Semester Pool Flashcards

1
Q

A communication between the ascending aorta and the main pulmonary artery is called:

a. Aortopulmonary window
b. Patent ductus arteriosus
c. Supracristal ventricular septal defect
d. Coarctation of the aorta

A

a. Aortopulmonary window

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2
Q

A complete atrioventricular septal defect is ostium primum atrial septal defect with:

a. Cleft mitral valve
b. Canal (inlet)-type ventricular septal defect, common atrioventricular valve
c. Coarctation of the aorta
d. Canal (inlet)-type ventricular septal defect, patent ductus arteriosus

A

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

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3
Q

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:

a. Ebstein’s anomaly
b. Tricuspid atresia
c. Epstein-Barr anomaly
d. Tricuspid stenosis

A

a. Ebstein’s anomaly

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4
Q

A defect is found in the central portion of the inter-atrial septum. The type of atrial septal defect present is:

a. Ostium primum
b. Ostium secundum
c. Sinus venosus
d. Coronary sinus

A

b. Ostium secundum

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5
Q

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:

a. Aortic dissection
b. Discrete subaortic stenosis
c. Hourglass aortic stenosis
d. “Strand” aorta

A

b. Discrete subaortic stenosis

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6
Q

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:

a. Aortic dissection
b. Mitral stenosis
c. Pericarditis
d. Acute severe mitral regurgitation

A

a. Aortic dissection

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7
Q

A possible etiology for aortic aneurysm is:

a. Marfan syndrome
b. Dilated cardiomyopathy
c. Aortic regurgitation
d. Coronary artery disease

A

a. Marfan syndrome

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8
Q

A potential complication of patent foramen ovale is:

a. Paradoxical embolus
b. Valvular stenosis
c. Congestive heart failure
d. Mitral valve stenosis

A

a. Paradoxical embolus

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9
Q

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

a. ASH
b. SAM
c. DSS
d. ASA

A

d. ASA

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10
Q

A two-dimensional echocardiographic finding for an aortic intimal flap indicates aortic:

a. Regurgitation
b. Dissection
c. Aneurysm
d. Stenosis

A

b. Dissection

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11
Q

All of the following are associated echocardiographic findings for atrial septal defect EXCEPT:

a. Right atrial enlargement
b. Paradoxical interventricular septal motion
c. Left ventricular enlargement
d. Right ventricular enlargement

A

c. Left ventricular enlargement

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12
Q

All of the following are associated with pulmonary stenosis EXCEPT:

a. Systolic doming of the pulmonary valve
b. Coarctation of the aorta
c. Pulmonary regurgitation
d. Right ventricular hypertrophy

A

b. Coarctation of the aorta

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13
Q

All of the following are true concerning supravalvular aortic stenosis EXCEPT:

a. Parasternal long-axis view allows visualization
b. Left ventricular volume overload
c. Hourglass type associated with Williams syndrome
d. Associated with proximal coronary artery dilatation

A

b. Left ventricular volume overload

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14
Q

All of the following surgical repairs for congenital heart disease are correctly matched EXCEPT:

a. Fontan: Single ventricle repair
b. Blalock-Taussig: Right subclavian artery to the right
pulmonary artery
c. Modified Glenn: Superior vena cava to the right pulmonary artery
d. Ross: Surgical ligation of a patent ductus arteriosus

A

d. Ross: Surgical ligation of a patent ductus arteriosus

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15
Q

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:

a. I
b. B
c. III
d. II

A

a. I

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16
Q

Associated anomalies of sinus of Valsalva aneurysm include all of
the following EXCEPT:

a. Bicuspid aortic valve
b. Atrial septal defect
c. Ventricular septal defect
d. Coarctation of the aorta

A

b. Atrial septal defect

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17
Q

Congenital heart defects strongly associated with Ebstein’s anomaly include:

a. Parachute mitral valve
b. Discrete subaortic stenosis
c. Coarctation of the aorta
d. Atrial septal defect

A

d. Atrial septal defect

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18
Q

Defects associated with tetralogy of Fallot in approximately 30% of cases include:

a. Bicuspid aortic valve
b. Overriding pulmonary artery
c. Right aortic arch
d. Tricuspid atresia

A

c. Right aortic arch

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19
Q

Echocardiographic criteria for the diagnosis of aortic dissection include all of the following EXCEPT:

a. Recognition of an intimal flap within the aorta
b. Pleural effusion
c. Pericardial effusion
d. Decrease in aortic dimension

A

d. Decrease in aortic dimension

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20
Q

Eisenmenger’s syndrome may be associated with all of the following EXCEPT:

a. Ventricular septal defect
b. Bicuspid aortic valve
c. Atrial septal defect
d. Patent ductus arteriosus

A

b. Bicuspid aortic valve

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21
Q

For an agitated saline contrast exam, where will contrast appear proving the patient has an atrial septal defect?

a. Main pulmonary artery
b. Left atrium
c. Right atrium
d. Right ventricle

A

b. Left atrium

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22
Q

Important factors in evaluating post-surgical repair of tetralogy of Fallot include all of the following EXCEPT:

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

b. Evaluate right and left ventricular function

c. Rule out shunting at the margins of the ventricular septal defect repair

d. Rule out residual right ventricular outflow tract obstruction

A

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

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23
Q

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:

a. 110 mm Hg
b. 20 mm Hg
c. 120 mm Hg
d. 30 mm Hg

A

b. 20 mm Hg

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24
Q

In coarctation of the aorta blood pressure in the legs:

a. Is higher than in the right arm

b. Is equal to blood pressure in the right arm

c. Is lower than the right arm

d. Cannot be compared with blood pressure in the right arm

A

c. Is lower than the right arm

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25
Q

Narrowing of the aortic isthmus is:

a. Aortic arch aneurysm

b. Aortic dissection

c. Coarctation of the aorta

d. Patent ductus arteriosus

A

c. Coarctation of the aorta

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26
Q

Patent ductus arteriosus results in

a. Right ventricular volume overload

b. Left ventricular pressure overload

c. Right ventricular pressure overload

d. Left ventricular volume overload

A

d. Left ventricular volume overload

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27
Q

Possible complications of aortic dissection include all of the following EXCEPT:

a. Aortic regurgitation

b. Left ventricular inflow tract obstruction

c. Progressive enlargement of the aorta

d. Pericardial effusion

A

b. Left ventricular inflow tract obstruction

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28
Q

Prime characteristics of tetralogy of Fallot include all of the following EXCEPT:

a. Right ventricular outflow tract obstruction

b. Malalignment ventricular septal defect

c. Right ventricular hypertrophy

d. Atrial septal defect

A

d. Atrial septal defect

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29
Q

The Doppler finding associated with patent ductus arteriosus is:

a. Holodiastolic flow reversal in the descending thoracic aorta

b. Increased flow velocity at the aortic isthmus

c. Decreased pressure half-time of the mitral valve

d. Systolic flow reversal in the pulmonary veins

A

a. Holodiastolic flow reversal in the descending thoracic aorta

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30
Q

The _____________ sinus of Valsalva is the most common sinus involved in sinus of Valsalva aneurysm.

a. Left

b. Non-coronary

c. All three are equally involved in sinus of Valsalva aneurysm

d. Right

A

d. Right

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31
Q

The cardiac chambers that are enlarged in ventricular septal defect initially are:

a. Left atrium; left ventricle

b. Right atrium; right ventricle

c. Right ventricle; left ventricle

d. Right atrium; left atrium

A

a. Left atrium; left ventricle

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32
Q

The cardiovascular abnormalities seen with Marfan syndrome include all of the following EXCEPT:

a. Aortic dissection

b. Mitral supravalvular ring

c. Mitral valve prolapse

d. Dilatation of the aortic root, sinuses of Valsalva, ascending aorta

A

b. Mitral supravalvular ring

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33
Q

The congenital heart defect most often associated with Down syndrome (trisomy 21) is:

a. Coarctation of the aorta

b. Peripheral pulmonary stenosis

c. Atrioventricular septal defect

d. Tetralogy of Fallot

A

c. Atrioventricular septal defect

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34
Q

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:

a. Atrial septal defect

b. Deviation of the aorta

c. Coarctation of the aorta

d. Cleft mitral valve

A

b. Deviation of the aorta

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35
Q

The most common location for aneurysm of the aorta is the:

a. Transverse aorta

b. Descending thoracic aorta

c. Abdominal aorta

d. Ascending aorta

A

c. Abdominal aorta

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36
Q

The most common type of ventricular septal defect is:

a. Trabecular

b. Inlet

c. Perimembranous

d. Outlet (supracristal)

A

c. Perimembranous

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37
Q

The normal Qp/Qs ratio is:

a. 1:1

b. 2:1

c. 50%

d. 1:2

A

a. 1:1

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38
Q

The physical finding of cyanosis is most common in:

a. Eisenmenger’s syndrome

b. Patent foramen ovale

c. Mitral valve prolapse

d. Pulmonary regurgitation

A

a. Eisenmenger’s syndrome

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39
Q

The type of ventricular septal defect most often associated with ventricular septal aneurysm is:

a. Outlet

b. Trabecular

c. Inlet

d. Perimembranous

A

d. Perimembranous

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40
Q

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:

a. 36 mm Hg

b. 4 mm Hg

c. 26 mm Hg

d. 64 mm Hg

A

c. 26 mm Hg

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41
Q

The typical murmur associated with patent ductus arteriosus is:

a. Late systolic murmur

b. Decrescendo diastolic murmur

c. Holosystolic murmur

d. Continuous murmur

A

d. Continuous murmur

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42
Q

The view of choice when examining a patient with secundum atrial septal defect is:

a. Parasternal short-axis of the aortic valve

b. Apical four-chamber

c. Parasternal long-axis

d. Subcostal four-chamber

A

d. Subcostal four-chamber

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43
Q

Types of supravalvular aortic stenosis include all of the following EXCEPT:

a. Hypertrophic

b. Hourglass

c. Dissected

d. Tunne

A

c. Dissected

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44
Q

Uhl’s anomaly is:

a. Ostium primum atrial septal defect with cleft mitral valve

b. Right ventricular dysplasia

c. Left atrium aneurysm

d. Abnormal displacement of the tricuspid valve

A

b. Right ventricular dysplasia

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45
Q

Valvular lesions with which coarctation of the aorta is strongly associated include:

a. Tricuspid atresia

b. Aortic valve flail

c. Bicuspid aortic valve

d. Aortic valve vegetation

A

c. Bicuspid aortic valve

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46
Q

When evaluating atrial septal defect flow with color Doppler, the sonographer should:

a. Invert the color flow map

b. Invert the color flow map

c. Reduce the color velocity scale

d. Increase the color Doppler filter

A

c. Reduce the color velocity scale

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47
Q

A common echocardiographic finding in a cardiac surgery patient is:

a. Pleural effusion

b. Valvular stenosis

c. Paradoxical interventricular septal motion

d. Valvular prolapse

A

c. Paradoxical interventricular septal motion

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48
Q

A common two-dimensional echocardiographic finding in patients with chronic renal failure is:

a. Mitral valve prolapse

b. Aortic dissection

c. Pericardial effusion

d. Pulmonary hypertension

A

c. Pericardial effusion

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49
Q

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:

a. Normal

b. Persistent left superior vena cava

c. Inlet ventricular septal defect

d. Inlet ventricular septal defect

A

b. Persistent left superior vena cava

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50
Q

A left atrial volume is determined to be 44 ml/m^2. The left atrium is:

a. Hyperdynamic

b. Enlarged

c. Thrombosed

d. Normal

A

b. Enlarged

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51
Q

A membrane is visualized in the left atrium and appears to be superior to the fossa ovalis. This finding suggests:

a. Cor triatriatum

b. Mitral stenosis

c. Tetralogy of Fallot

d. Supravalvular mitral ring

A

a. Cor triatriatum

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52
Q

A membrane located at the level of the mitral valve annulus is mitral valve:

a. Prolapse

b. Flail

c. Annular calcification

d. Ring

A

d. Ring

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53
Q

A string-like structure is seen in the apex of the left ventricle. This finding may be called all of the following EXCEPT:

a. False tendon

b. Moderator band

c. Chordal web

d. Ectopic chordae

A

b. Moderator band

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54
Q

All of the following are associated echocardiographic/Doppler finding for the Marfan syndrome EXCEPT:

a. Mitral stenosis

b. Aortic dissection

c. Aortic root dilatation

d. Valvular regurgitation

A

a. Mitral stenosis

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55
Q

All of the following are associated findings for pulmonary embolism EXCEPT:

a. Tricuspid regurgitation

b. D-shaped left ventricle

c. Right ventricular dilatation

d. Left ventricular hypertrophy

A

d. Left ventricular hypertrophy

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56
Q

All of the following are expected echocardiographic/Doppler finding in the elderly EXCEPT:

a. Aortic valve sclerosis

b. Mitral annular calcification

c. Mitral valve E/A ratio of 1.5

d. Mild left atrial dilatation

A

c. Mitral valve E/A ratio of 1.5

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57
Q

All of the following are expected echocardiographic/Doppler findings for atrial fibrillation EXCEPT:

a. Reduced left atrial appendage peak velocity

b. Normal mitral valve E/A ratio

c. Pulmonary vein absent atrial reversal wave

d. Biatrial dilatation

A

b. Normal mitral valve E/A ratio

58
Q

All of the following are findings for ankylosing spondylitis EXCEPT:

a. Dilatation of the sinuses of Valsalva

b. Acute myocardial infarction

c. formula

d. Dilatation of the aortic annulus

A

b. Acute myocardial infarction

59
Q

All of the following are most likely to mimic the findings of mitral
stenosis EXCEPT:

a. Parachute mitral valve

b. Infective endocarditis

c. Cor triatriatum

d. Left atrial myxoma

A

b. Infective endocarditis

60
Q

All of the following are normal characteristics of a normal athlete’s heart EXCEPT:

a. Tissue Doppler E’ peak velocity > 8 cm/s

b. Normal E/A mitral ratio

c. Concentric hypertrophy (< 17 mm)

d. Left atrial dilatation

A

d. Left atrial dilatation

61
Q

All of the following are normal findings in cardiac transplantation patients EXCEPT:

a. Biatrial dilatation

b. Mild tricuspid regurgitation

c. Reduced global ventricular systolic function

d. Paradoxical interventricular septal motion

A

c. Reduced global ventricular systolic function

62
Q

All of the following are possible echocardiographic/Doppler findings for Ehlers-Danlos EXCEPT:

a. Ventricular septal defect

b. Mitral stenosis

c. Valvular prolapse

d. Ascending aortic aneurysm

A

b. Mitral stenosis

63
Q

All of the following are possible sources of systemic embolism EXCEPT:

a. Aortic atherosclerotic plaque

b. Left atrial myxoma

c. Left ventricular apical thrombus

d. Aortic regurgitation

A

d. Aortic regurgitation

64
Q

An aortic arteritis associated with marked intimal proliferation and fibrous scarring is:

a. Takayasu’s disease

b. Marfan’s syndrome

c. Libman-Sacks

d. Shone’s complex

A

a. Takayasu’s disease

65
Q

Dilated coronary sinus has been associated with all of the following EXCEPT:

a. Coronary atrioventricular fistula with drainage into the coronary sinus

b. Right atrial hypertension

c. Mitral regurgitation

d. Persistent left superior vena cava

A

c. Mitral regurgitation

66
Q

Electrical pacing of the right ventricle mimics the electrocardiographic and echocardiography findings of:

a. Wolff-Parkinson-White syndrome

b. Complete atrioventricular block

c. Right bundle branch block

d. Left bundle branch block

A

d. Left bundle branch block

67
Q

In normal young patients most ventricular filling occurs during:

a. During the PR interval

b. Early ventricular diastole

c. Atrial systole

d. Diastasis

A

b. Early ventricular diastole

68
Q

In the parasternal short-axis of the mitral valve two separate mitral valve orifices are seen during ventricular diastole. This suggests:

a. Cleft mitral valve

b. Flail mitral valve

c. Double orifice mitral valve

d. Mitral valve prolapse

A

c. Double orifice mitral valve

69
Q

Osler-Weber-Rendu disease is associated with pulmonary arteriovenous fistula. The preferred echocardiographic/Doppler technique to determine the presence of this finding is:

a. Two-dimensional

b. Agitated saline contrast

c. M-mode

d. Color flow Doppler

A

b. Agitated saline contrast

70
Q

Papillary muscle dysfunction usually results from:

a. Rheumatic heart disease

b. Infective endocarditis

c. Dressler’s syndrome

d. Ischemic heart disease

A

d. Ischemic heart disease

71
Q

Penetrating aortic ulcer is considered to be:

a. Aortopulmonary window

b. Idiopathic

c. Aortic dissection

d. Congenital

A

c. Aortic dissection

72
Q

Pulmonary vein stenosis may result in:

a. Left atrial enlargement

b. Mitral regurgitation

c. Left ventricular hypertrophy

d. Pulmonary hypertension

A

d. Pulmonary hypertension

73
Q

Rupture of the vasa vasorum into the media of the aortic wall may result in:

a. Intramural hematoma

b. Aortic aneurysm

c. Coarctation of the aorta

d. Supravalvular aortic stenosis

A

a. Intramural hematoma

74
Q

The classic echocardiographic finding for Pompe’s disease is:

a. Aortic stenosis

b. Left ventricular hypertrophy

c. Mitral stenosis

d. Coarctation of the aorta

A

b. Left ventricular hypertrophy

75
Q

The classic echocardiographic findings for Noonan syndrome is:

a. Dilated cardiomyopathy

b. Dysplastic pulmonary valve

c. Ventricular septal defect

d. Bicuspid aortic valve

A

b. Dysplastic pulmonary valve

76
Q

The combination of left ventricular inflow tract obstruction and left ventricular outflow tract obstruction is called:

a. Shone’s complex

b. Uhl’s anomaly

c. Ebstein’s anomaly

d. Takayasu’s disease

A

a. Shone’s complex

77
Q

The echocardiographic/Doppler findings for Friedreich ataxia include:

a. Left ventricular hypertrophy

b. Aortic stenosis

c. Thickened mitral valve

d. Libman-Sacks endocarditis

A

a. Left ventricular hypertrophy

78
Q

The echocardiographic/Doppler findings for cor pulmonale are very similar to:

a. Hypertrophic cardiomyopathy

b. Hemochromatosis

c. Pulmonary hypertension

d. Ischemic heart disease

A

c. Pulmonary hypertension

79
Q

The echocardiographic/Doppler findings for diabetes include:

a. Restrictive cardiomyopathy

b. Arrhythmogenic right ventricular cardiomyopathy

c. Hypertrophic cardiomyopathy

d. Dilated cardiomyopathy

A

d. Dilated cardiomyopathy

80
Q

he echocardiographic/Doppler findings for hyperthyroidism is:

a. Aortic stenosis

b. Mitral stenosis

c. Significant valvular regurgitation

d. Enhanced global left ventricular systolic function

A

d. Enhanced global left ventricular systolic function

81
Q

The echocardiographic/Doppler findings for pheochromocytoma include all of the following EXCEPT:

a. Concentric left ventricular hypertrophy

b. Acute myocarditis

c. Aortic aneurysm

d. Segmental wall motion abnormalities

A

c. Aortic aneurysm

82
Q

The echocardiographic/Doppler findings in hypothyroidism include:

a. Coarctation of the aorta

b. Thickened mitral valve

c. Reduced global left ventricular systolic function

d. Pericardial effusion

A

c. Reduced global left ventricular systolic function

83
Q

The expected echocardiographic finding for Fabry’s disease is mitral valve:

a. Vegetation
b. Flail
c. Stenosis
d. Prolapse

A

d. Prolapse

84
Q

The expected echocardiographic/Doppler findings for cocaine ingestion include all of the following EXCEPT:

a. Reduced global ventricular systolic function

b. Acute aortic dissection

c. Hypertrophic cardiomyopathy

d. Acute myocardial infarction

A

c. Hypertrophic cardiomyopathy

85
Q

The most common echocardiographic/Doppler finding for scleroderma is:

a. Ebstein’s anomaly

b. Pericardial effusion

c. Pulmonary stenosis

d. Mitral stenosis

A

b. Pericardial effusion

86
Q

The most common echocardiographic/Doppler finding in systemic lupus erythematosus is:

a. Coarctation of the aorta

b. Aortic stenosis

c. Left atrial myxoma

d. Pericardial effusion

A

d. Pericardial effusion

87
Q

The most common reason for congestive heart failure in the United States is:

a. Reduced global systolic function due to coronary artery disease

b. Pressure overload (e.g., systemic hypertension)

c. Diastolic dysfunction

d. Volume overload (e.g., significant mitral regurgitation)

A

a. Reduced global systolic function due to coronary artery disease

88
Q

The motion of a congenitally stenotic aortic valve can be described as:

a. Flail

b. Doming

c. Fluttering

d. Hypokinetic

A

b. Doming

89
Q

The principal echocardiographic feature of left bundle branch block is:

a. Hyperkinesis of the lateral wall of the left ventricle

b. Hyperkinesis of the interventricular septum

c. Early systolic dip of the interventricular septum

d. Posterior motion of the interventricular septum

A

c. Early systolic dip of the interventricular septum

90
Q

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:

a. Sclerosis
b. Prolapse
c. Flail
d. Stenosis

A

a. Sclerosis

91
Q

Tuberous sclerosis is associated with:

a. Angiosarcoma
b. Fibroma
c. Myxoma
d. Rhabdomyoma

A

d. Rhabdomyoma

92
Q

Turner syndrome is associated with:

a. Mitral valve prolapse
b. Aortic dissection
c. Rhabdomyoma
d. Coarctation of the aorta

A

d. Coarctation of the aorta

93
Q

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):

a. Holter monitor

b. Cardiac resynchronization therapy

c. Conventional pacemaker therapy

d. Left ventricular assist device

A

b. Cardiac resynchronization therapy

94
Q

Which of the following is NOT associated with concentric left ventricular hypertrophy?

a. Cor pulmonale

b. Aortic stenosis

c. Discrete subaortic stenosis

d. Supravalvular aortic stenosis

A

a. Cor pulmonale

95
Q

Which of the following is strongly associated with syncope?

a. Rheumatic fever

b. Perimembranous ventricular septal defect

c. Left ventricular outflow tract obstruction

d. Carcinoid heart disease

A

c. Left ventricular outflow tract obstruction

96
Q

Which of the following is the most likely finding in Chagas disease?

a. Dilated cardiomyopathy

b. Aortic stenosis

c. Mitral stenosis

d. Hypertrophic cardiomyopathy

A

a. Dilated cardiomyopathy

97
Q

Which of the following mitral valve PW Doppler parameters suggests increased left heart filling pressures in a patient with atrial fibrillation?

a. Absent mitral valve A wave

b. Increased mitral valve A duration

c. Reduced mitral valve deceleration time (< 130 msec)

d. Decreased mitral valve E velocity

A

c. Reduced mitral valve deceleration time (< 130 msec)

98
Q

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:

a. Primary pulmonary hypertension
b. Pulmonary regurgitation
c. Tricuspid regulation
d. Grade I diastolic dysfunction

A

a. Primary pulmonary hypertension

99
Q

A dumbbell-shaped configuration of the inter-atrial septum is associated with

a. Sarcoma
b. Amyloidosis
c. Lipomatous hypertrophy
d. Sarcoidosis

A

c. Lipomatous hypertrophy

100
Q

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:

a. Hypertrophic obstructive cardiomyopathy

b. Left ventricular systolic gradient

c. Coarctation of the aorta

d. Discrete subaortic stenosis

A

b. Left ventricular systolic gradient

101
Q

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:

a. I
b. III
c. IV
d. II

A

a. I

102
Q

A posterior echo-free space is detected during the systolic phase only by M-mode/two-dimensional echocardiography. This is considered a:

a. Large pericardial effusion
b. Normal finding
c. Moderate pericardial effusion
d. Small pericardial effusion

A

b. Normal finding

103
Q

A thickened, inflamed, adherent or calcific pericardium is associated with:

a. Cardiac tamponade
b. Constrictive pericarditis
c. Mitral stenosis
d. Pulmonary embolism

A

b. Constrictive pericarditis

104
Q

A two-dimensional echocardiographic finding associated with pulmonary hypertension is:

a. Hyperkinetic interventricular septal motion

b. Interventricular myocardial infarction

c. Atrial septal aneurysm

d. Flattening of the interventricular septum during ventricular systole

A

d. Flattening of the interventricular septum during ventricular systole

105
Q

Air in the pericardial sac is known as:

a. Cardiac tamponade

b. Effusive-constrictive pericardium

c. Pneumopericardium

d. Hemopericardium

A

c. Pneumopericardium

106
Q

All of the following are associated M-mode/two-dimensional echocardiography findings for cardiac tamponade EXCEPT:

a. Right atrial diastolic collapse

b. Right ventricular systolic collapse

c. Pericardial effusion (usually moderate to large)

d. Inferior vena cava plethora

A

b. Right ventricular systolic collapse

107
Q

All of the following are associated findings for pericarditis EXCEPT:

a. Fever
b. Pericardial friction rub
c. Tachycardia
d. Pericardial effusion by echocardiography

A

d. Pericardial effusion by echocardiography

108
Q

All of the following are possible etiologies of constrictive pericarditis EXCEPT:

a. Atherosclerosis
b. Tuberculosis
c. Radiation therapy to the chest region
d. Prior pericardiotomy

A

a. Atherosclerosis

108
Q

All of the following may be used to calculate pulmonary artery pressure by cardiac Doppler EXCEPT:

a. Pulmonary regurgitation
b. Tricuspid regurgitation
c. Mitral regurgitation
d. Right ventricular outflow tract acceleration time

A

c. Mitral regurgitation

109
Q

All of the following may result in secondary pulmonary hypertension EXCEPT:

a. Mitral stenosis

b. Left ventricular failure

c. Tricuspid regurgitation

d. Coronary artery disease

A

c. Tricuspid regurgitation

110
Q

An anterior clear space is noted in the parasternal long-axis view. The diagnosis is most likely:

a. Cardiac tamponade
b. Adipose tissue
c. Constrictive pericarditis
d. Pericardial effusion

A

b. Adipose tissue

111
Q

An echocardiographic finding for congenital absence of the pericardium is volume overload of the:

a. Right ventricle
b. Left ventricle
c. Left atrium
d. Right atrium

A

a. Right ventricle

112
Q

An unattached freely moving thrombus within the left atrium is referred to as a:

a. Sessile thrombus

b. Ball-valve thrombus

c. Myxoma

d.Pedunculated thrombus

A

b. Ball-valve thrombus

113
Q

As the mean pulmonary artery pressure increases, the right ventricular outflow tract acceleration time:

a. Decreases
b. Remains unchanged
c. Increases
d. Depends upon patient age

A

a. Decreases

114
Q

Cardiac catheterization findings for constrictive pericarditis include:

a. Increased peak-to-peak pressure gradient

b. Dip-and-plateau

c. Increased “v” wave

d. Absent “a” wave

A

b. Dip-and-plateau

115
Q

Complications of a right atrial thrombus include:

a. Interatrial septal aneurysm

b. Pulmonary embolism

c.Valvular prolapse

d. Patent foramen ovale

A

b. Pulmonary embolism

116
Q

Doppler evidence of constrictive pericarditis from diastolic hepatic vein flow is:

a. Inspiratory increase
b. Expiratory decrease
c. Expiratory increase
d. Systolic flow reversal

A

b. Expiratory decrease

117
Q

Echocardiographic signs associated with constrictive pericarditis include all of the following EXCEPT:

a. Increased EPSS
b. Septal bound
c. Railroad track sign
d. Inferior vena cava plethora

A

a. Increased EPSS

118
Q

Fibrin within the pericardial effusion most likely indicates:

a. Acute myocardial infarction

b. Cardiac tamponade

c. Constrictive pericarditis

d. Long-standing pericardial effusion

A

d. Long-standing pericardial effusion

119
Q

M-mode findings associated with pulmonary hypertension include:

a. Reverse “a” dip of the pulmonic valve

b. Deep “a” dip of the pulmonic valve

c. Absent or shallow “a” dip of the pulmonary valve

d. Paradoxical “a” dip of the pulmonic valve

A

c. Absent or shallow “a” dip of the pulmonary valve

120
Q

Possible echocardiographic findings for pulmonary hypertension include all of the following EXCEPT:

a. Right ventricular hypertrophy
b. Tricuspid regulation
c. Abdominal aortic aneurysm
d. Dilated main pulmonary artery

A

c. Abdominal aortic aneurysm

121
Q

Pulsed-wave Doppler evidence of cardiac tamponade from diastolic hepatic vein flow is:

a. Inspiratory increase
b. Inspiratory reversal
c. Expiratory increase
d. Expiratory decrease

A

d. Expiratory decrease

122
Q

Pulsed-wave Doppler evidence of cardiac tamponade includes:

a. Systolic flow reversal in the hepatic veins

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

c. Systolic flow reversal in the pulmonary veins

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

A

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

123
Q

Pulsed-wave Doppler evidence of constrictive pericarditis includes:

a. Increased peak velocity across the aortic valve with inspiration

b. Increased peak velocity across the mitral valve with expiration

c. Increased peak velocity across the tricuspid valve with expiration

d. Increased peak velocity across the mitral valve with inspiration

A

b. Increased peak velocity across the mitral valve with expiration

124
Q

Secondary findings associated with systemic hypertension include all of the following EXCEPT:

a. Increased main pulmonary artery
b. Left atrial enlargement
c. Increased left ventricular mass
d. Left ventricular hypertrophy

A

a. Increased main pulmonary artery

125
Q

The best guideline for differentiating pericardial effusion from pleural effusion by two-dimensional echocardiography is

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

b. Pericardial effusion is usually seen as an anterior clear space; pleural effusion is usually seen as a posterior clear space.

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

d. Pericardial effusion is usually seen as a posterior clear space; pleural effusion is usually seen as an anterior clear space.

A

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

126
Q

The combination of pericardial effusion and constrictive pericarditis is called:

a. Pericardial cyst
b. Effusive-constrictive pericarditis
c. Cardiac tamponade
d. Libman-Sacks

A

b. Effusive-constrictive pericarditis

127
Q

The most common etiology of systemic hypertension is:

a. Coarctation of the aorta
b, Pheochromocytoma
c. Renal disease
d. Idiopathic processes

A

d. Idiopathic processes

128
Q

The most common intracardiac tumor in adults is (the):

a. Metastatic
b. Angiosarcoma
c. Myxoma
d. Rhabdomyoma

A

a. Metastatic

129
Q

The most common location for a pericardial cyst is the:

a. Hilum
b. Superior mediastinum
c. Right costophrenic angle
d. Left costophrenic angle

A

c. Right costophrenic angle

130
Q

The most common presenting symptom of acute pericarditis is:

a. Cachexia
b. Hemoptysis
c. Fatigue
d. Chest pain

A

d. Chest pain

131
Q

The most common primary benign intracardiac tumor found in children is:

a. Papilloma
b. Myxoma
c. Rhabdomyosarcoma
d. Rhabdomyoma

A

d. Rhabdomyoma

132
Q

The most common primary benign valvular tumor in adults is the:

a. Myxoma
b. Fibroelastoma
c. Angiosarcoma
d. Rhabdomyoma

A

b. Fibroelastoma

133
Q

The most common primary malignant intracardiac tumor in adults is the:

a. Papillary fibroelastoma

b. Fibroma

c. Myxoma

d. Angiosarcoma

A

d. Angiosarcoma

134
Q

The most effective treatment for cardiac tamponade is:

a. Aspirin
b. Pericardiectomy
c. Bed rest
d. Pericardiocentesis

A

d. Pericardiocentesis

135
Q

The most likely pulsed-wave Doppler mitral flow pattern in constrictive pericarditis is:

a. Impaired relaxation
b. Restrictive
c. Normal for age
d. Pseudonormal

A

b. Restrictive

136
Q

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

a. II
b. III
c. I
d. IV

A

c. I

137
Q

The pulse associated with cardiac tamponade is:

a. Pulsus bisferiens
b. Pulsus alternans
c. Pulsus parvus et tardus
d. Pulsus paradoxus

A

d. Pulsus paradoxus

138
Q

The swinging heart syndrome is associated with:

a. Constrictive pericarditis

b. Cardiac trauma

c. Pericardial effusion

d. Mitral valve prolapse

A

c. Pericardial effusion

139
Q

The tissue Doppler finding for constrictive pericarditis is mitral valve annulus:

a. Increased S’ wave peak velocity

b. E’/A’ ratio reversal

c. Normal E’ wave peak velocity

d. Absent A’ wave

A

c. Normal E’ wave peak velocity