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Flashcards in Quiz 2 review Deck (36)
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1
Q

How would you qualitatively assess the degree of Mitral regurgitation on this image?

  1. Mild
  2. Severe MR
  3. Trivial MR
  4. Moderate MR
A

Severe MR

2
Q

At which level of obstruction does hypertrophic cardiomyopathy occur?

  1. Sub-valvular aortic stenosis
  2. Valvular stenosis
  3. Pulmonary stenosis
  4. Supra-valvular aortic stenosis
A

Sub-valvular aortic stenosis

3
Q

The PISA radias is 2mm. What degree of mitral regurgitation is the most consistent?

  1. Severe MR
  2. Mild MR
  3. Moderate MR
  4. Trivial MR
A

Mild

Mild <0.4cm
Mod 0.4 - 0.89
Severe >0.9 cm

4
Q

What degree of aortic regurgitation severity is consistent with a regurgitant volume of 47ml?

  1. Moderate AR
  2. Mild AR
  3. Trivial AR
  4. Severe AR
A

Moderate AR

Moderate R volume AI = 30-60

5
Q

Which is the best view for diagnosing a mitral valve prolapse?

A

PLAX

6
Q

Angina is one of the main symptoms of AS. Which 2 choices represents the mechanism by which angina appears with AS?

  1. Increased myocardial oxygen demand due to LVH
  2. Increased afterload reduces stroke volume
  3. Increased LV pressure causes compression of the intramyocardial coronary arteries
  4. Increased LA pressure causes increased pulmonary pressures
A
  1. Increased myocardial oxygen demand due to LVH
  2. Increased LV pressure causes compression of the intramyocardial coronary arteries
7
Q
  1. Flow through the MV diastole is 130 ml
  2. Flow through the LVOT is 75ml

What grade of MR is the regurgitant volume most consistent with?

A

Moderate MR

Rvol = SV regurg valve - SV normal valve

Mod MR = Rvole 30-60 ml

8
Q

What are the three crucial pieces of information that one needs in order to perform a PISA calculation on mitral regurgitation?

A
  1. Nyquist limit
  2. MR peak velocity
  3. MR VTI
9
Q

Which etiology of AS has thickening that starts on the underside of the cusps?

A

Calcific AS

10
Q

Which etiology of aortic regurgitation is most likely to lead to severe acute AI?

A

Bicuspid aortic valve

11
Q

What is the mitral regurgitation severity of a patient with MV vena contracta of 9mm?

A

Severe

MR vena contract
1. Mild <0.3
2. Mod 0.3 - 0.69
3. Severe >0.7

12
Q

A sonographer is asked to perform an aortic valve regurgitant volume and regurgitant fraction calculation using the stroke method. The MV is also leaking moderately.

What of the following describes the best course of action?

  1. Use the PV as the control valve
  2. Use the MV as the control valve and adjust for MR
  3. Tell the doctor that the calculation cannot be done due to the MR
  4. Use the MV as the control valve
A

Use the PV as the control valve

13
Q

Why is the right heart pressure assessment vital in the consideration of surgical correction for mitral stenosis?

A

Chronically elevated right heart pressures lead to permanent lung damage that does not result after surgery

14
Q

What cause of aortic regurgitation is most likely to produce an eccentric AI jet?

  1. Bicuspid
  2. Senile AV
  3. Rheumatic AV
  4. Calcified AV
A

Bicuspid AV

15
Q

Which of the following criteria should be evaluated on a M-mode tracing of a patient with AS?

  1. Cusp thickening
  2. AV cusp excursion
  3. AV closure line
  4. All of these are correct
A

All of these are correct

16
Q

A patient with severe MR is shown to also demonstrate an increased LV end systolic volume and decreased EF.

Which type of MR is this consistent with?

  1. Acute
  2. Mild
  3. Compensated
  4. Decompensated
A

Decompensated

17
Q

Which grade of AR is present if the pressure half time on the AI jet is 190ms?

A

Severe AR

Mild >500ms
Mod: 200-500
severe <200ms

18
Q

Based on the MR jet seen in this A3C cine clip, which MV leaflet is prolapsing?

A

Posterior MVL

19
Q

Which type of MV congenital disease has the characteristic of having one papillary muscle which is placed too far superiorly?

A

Parachute mitral valve

20
Q

How might the sonographer adjust the probe to better align the abnormal flow seen in the clop below?

  1. Slide laterally
  2. Slide inferiorly
  3. Slide medially
  4. Slide superiorly
A

Slide medially

21
Q

Which parameter would change the most if mitral regurgitation increased the preload to the left ventricle?

  1. MV annulus tissue doppler
  2. MV inflow
  3. LVOT outflow
  4. TR jet (RVSP)
A

MV inflow

22
Q

Which grade of aortic regurgitation is present on the AV with a vena contracta of 7mm?

A

Severe AR

AI vena contract: Mod = 3-6 mm

23
Q

Calculate the aortic valve are for the given valves. You must choose the appropriate valve for calculation.

A

0.95cm2

AVA = ((0.785(LVOTd)^2) x LVOTvti)/AVvti
AVA = ((0.785(2.2)^2)x23)/92
AVA = 0.95cm2

24
Q

What type of murmur is associated with mitral valve prolapse?

A

Mid- systolic click followed by a murmur

25
Q

Given a MV pressure half time measurement of 180ms, what is the MVA?

A

1.22 cm2

26
Q

Which grade of aortic stenosis is consistent with VTI ratio of 0.65?

A

Mild stenosis

Mild >0.5
Mod 0.25-0.5
Severe <0.25

27
Q

Which measure of systolic function should be used on a patient with significant mitral regurgitation?

  1. dp/dt
  2. Simpsons biplane method of disk EF
  3. Linear EF
  4. Visual Estimation
A

dp/dt

28
Q

Which of the following is true regarding MV anatomy?

  1. The anterior MVL is shorter than the posterior MVL
  2. The anterior MVL has 3 distinct scallops
  3. The anterior MVL covers 1/3 of the orifice area
  4. The anterior MVL is connected to the MV annulus for 1/3 of the circumference
A

The anterior MVL is shorter than the posterior MVL

The anterior MVL is connected to the MV annulus for 2/3 of the circumference

29
Q

Which structures are important when looking for the cause of mitral regurgitation?

A
  1. The LV (dilation) and papillary structures
  2. Mitral Annular calcification (MAC) restricting movements of the leaflets
  3. The chordal structures and leaflets
30
Q

The image is a zoom MV in PSAX
How severe is the stenosis?

A

Mild MS

MVA by pressure half time
Mild >1.5
Mod 1.0 - 1.5
Severe <1.0

31
Q

The image is a zoom MV in PSAX. How severe is the MAC if any exists?

A

Severe MAC

32
Q

How should a sonographer expand their exam if they obtain an AV peak velocity of >2.0 m/s?

A

Peddoff

33
Q

Which papillary muscle is most susceptible to complications due to myocardial ischemia and infarct?

A

Posteromedial

34
Q

What is indicated by the values below?

  1. AV peak velocity = 2.7 m/s
  2. AV mean PG = 1.8 mmHg
A

Mild AS

35
Q

Which pathology is indicated by harsh ejection murmurs radiating to carotid arteries?

A

Aortic stenosis

36
Q

Which pathology is most likely indicated by the m-mode seen below?

A

Mitral stenosis