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Echocrdiography > Board review 1 > Flashcards

Board review 1 Flashcards

1
Q

Positive Doppler shift

A

Reflector is moving creating an angle >90 b/w flow and transmitted beam

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2
Q

Time gain compensation helps with?

A

Attenuation

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3
Q

Increase strengh of transmitted beam with?

A

Power control

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4
Q

Increase strength of received signal with?

A

Gain control

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5
Q

Is there ever a gap b/w adjacent pixels?

A

No

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6
Q

Inverse of frame rate

A

Temporal resolution

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7
Q

Adjusts the dynamic range of echoes

A

Compression control

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8
Q

Relationship b/w frequency and depth

A

Higher frequency, smaller depth

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9
Q

What does increased frequency do to spatial resolution?

A

Increases spatial resolution

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10
Q

Relationship b/w depth and frame rate?

A

Decrease depth = higher frame rate

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11
Q

?Sector angle, does what to frame rate?

A

?Frame rate (less stuff to image)

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12
Q

displays a power spectrum of velocities over time (over a single scan line, like M-mode)

A

Spectral Doppler

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13
Q

Mosaic patern on color doppler indicates?

A

Turbulence

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14
Q

Speed of ultrasound in tissue

A

1540 m/s

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15
Q

Maneuvers to distinguish LV thrombus from artifact

A

Inc transducer frequency

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16
Q

What to do with mechanical index to decrease contrast bubble destruction?

A

Decrease

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17
Q

Which leaflets of TV are seen in apical 4C?

A

Anterior and septal

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18
Q

When making chamber measurements, which one is smaller: 2D or M-mode?

A

2D

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19
Q

What is only view to see posterior leaflet of TV?

A

RV inflow

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20
Q

With tissue doppler, what do u do to receiver gain and wall filters to get velocities?

A

Decrease receiver gain

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21
Q

220/PHT = ?

A

MVA

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22
Q

CW or PW to get pressure half time?

A

CW

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23
Q

Cont. eq’n for AVA

A

(LVOT diameter)2 x .785 x TVI LVOT/ TVI AV

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24
Q

What mean gradient is c/w severe MS?

A

> 10mmHg

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25
Q

If u want to inow flow at a specific location, do u use CW or PW?

A

PW

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26
Q

On CW, which valve disorder varies the jet height w/ respiration ?

A

TR

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27
Q

Is TVI directly proportional to SV (stroke vol)

A

Yes

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28
Q

What % change in SV w/ dobutamine is needed to have contractility reserve?

A

20% (20% increase in TVI)

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29
Q

PHT= ? x DT

A

? = .29

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30
Q

Why would a pt with mild AR have a short PHT (implying sev AR)?

A

LV diastolic dysfunction

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31
Q

Why would a pt w/ mild AR have a short PHT (implying sev AR)?

A

LV Diastolic dysfunction

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32
Q

Eq’n to calc LVEDP when there is AR

A

Diastolic BP - 4V2

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33
Q

AVA= SV/?

A

TVIav

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34
Q

which TTE view shows the LAA?

A

Apical 2C

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35
Q

What view do you Doppler Pulm veins?

A

Apical 4C

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36
Q

For low velocity flows, do you use a high or low wall filter?

A

Low

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37
Q

Normal RV subcostal wall thickness in cm?

A
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38
Q

Normal RVOT PLAX proximal diameter in cm?

A
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39
Q

Normal RA minor dimension in cm?

A
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40
Q

Normal RV pulsed Doppler peak velocity at annulus in cm/s

A

> 10

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41
Q

Normal RV Tissue Doppler MPI

A
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42
Q

Normal RV E/E’

A
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43
Q

What view do you measure RVOT for Qp:Qs

A

PSAX

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44
Q

The RV should be

A

3-Feb

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45
Q

Normal RV wall thickness?

A
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46
Q

TAPSE mm means abnormal RV systolic fxn?

A

16mm or

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47
Q

TAPSE means…

A

Tricuspid Annular Plane Systolic Excursion

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48
Q

Fractional Area Change % means dec’d RV systolic fxn?

A

35%

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49
Q

Eq’n for RV Myocardial Performance Index (MPI)

A

(ICT-IRT)/ET

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50
Q

Another name for MPI?

A

Tei index

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51
Q

Normal MPI values for RV fxn

A
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52
Q

What value indicates abnormal RV fxn with pulsed doppler peak velocuty at annulus?

A
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53
Q

What is bedt view to measure RVOT to r/o ARVC?

A

PLAX

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54
Q

Normal RV basal dimension?

A

42mm

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55
Q

Normal RA size

A

18cm2

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56
Q

If IVC diam

A

0-5mm Hg

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57
Q

IVC Diam >2.1cm, collapses

A

10-20mm Hg

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58
Q

RV Systolic Pressure = RAP + ?

A

TR gradient

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59
Q

PAP in presence of PS?

A

RV Systolic Pressure- PS gradient

60
Q

PAP = ? (No PS)

A

RV Systolic Pressure

61
Q

Assuming no TS, RV Diastlic Pressure= ?

A

RA Pressure

62
Q

with TS, RA Diastolic Pressure = ?

A

RAP - TS gradient

63
Q

systolic flying W seen in ?

A

severe PH (M-mode of PV)

64
Q

septal flattening (PSAX) during systole and diastole indicates?

A

high RV pressures

65
Q

Mean PAP eq’n w/ RVOT acceleration time

A

Mean PAP = 79- (.45 x AcT)

66
Q

(MIG is Maximal Instantaneous gradient)

A

P2P gradient

67
Q

for AV gradient, MIG (max instantaneous gradient) is obtained via cath or echo? P2P?

A

echo - MIG

68
Q

with AR, LVEDP = ?

A

DBP - AR gradient

69
Q

Without MS, what is LVDP approx. equal to?

A

LAP

70
Q

Restrictive-

A

Nl- 6-12

71
Q

what E/E’ indicates normal LAP?

A
72
Q

what E/E’ indicates high LAP?

A

> 15

73
Q

Normal/bicuspid/marfans

A

55mm/50/45

74
Q

In bicuspid AV, if aortic root dilated, when to operate (3 answers)?

A

1) >5cm

75
Q

3 most common sites for aortic trauma?

A

Aortic isthmus (tethered by ligament in arteriosum)

76
Q

In coarctation of Aorta, what par of cardiac cycle do u see gradient?

A

Systole and diastole

77
Q

When do u operate on coarct?

A

> 20mmHg peak to peak gradient or if collateral flow seen

78
Q

Normal values for TDI of TV annulus

A

S’ > 10cm/s

79
Q

In constrictive pericarditis, which type of strain is affected?

A

Rotational

80
Q

In amyloidosis which type of strain is affected?

A

Longitudinal

81
Q

What characterizes the low velocity high intensity signals from the wall?

A

TDI

82
Q

Is strain/strain rate influenced by tethering or translational motion?

A

No

83
Q

Normal LA vol

A
84
Q

Is it restrictive or constrictive CM where e’ is impaired?

A

Restrictive (b/c e’ is myocardial relaxation)

85
Q

Normal or what grade of dysfunction?

A

Normal

86
Q

Normal or what grade of dysfunction?

A

Grade I

87
Q

Normal or what grade of dysfunction?

A

Grade 2 (pseudo normal)

88
Q

What can u do to show E/a reversal in a pseudonormal pattern ?

A

Valsalva (it will show E/A reversal

89
Q

What are the 2 types of diastolic dysfxn that will show E/A reversal on valsalva?

A

Type 2 (pseudonormal)

90
Q

Restrictive (very high E)

A
91
Q

Normal or what grade of dysfxn?

A

Grade 3 (fixed restrictive)

92
Q

Normal or abnormal diastolic fxn?

A

Normal

93
Q

Early closure of MV and diastolic MV fluttering (M-mode) indicate what?

A

AR

94
Q

What does SAM of MV indicate?

A

Dynamic subaortic outflow obstruction

95
Q

Diastolic flattening of IVS means?

A

RV volume overload

96
Q

Systolic flattening of IVS means?

A

RV pressure overload (RVSP)

97
Q

TVI x CSA = ?

A

SV

98
Q

What do u see in hepatic vein with severe TR?

A

Systolic flow reversal

99
Q

Anatomic variants of mass in LA

A

Pectinate muscles

100
Q

Anatomic variants of mass in RA

A

Crista terminalis

101
Q

Majority of primary cRdiac tumors are malignant or benign?

A

Benign

102
Q

Most common primary cardia tumor

A

Sarcoma

103
Q

Where exactly do most myxomas live?

A

LA near fossa ovalis

104
Q

Most common tumor to involve valves?

A

Papillary fibroelastoma

105
Q

Most common malignant cardiac tumor

A

Sarcoma

106
Q

Where are sarcomas usually found?

A

RA

107
Q

What are the 2 most commonly encountered tumor mets to heart?

A

Breast and lung CA

108
Q

What CA has highest propensity for mets to heart?

A

Melanoma

109
Q

Thick calcified leaflet at base with tips spared; Dx?

A

Radiation

110
Q

If u see prox septal WMA, what Dz should u think of?

A

Sarcoidosis

111
Q

Mild MR and Severe MR by Jet area

A
112
Q

Severity of MR by vena contracta?

A
113
Q

MR Vol/MR TVI = ?

A

ERO

114
Q

Regurgitant Fraction of MR equation

A

RF= MR vol/MV stroke vol

115
Q

Mild and severe MR by MR volume

A

Mild-

116
Q

Mild and Sev MR by Regurgitant Fraction

A

Mild

117
Q

Mild and sev MR by ERO

A

Mild

118
Q

What part of MV is affected by rheumatic dz?

A

Leaflet tips

119
Q

Can MV doming happen in rheumatic MS?

A

Yes

120
Q

What MVA is mild MS? Sev MS?

A

Mild >1.5cm2

121
Q

MVA= ?/DT

A

MVA= 750/DT

122
Q

If LV stiffness increases, what happens to DT?

A

Decreases (faster)

123
Q

4 variables used to decide echo score of MS morphology before valvuloplasty

A

Mobility

124
Q

What echo score predicts success for percutaneous mitral valvuloplasty?

A
125
Q

6 contraindications to mitral valvuloplasty

A

Calcific MS

126
Q

What SV index indicates low cardiac output?

A
127
Q

What theory is continuity eq’n based on?

A

Conservation of mass

128
Q

3 criteria to index AVA

A

Height

129
Q

AVA Index >.85 and DVI >.5, mild or sev AS?

A

Mild

130
Q

AVA Index

A

Sev

131
Q

Vpeak, Mean gradient, AVA in mild AS

A

Vpeak

132
Q

Vpeak, Mean Gradient, AVA in sev AS

A

Vpeak >4m/s

133
Q

For AS when is pressure recovery relevant?

A

AVA .8-1.2cm2 on Doppler

134
Q

When can u do stress test on pt with AS?

A

Asymptomatic

135
Q

Which AS patients do you do a dobutamine stress on? What are u looking for?

A

Low flow low gradient AS

136
Q

TVA= ?/PHT

A

TVA= 190/PHT

137
Q

continuity eq’n for TVA

A

(LVOT CSA x LVOT V1)/Vmax of TV inflow

138
Q

What nyquist limit do u set for TR by PISA?

A

28cm/s

139
Q

What radius is mild and severe for TR by PISA (nyquist limit 28)

A

Mild

140
Q

Is hepatic vein reversal after atrial contraction (p wave) normal?

A

Yes!

141
Q

Is hepatic vein reversal during systole normal?

A

No

142
Q

Vena contracta width in severe TR

A

> .7 cm

143
Q

Jet area in mild and sev TR

A

Mild

144
Q

PISA radius in mild and sev TR

A

Mild

145
Q

Appearance of jet density in severe TR

A

dense, triangular, early peaking

146
Q

Peak velocities in mild and sev PS

A

Mild

Echocrdiography (2 decks)

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