortic valve
- Diastolic flutter of the aortic valve
- Early systolic closure of the aortic valve.
A
- Diastolic flutter of the aortic valve.
8
Q
What two cardiac anomalies are frequently noted on the echocardiogram of patients with Marans syndrome?
A
Aortic dilation and MVP
9
Q
A true aneurysm of the left ventricle can usually be distinguished from a pseudo aneurysm because a pseudo aneurysm?
A
Has a smaller more narrow neck than a true aneurysm
10
Q
What type of cardiomyopathy is associated with amyloidosis?
A
Infiltrative
11
Q
In a patient with carcinoid heart disease what should you devote special attention to?
A
The tricuspid valve
12
Q
Infundibular pulmonary stenosis is uncommon as an isolated lesion is usually associated with?
- Tricuspid Artesia
- ASD
- Coarctation of the aorta
4.VSD
A
VSD
13
Q
Which echo view is best for the assessment of the inter-atrial septum
A
Subcostal 4 chamber
14
Q
What is the most common type of ASD?
A
Ostium Secundum
15
Q
What is tricuspid Artesia?
A
A congenital heart defect where there is no TV at all. Therefore blood can not enter the RA.
This causes a hypo plastic right ventricle (underdeveloped Right side)
16
Q
What is hypoplastic Right heart syndrome?
A
Underdeveloped right heart
17
Q
M-mode echo demonstration of mid systolic closure of the pulmonary valve along with a decreased “a” wave is most consistent with?
- Pulmonary hypertension
- Pulmonary insufficiency
- Valvular pulmonary stenosis
- Infundibular pulmonary stenosis
A
- Pulmonary hypertension
18
Q
False overwriting of aorta may be produced on m-mode by?
A
Positioning the transducer too high an intercostal
Space
19
Q
What is an over riding aorta?
A
A congenital defect where the aorta is incorrectly positioned over a VSD instead of the LV.
20
Q
A-fib is most commonly associated with what valve disease?
A
Rheumatic mitral stenosis
21
Q
The Bernoulli equation measures ____ gradient across the valve
- Mean
- Peak to peak
- Peak instantaneous
- PHT
A
- Peak instantaneous
22
Q
When a patient has a clinical diagnosis of pericarditis:
- A pericardial effusion is always always present.
- A pericardial effusion may not be present
- Pericardial thickening is always present
- Pericardial thickening may not always present
A
- PE may not be present
23
Q
In normal patients the most ventricular filling occurs?
A
Within the first 3rd of diastole
24
Q
The patient your examining has clear cut auscultation and angiographic evident for MVP, but the echo is normal. You should then?
A
Echo the patient in a standing position
25
TV closure normally occurs:
1. Before MV closure
2. Simultaneous with mitral closure
3. Less than 0.06 seconds after mitral closure
4. More than 0.06 seconds after mitral closure
3. Less than 0.06 seconds after MV closure
26
Kawasaki disease may lead to?
1. AV prolapse
2. TR
3. Coronary artery aneurysm
4. Ruptured charade
3. Coronary artery aneurysm
27
What is Kawasaki disease?
A disease that causes inflammation of the walls of small to medium sized blood vessels.
28
What arteries does Kawasaki disease affect the most?
Coronary arteries
29
Kawasaki disease usually affects _____ and more often of the ____ sex.
Children: female
30
A speckled appearance of the myocardium might represent what cardiomyopathy?
Infiltrative
31
Atrial Myxomas are usually attached to the?
2. LAA
3. MV leaflets
3. posterior LAA free wall
4 fossa ovalis region of the IAS
4. Fossa ovalis region of the IAS
32
Which two Echo views are best for direct imaging of a discrete subaortic membrane?
Ap5 and long axis PLAX
33
Premature opening of the pulmonary valve may be seen in?
Acute severe PHTN
34
An underestimation of the severity of aortic stenosis by continuous wave Doppler may occur with?
1. High gain settings
2. Low CO
3. High CO
4. AR
2. Low CO
35
Estimation of the mitral valve area from Doppler is calculated by the?
PHT
36
Doppler ultrasound may show retrograde flow velocity within the ascending aorta during diastole in the presence of?
1. PDA
2. AR
3. VSD
4. Atriosubclavian shunts
2. AR
37
A patient with a recent myocardial infarction is diagnosed with dressers syndrome. Special care and performing a 2D should be followed to rule out?
Pericardial effusion
38
A 22-year-old patient with down syndrome is referred to the echo lab. what is the most commonly associated with these patients?
AV septal defect
39
When obtaining a continuous wave Doppler aortic profile from the Apex through a heavily calcified aortic valve you might:
1. Overestimate the velocity.
2. Underestimate the velocity.
3. Confused the jet with mitral inflow
4. Confused the jet with pulmonic stenosis.
2. Underestimate the velocity
40
The Doppler jet of mitral stenosis obtained at the Apex is sometimes confused with?
1. AI
2. MR
3. PI
4. TR
1. AI
41
When Starr- Edward’s prosthetic valve is in both the MV and AV. MR is best detected from which window?
Subcostal
42
What’s a R-R interval?
The time between one ventricular contraction to the next one. One QRS to the next QRS.
43
What’s the normal R-R interval?
0.6-0.12 seconds
44
For patients with aortic stenosis and a- fib peak systolic aortic velocity will be?
2. Higher following shorter R-R intervals
3. Unaffected by R-R intervals
3. Higher following longer R-R intervals
4. Lower following longer R-R intervals
3. Higher following longer R-R intervals
45
Aliasing on color flow Doppler is shown by?
1. Reversal in color
2. Reversal in intensity
3. Display of green
4. Mosaic of colors
1. Reversal in color
46
Premature mitral valve closure on M mode is a sign of high left ventricular diastolic pressure in?
1. 1st degree heart blocks
2. AI
3. AS
4. MI
3. AI ( because this causes increased preload and increase pressure in the LV.)
47
Mid systolic or late systolic murmurs are most characteristic of?
MVP
48
What are the two most frequently encountered congenital heart lesions in adults??
Bicuspid AV valve and ASD
49
Endothelialized __can have the same tissue characteristics as myocardium on echo.
Thrombi
50
Epstein’s anomaly is characterized by a _____ displacement of all our part of the tricuspid valve into the right ventricular cavity.
Inferior
51
On Echo, the motion of a congenital stenotic aortic valve can usually be described as?
1. Prolapsing
2. Fluttering
3. Doming
4. Akinetic
3. Doming
52
On Echo, a dense band, an echoes between the posterior left ventricular wall, and the mitral valve may represent?
Mitral ring calcification
53
On m-mode a flail MV leafelet have look similar to ?
An infected MV
54
What is one of the most common complications of myocardial infarction?
Aneurysm formation
55
In patience with a large pericardial effusion the motion of the pericardium may be?
Damped
56
On Echo, a cleft my travel valve may be confused with?
The TV
57
In which view is the ultrasound beam most perpendicular to the into atrial septum?
Subcostal 4 ch
58
Impatience with VSDs and left to right shunting which chamber might be dilated?
LA
59
What is one advantage to using the PLAX view to diagnose mitral valve prolapse?
You can avoid false prolapse caused by the annulus shape
60
Patients with aortic insufficiency may have serial echoes to check for?
1. LV wall thickness
2. LV dimension changes
2. Dimension changes of LV
61
Which of the following is least likely to affect serial left ventricular dimension measurements on M mode?
1. Respiration
2. Patient position
3. Transducer position
4. Transducer frequency
4 frequency
62
A LV thrombus is usually in an area of?
Abnormal wall motion
63
Rupture of the IVS is most often a complication of?
A MI
64
A M-mode of a mitral heterograft valve resembles an M-mode of which valve?
Aortic
65
“Electrical Alterans” is seen on a patients EKG. What will the echo most likely show?
LARGE PE
66
Ventricular repolarization is represented in the EKG where?
The T wave
67
A common cause for RV volume overload is?
TR
68
Premature closure of the MV can be seen in patients with?
AI
69
** the most common cause of MR is elderly patients is?
1. Rheumatic heart disease
2. Calcified mitral annulus
2. Calcified mitral annulus
70
A patient has constrictive pericarditis. You perform contrast study to look for?
Pre systolic appearance of contrast in IVC
71
A patient with a systolic murmur and a fixed split S2 may have what issue?
ASD
72
An ASD is associated with what murmur?
Systolic murmur with fixed split S2
73
An ASD is associated with what murmur?
Systolic murmur with fixed split S2
74
Pulmonary wedge pressure is equal to pressure in the?
LA
75
Filling of the cornary arteries occurs during which part of the cardiac cycle?
Ventricular diastole
76
The A-dip in the m-mode of the pulmonary valve is caused by the contraction of the?
RA ( because the RA contrasts when there’s an elevation of pressure near the same level of the pulmonary artery pressure)
77
Which of the following is associated with severe acute MR?
1. MS
2. LAE
3. Pulmonary edema
4. LVH
3. Pulmonary edema
78
Positional and respiratory variation in chest pain is a sign of what disease?
Pericarditis
79
What percentage of LV filling is normally contributed by atrial systole?
30%
80
Which valve lesion is most commonly associated with a LBBB?
1. Ebsteins
2. Calcified aortic stenosis
3. MVP
4. Calcified Mitral stenosis
2. Calcified aortic stenosis
81
An advantage of CW Doppler over PW is?
1. Range resolution
2. Low nyquist limit
3. Peak velocity detection
4. Aliasing can be detected
3. Peak velocity detection
82
Which echo view is best for long evaluating the ball excursion of a start-Edward’s MV using m-mode?
Apical
83
A patient has Kawasaki disease. Which of the following are you looking for?
1. ASD
2 VSD
3. Regional WMA
4. MVP
3. Regional WMA
84
Normally, pericardial fluid drains into the?
Lymphatic system
85
A patient that has a higher BP in the right arm than the left may have?
Aortic coartation
86
Premature closure of the Av valve on m-mode may be due to?
MR ( extra fluid in the LV closes AV early)
87
An intra-aortic ballon pump assists the LV by increasing?
Company blood flow
88
Angina, Dyspena and syncope are signs of advanced?
AS
89
Over stimulation of the parasympathetic nervous system will?
Decrease HR
90
The patient has equal end diastolic pressures between both atrium and both ventricles. What does this suggest?
1. PDA
2. PE
3. Tamponade
4. Constrictive pericarditis
4.
91
In normal patients why does the peak velocity of flow in the pulmonary artery occur later than the peak velocity of the aorta?
1. Vascular resistance is lower
2. Vascular resistance is higher
3. Flow volume is higher
4. Flow volume is lower
1. Vascular resistance is lower
92
What murmur is suggestive of a bicuspid aortic valve?
Systolic ejection click
93
True or false- high frequency systolic vibrations of the AV valve of m-mode are not normal
Flase. This is normal
94
IHSS may be suspected if the ratio of IVS thickness to LV posterior wall thickness is?
1.3-1
95
An m-mode sweep from LV to aorta is used in patients suspected with PE to?
Differentiate pericardial from pleural effusion
96
True or false- a false MVP may be caused by a large PE.
True
97
When measuring the orifice of the in patient with MS. You just measure where?
At the opening at the leaflet tips
98
True or false- when measuring MV orifice you should measure as close to the LA opening as possible
False. You should measure near leaflet tips
99
The continuity equation is based on the premise that?
Flow blow the valve is equal to flow above the valve
100
The false appearance of MVP on m-mode can be due to?
Placing your transducer to high on the chest
