Wk 3 Terry Reynolds *Ischemic Heart Disease & Stress Echo

Question 1

404. A common echocardiographic postoperative finding in a cardiac surgery patient is:

A. Paradoxical septal motion
B. Pleural effusion
C. Valvular prolapsed
D. Valvular stenosis

Answer 1

A

Question 2

375. A wall segment of the heart that is without motion is best described as:
     A. Akinetic
     B. Dyskinetic
     C. Hyperkinetic
     D. Hypokinetic

Answer 2

A. Akinetic

Question 3

374. Medications that may be used to perform stress echocardiography include all the following EXCEPT:
     A. Adenosine
     B. Dipyridamole
     C. Dobutamine
     D. Propranolol

Answer 3

D. Propranolol

*note: Beta blocker

It can treat high blood pressure, chest pain (angina), and uneven heartbeat (atrial fibrillation). It can also treat tremors and proliferating infantile hemangioma. In addition, it can prevent migraine headaches.

Question 4

373. While examining a patient with Kawasaki disease, the echocardiographer should be careful to rule out:

A. Aortic root dilatation
B. Coronary artery aneurysm
C. Coronary artery atherosclerosis
D. Mitral valve prolapse

Answer 4

B. Coronary artery aneurysm

Question 5

372. The principle echocardiographic/Doppler abnormalities of right ventricular infarction include all the following EXCEPT:

A. Abnormal motion of the right ventricular free wall
B. Right ventricular dilatation
C. Right ventricular hypertrophy
D. TR

Answer 5

C Right ventricular hypertrophy

Question 6

368. Possible mechanisms in the development of mitral regurgitation following an acute myocardial infarction include all the following EXCEPT:

A. Fibrosis of the papillary muscle
B. Incomplete closure of the mitral valve
C. Mitral valve prolapsed
D. Papillary muscle rupture

Answer 6

C. Mitral valve prolapsed

Question 7

367. An area of diseased myocardium is resected and the remaining healthy tissue is sutured together. This surgical procedure is called:

A. Aneurysmectomy

B. Myectomy
C. Myotomy
D. Pericardiectomy

Answer 7

A. Aneurysmectomy - a surgical procedure performed to repair a weak area in the aorta

*note: resected - (of tissue or part of an organ) cut out.

Myectomy - a surgical procedure performed to reduce heart muscle thickening in patients with hypertrophic cardiomyopathy (HCM).

myotomy includes cutting of the muscular layer of the lower part of the esophagus and the upper part of the stomach to completely open the lower esophageal sphincter and relieve dysphagia

Question 8

365. The infarction most commonly associated with left ventricular aneurysm is:
     A. Anterior
     B. Inferior
     C. Lateral
     D. True posterior

Answer 8

A. Anterior

Question 9

364. The correct term for describing decreased ventricular wall motion is:
     A. Akinetic
     B. Dyskinetic
     C. Hyperkinetic
     D. Hypokinetic

Answer 9

D. Hypokinetic

Question 10

363. Echocardiographic findings in the post -myocardial infarction patient include:

A. Mitral annular calcification
B. Mural thrombus
C. Valvular Stenosis
D. Ventricular septal aneurysm

Answer 10

B. Mural thrombus

A mural thrombus is an organizing blood clot attached to the wall of a blood vessel or the endocardium of the heart

Question 11

362. The echocardiographic appearance of necrotic myocardium secondary to myocardial infarction includes all the following EXCEPT:

A. Akinetic myocardial wall
B. Echogenic wall segment
C. Ground-glass appearance
D. Thin ventricular wall

Answer 11

C. Ground-glass appearance

Question 12

361. Coronary artery perfusion occurs from:

A. Endocardium to epicardium

B. Epicardium to endocardium

C. Epicardium to myocardium

D. Myocardium to endocardium

Answer 12

B. Epicardium to endocardium

Question 13

360. The normal response of non-infarcted myocardium in a patient with acute myocardial infarction is:

A. A.Akinesis
B. Dyskinesis
C. Hyperkinesis
D. Hypokinesis

Answer 13

C. Hyperkinesis

Question 14

359. In determining the size of myocardial infarction, echocardiography generally:

A. Is unpredictable
B. Overestimates recent myocardial infarction and underestimates old myocardial infarction
C. Predicts the exact size of infarct
D. Underestimates recent myocardial infarction and overestimates old myocardial infarction

Answer 14

B. Overestimates recent myocardial infarction and underestimates old myocardial infarction

Question 15

358. Stress echocardiography methods may be used to detect stunned or hibernating myocardium include:

A. Cold pressure
B. Handgrip
C. Low-dose dobutamine
D. Treadmill

Answer 15

C. Low-dose dobutamine

Question 16

357. Hibernating myocardium is:

A. Myocardium that is hyperkinetic post-myocardial infarction
B. Reperfused viable myocardium that is not functioning
C. Viable myocardium at rest but not functioning with exercise
D. Viable myocardium that is nonfunctioning because of chronic ischemia

Answer 16

D. Viable myocardium that is nonfunctioning because of chronic ischemia

Question 17

356. The definition of stunned myocardium is:

A. Myocardium after cardiopulmonary resuscitation
B. Myocardium after electrical cardioversion
C. Myocardium that is hyperkinetic post-myocardial infarction
D. Reperfused viable myocardium that is not functioning

Answer 17

D. Reperfused viable myocardium that is not functioning

Question 18

355. A wall motion score of 3 assigned to a certain segment of left ventricular muscle indicates:

A. Akinetic wall motion
B. Dyskinetic wall motion
C. Hypokinetic wall motion
D. Normal wall motion

Answer 18

A. Akinetic wall motion

*systolic wall thickening <10%

Question 19

A wall motion score of 5 assigned to a certain segment of left ventricular muscle indicates:

A. Akinetic wall motion
B. Dyskinetic wall motion
C. Hypokinetic wall motion
D. Aneurysmal

Answer 19

D. Aneurysmal

*fixed defect

Question 20

A wall motion score of 4 assigned to a certain segment of left ventricular muscle indicates:

A. Akinetic wall motion
B. Dyskinetic wall motion
C. Hypokinetic wall motion
D. Aneurysmal

Answer 20

B. Dyskinetic wall motion

*Systolic wall thinning with
myocardial segment moving
outward during systole

Question 21

354. Tardokinesis is a delay in:

A. Left ventricular filling
B. Right ventricular filling
C. Valve opening
D. Wall motion

Answer 21

D. Wall motion

*Tardokinesia is an abnormal slowness of contraction of a region of the left ventricular (LV) wall. This concept was stated in quantitative terms and used for analyzing LV regional wall motion

Question 22

353. The most specific echocadiographic findings for ischemic muscle is:

A. Abnormal diastolic wall motion at the ischemic segment
B. Alterations In systolic thickening
C. Normal diastolic wall motion
D. Normal systolic wall motion

Answer 22

B. Alterations In systolic thickening

Question 23

352. Angina occurring at rest that is not preceded by exercise or an increase in heart rate is called:

A. Labile
B. Prinzmetal’s

C. Stable
D. Unstable

Answer 23

B. Prinzmetal’s

*Prinzmetal’s angina is:

• rare (representing about two out of 100 cases of angina)
• usually occurs in younger patients

Prinzmetal angina (vasospastic angina or variant angina) is a known clinical condition characterized by chest discomfort or pain at rest with transient electrocardiographic changes in the ST segment, and with a prompt response to nitrates. These symptoms occur due to abnormal coronary artery spasm

Question 24

MI Type

MI occurs secondary to an acute imbalance in myocardial oxygen supply and demand without atherothrombosis

Answer 24

type 2

Question 25

351. The most common etiology for ischemic heart disease is coronary artery: A. Aneurysm B. Atherosclerosis C. Embolus D. Spasm

Answer 25

B. Atherosclerosis

Question 26

_MI type_ MI is a primary coronary arterial event attributable to _atherothrombotic plaque rupture or erosion_

Answer 26

type 1

Question 27

_MI type_ Sudden unexpected cardiac death often with symptoms suggestive of myocardial ischemia \*this type of MI continues the concept that there may be an occasional patient who has characteristic symptoms of myocardial ischemia but whose cTn values have not become elevated because the patient succumbs before values are measured or who is stricken by sudden death with evidence of MI by autopsy

Answer 27

type 3

Question 28

_MI type_ MI associated with cardiac surgery (i.e. CABG)

Answer 28

type 5

Question 29

_MI type_ MI associated with PCI (percutaneous coronary intervention)

Answer 29

Type 4a

Question 30

_MI type_ MI associated with in-stent thrombosis

Answer 30

type 4b

Question 31

complication of MI

Answer 31

DARTH VADER D-eath A-arrythmia R-upture T-amponade H-eart failure V-alve disease A-neurysm of ventricles D-ressler's syndrom E-mbolism R-eccurence/MR

Question 32

_ECG MI_ ST elevation & T inversion indicate….

Answer 32

myocardial injury

Question 33

pathologic Q wave indicates

Answer 33

myocardial necrosis Pathologic Q waves are a sign of **previous** [**myocardial infarction**](https://en.ecgpedia.org/index.php?title=Myocardial_Infarction). They are the result of absence of electrical activity. A myocardial infarction can be thought of as an elecrical 'hole' as scar tissue is electrically dead and therefore results in pathologic Q waves. Pathologic Q waves are not an early sign of myocardial infarction, but **generally take several hours to days to develop**. Once pathologic Q waves have developed they rarely go away.

Question 34

an imaging test to see how your heart pumps blood. It measures a percentage called ejection fraction (EF). Your healthcare provider may order this test to check for conditions such as heart failure.

Answer 34

MUGA (multigated aquisition radionuclide angiography)

Question 35

\_\_\_\_\_\_\_\_\_\_\_ is inflammation of the pericardium (pericarditis). It's believed to occur as the result of the immune system responding to damage to heart tissue or damage to the pericardium. The damage can result from a heart attack, surgery or traumatic injury

Answer 35

Dressler syndrome