Technique of Echocardiography

Question 1

Which of the following may lead to a misdiagnosis for the presence of aortic dissection with transesophageal echocardiography?
A. Thickened mitral valve
B. Aberrant right subclavian artery
C. Linear artifact
D. Mirror-image

Answer 1

B. Aberrant right subclavian artery
C. Linear artifact
D. Mirror-image

Question 2

The Doppler high-pass filter eliminates:
A. Peak velocity flow
B. Spectral broadening
C. Strong amplitude signals
D. Window fill-in

Answer 2

C. Strong amplitude signals

Question 3

Which 2D view would be most useful to use when evaluating pulmonary stenosis and pulmonary regurgitation?
A. Suprasternal long-axis
B. Parasternal long-axis of the LV
C. Apical four-chamber
D. Parasternal short-axis at the aortic valve

Answer 3

D. Parasternal short-axis at the aortic valve

Question 4

Which instrument control directly affects the dynamic range?
A. Image depth
B. Transmit gain
C. TGC
D. Compression

Answer 4

D. Compression

Question 5

A swirling of transpulmonary contrast is noted at the apex of the left ventricle. The sonographer should:
A. Inject the contrast at a slower rate
B. Decrease the transmit gain
C. Use respiratory maneuvers
D. Call the nurse

Answer 5

B. Decrease the transmit gain

Question 6

All of the following cardiac pathologies are best evaluated with cardiac doppler in the apical views EXCEPT:
A. Atrial septal defect
B. Mitral regurgitation
C. Aortic stenosis
D. Mitral stenosis

Answer 6

A. Atrial septal defect

Question 7

Possible pharmacologic treatments for hypertrophic obstructive cardiomyopathy include:
A. Propranolol
B. Epinephrine
C. Lasix
D. Dobutamine

Answer 7

A. Propranolol

Question 8

The sonographer may avoid PW Doppler aliasing by all of the following techniques EXCEPT:
A. Increase the velocity scale
B. Decrease the doppler transmit gain
C. Shift the zero baseline
D. Decrease the image depth

Answer 8

B. Decrease the doppler gain

Question 9

All of the following are ways in which the sonographer can improv the lateral resolution while imaging EXCEPT:
A. Increase transducer diameter
B. Utilize harmonic imaging
C. Increase the transmit frequency
D. Increase the number of focuses

Answer 9

A. Increase transducer diameter

Question 10

What is the standard sweep for M-mode echocardiography and cardiac doppler?
A. 100 mm/s
B. 150 mm/s
C. 25 mm/s
D. 50 mm/s

Answer 10

D. 50 mm/s

Question 11

The four acoustic windows for transthoracic echocardiography are:
A. Parasternal, apical, subcostal, suprasternal
B. Apical, subcostal, short-axis, parasternal
C. Parasternal, long-axis, short-axis, subcostal
D. Long-axis, short-axis, four chamber, suprasternal

Answer 11

A. Parasternal, apical, subcostal, suprasternal

Question 12

A maneuver that will result in tachycardia and a transient decrease in blood pressure is:
A. Inhalation of amyl nitrite
B. Squatting
C. Straight leg raising
D. Standing to supine

Answer 12

A. Inhalation of amyl nitrite

Question 13

The image artifact associated with displaying double images of a structure due to the change in direction of the sound beam is called:
A. Range ambiguity
B. Acoustic shadowing
C. Reverberation
D. Refraction

Answer 13

D. Refraction

Question 14

Which transmit frequency would most likely to be useful for an adult echocardiogram?
A. 5.0 MHz
B. 7.5 MHz
C. 2.5 MHz
D. 3.5 MHz

Answer 14

C. 2.5 MHz

Question 15

Which doppler intercept angle will result in the maximum flow velocity?
A. 0
B. 30
C. 90
D. 60

Answer 15

A. 0

Question 16

The three 2D planes used to examine the heart with transthoracic echocardiography are:
A. Long-axis, short-axis, apical
B. Long-axis, short-axis, five-chamber
C. Parasternal, apical, subcostal
D. Long-axis, short-axis, four-chamber

Answer 16

D. Long-axis, short-axis, four-chamber

Question 17

All of the following may be evaluated with cardiac doppler in the apical five-chamber view EXCEPT:
A. Hypertrophic cardiomyopathy 
B. Patent foramen ovale
C. Valvular aortic stenosis
D. Discrete subaortic stenosis

Answer 17

B. Patent foramen ovale

Question 18

The measurement of the left ventricular outflow tract diameter during early ventricular systole is an important measurement in all of the following calculations EXCEPT:
A. Aortic valve area
B. Stroke volume
C. Right ventricular systolic pressure
D. Mitral valve area

Answer 18

C. Right ventricular systolic pressure

Question 19

Of all of the resolutions, which resolution is most difficult for the sonographer to improve during an exam?
A. Contrast
B. Temporal
C. Spatial (axis resolution, lateral resolution)
D. Elevational

Answer 19

D. Elevational

Question 20

Which color flow doppler map will display the color green to indicate turbulent flow?
A. Directional
B. Hue
C. Variance
D. Intensity

Answer 20

C. Variance

Question 21

All of the following are true statements concerning M-mode echocardiography EXCEPT:
A. Excellent axial resolution
B. Standard sweep speed is 50 mm/s
C. Primary method of determining the presence and severity of cardiac pathology
D. Excellent temporal resolution

Answer 21

C. Primary method of determining the presence and severity of cardiac pathology

Question 22

Multiple echoes equally spaced are called:
A. Reverberation
B. Side lobes
C. Refraction
D. Propagation speed error

Answer 22

A. Reverberation

Question 23

All of the following are primary advantages of transesophageal echocardiography EXCEPT:
A. Superior resolution with high transmit frequencies
B. Absence of lung and rib artifact
C. Preferred test for mitral valve stenosis
D. Preferred test for infective endocarditis

Answer 23

C. Preferred test for mitral valve stenosis

Question 24

The 2D view of choice for the evaluation of coarctation of the aorta is the:
A. Parasternal long-axis
B. Suprasternal long-axis of the aorta
C. Apical five-chamber
D. Parasternal short-axis of the aortic valve

Answer 24

B. Suprasternal long-axis of the aorta

Question 25

``` All of the following are true statements concerning color flow Doppler EXCEPT: A. Multigate B. Normal flow does not alias C. Mean velocity displayed D. Pulsed-wave Doppler technique ```

Answer 25

B. Normal flow does not alias

Question 26

``` Increasing the pulsed-wave doppler sample gate length will result in: A. Better determination of laminar flow B. Lower frame rates C. Increased spectral broadening D. Increased peak velocity ```

Answer 26

C. Increased spectral broadening

Question 27

``` All of the following are ways to increase the color flow Doppler frame rate and improve temporal resolution EXCEPT decrease: A. Color gain B. Line density C. Image depth D. Field of view ```

Answer 27

A. Color gain

Question 28

``` All of the following will increase the frame rate and improve temporal resolution EXCEPT decreasing the: A. Image depth B. Field of view C. Transmit gain D. Number of focuses ```

Answer 28

C. Transmit gain

Question 29

``` A maneuver which results in a decrease in venous return is: A. Inspiration B. Valsalva C. Squatting D. Straight leg raising ```

Answer 29

Valsalva

Question 30

``` Agitated saline contrast may be used to evaluate all of the following EXCEPT: A. Aortic regurgitation B. Tricuspid regurgitation C. Left to right atrial septal defect D. Patent foramen ovale ```

Answer 30

A. Aortic regurgitation

Question 31

``` All of the following may be evaluated using the apical window EXCEPT: A. Mitral valve prolapse B. Pulmonary vein flow C. Isovolumetric relaxation time D. Left atrial volume ```

Answer 31

A. Mitral valve prolapse

Question 32

The 2D view of choice for evaluating the inferior vena cava and hepatic veins is the: A. Apical four-chamber B. Subcostal four-chamber C. Parasternal long-axis D. Parasternal short-axis of the aortic valve

Answer 32

B. Subcostal four-chamber

Question 33

``` Left ventricular opacification may be accompanied by all of the following contrast agents EXCEPT: A. Agitated saline B. Optison C. Definity D. Imagent ```

Answer 33

A. Agitated saline

Question 34

``` Tissue harmonic imaging improves all of the following EXCEPT: A. Depth of penetration B. Beam width C. Frame rate D. Side lobe artifacts ```

Answer 34

C. Frame rate

Question 35

``` Which 2D view is likely to be LEAST useful when evaluating for atrial septal defect with cardiac doppler? A. PSAX AV with color flow doppler B. A4 with color flow doppler C. A2 view D. Subcostal four-chamber ```

Answer 35

C. A2 view

Question 36

``` All of the following 2D views may be useful when evaluating for the presence of perimembranous ventricular septal defect EXCEPT: A. PLAX B. PSAX AV C. Subcostal four-chamber D. A5 ```

Answer 36

C. Subcostal four-chamber

Question 37

``` The preferred 2D view for determining the presence of bicuspid aortic valve is the: A. PLAX B. Apical long-axis C. A5 D. PSAX AV ```

Answer 37

D. PSAX AV

Question 38

All of the following decrease with increasing transmit frequency EXCEPT: A. Depth of penetration B. Beam width C. Attenuation D. Spatial pulse length and pulse duration

Answer 38

C. Attenuation

Question 39

``` The image artifact which may cause the sonographer to fail to detect prosthetic mitral valve regurgitation from the apical window is: A. Grating lobes B. Shadowing (flow masking) C. Enhancement D. Comet tail ```

Answer 39

B. Shadowing (flow masking)

Question 40

All of the following are true statements concerning PW Doppler EXCEPT: A. Aliasing is a primary disadvantage B. Preferred modality to evaluate diastolic function C. Range resolution (range discrimination) D. Utilizes two elements

Answer 40

D. Utilizes two elements

Question 41

``` The primary advantage of CW Doppler is: A. Range discrimination B. Range ambiguity C. Aliasing will not occur D. Range resolution ```

Answer 41

C. Aliasing will not occur