Board review 1 Flashcards
1
Q
Positive Doppler shift
A
Reflector is moving creating an angle >90 b/w flow and transmitted beam
2
Q
Time gain compensation helps with?
A
Attenuation
3
Q
Increase strengh of transmitted beam with?
A
Power control
4
Q
Increase strength of received signal with?
A
Gain control
5
Q
Is there ever a gap b/w adjacent pixels?
A
No
6
Q
Inverse of frame rate
A
Temporal resolution
7
Q
Adjusts the dynamic range of echoes
A
Compression control
8
Q
Relationship b/w frequency and depth
A
Higher frequency, smaller depth
9
Q
What does increased frequency do to spatial resolution?
A
Increases spatial resolution
10
Q
Relationship b/w depth and frame rate?
A
Decrease depth = higher frame rate
11
Q
?Sector angle, does what to frame rate?
A
?Frame rate (less stuff to image)
12
Q
displays a power spectrum of velocities over time (over a single scan line, like M-mode)
A
Spectral Doppler
13
Q
Mosaic patern on color doppler indicates?
A
Turbulence
14
Q
Speed of ultrasound in tissue
A
1540 m/s
15
Q
Maneuvers to distinguish LV thrombus from artifact
A
Inc transducer frequency
16
Q
What to do with mechanical index to decrease contrast bubble destruction?
A
Decrease
17
Q
Which leaflets of TV are seen in apical 4C?
A
Anterior and septal
18
Q
When making chamber measurements, which one is smaller: 2D or M-mode?
A
2D
19
Q
What is only view to see posterior leaflet of TV?
A
RV inflow
20
Q
With tissue doppler, what do u do to receiver gain and wall filters to get velocities?
A
Decrease receiver gain
21
Q
220/PHT = ?
A
MVA
22
Q
CW or PW to get pressure half time?
A
CW
23
Q
Cont. eq’n for AVA
A
(LVOT diameter)2 x .785 x TVI LVOT/ TVI AV
24
Q
What mean gradient is c/w severe MS?
A
> 10mmHg
25
If u want to inow flow at a specific location, do u use CW or PW?
PW
26
On CW, which valve disorder varies the jet height w/ respiration ?
TR
27
Is TVI directly proportional to SV (stroke vol)
Yes
28
What % change in SV w/ dobutamine is needed to have contractility reserve?
20% (20% increase in TVI)
29
PHT= ? x DT
? = .29
30
Why would a pt with mild AR have a short PHT (implying sev AR)?
LV diastolic dysfunction
31
Why would a pt w/ mild AR have a short PHT (implying sev AR)?
LV Diastolic dysfunction
32
Eq'n to calc LVEDP when there is AR
Diastolic BP - 4V2
33
AVA= SV/?
TVIav
34
which TTE view shows the LAA?
Apical 2C
35
What view do you Doppler Pulm veins?
Apical 4C
36
For low velocity flows, do you use a high or low wall filter?
Low
37
Normal RV subcostal wall thickness in cm?
38
Normal RVOT PLAX proximal diameter in cm?
39
Normal RA minor dimension in cm?
40
Normal RV pulsed Doppler peak velocity at annulus in cm/s
>10
41
Normal RV Tissue Doppler MPI
42
Normal RV E/E'
43
What view do you measure RVOT for Qp:Qs
PSAX
44
The RV should be
3-Feb
45
Normal RV wall thickness?
46
TAPSE mm means abnormal RV systolic fxn?
16mm or
47
TAPSE means...
Tricuspid Annular Plane Systolic Excursion
48
Fractional Area Change % means dec'd RV systolic fxn?
35%
49
Eq'n for RV Myocardial Performance Index (MPI)
(ICT-IRT)/ET
50
Another name for MPI?
Tei index
51
Normal MPI values for RV fxn
52
What value indicates abnormal RV fxn with pulsed doppler peak velocuty at annulus?
53
What is bedt view to measure RVOT to r/o ARVC?
PLAX
54
Normal RV basal dimension?
42mm
55
Normal RA size
18cm2
56
If IVC diam
0-5mm Hg
57
IVC Diam >2.1cm, collapses
10-20mm Hg
58
RV Systolic Pressure = RAP + ?
TR gradient
59
PAP in presence of PS?
RV Systolic Pressure- PS gradient
60
PAP = ? (No PS)
RV Systolic Pressure
61
Assuming no TS, RV Diastlic Pressure= ?
RA Pressure
62
with TS, RA Diastolic Pressure = ?
RAP - TS gradient
63
systolic flying W seen in ?
severe PH (M-mode of PV)
64
septal flattening (PSAX) during systole and diastole indicates?
high RV pressures
65
Mean PAP eq'n w/ RVOT acceleration time
Mean PAP = 79- (.45 x AcT)
66
(MIG is Maximal Instantaneous gradient)
P2P gradient
67
for AV gradient, MIG (max instantaneous gradient) is obtained via cath or echo? P2P?
echo - MIG
68
with AR, LVEDP = ?
DBP - AR gradient
69
Without MS, what is LVDP approx. equal to?
LAP
70
Restrictive-
Nl- 6-12
71
what E/E' indicates normal LAP?
72
what E/E' indicates high LAP?
>15
73
Normal/bicuspid/marfans
55mm/50/45
74
In bicuspid AV, if aortic root dilated, when to operate (3 answers)?
1) >5cm
75
3 most common sites for aortic trauma?
Aortic isthmus (tethered by ligament in arteriosum)
76
In coarctation of Aorta, what par of cardiac cycle do u see gradient?
Systole and diastole
77
When do u operate on coarct?
>20mmHg peak to peak gradient or if collateral flow seen
78
Normal values for TDI of TV annulus
S' > 10cm/s
79
In constrictive pericarditis, which type of strain is affected?
Rotational
80
In amyloidosis which type of strain is affected?
Longitudinal
81
What characterizes the low velocity high intensity signals from the wall?
TDI
82
Is strain/strain rate influenced by tethering or translational motion?
No
83
Normal LA vol
84
Is it restrictive or constrictive CM where e' is impaired?
Restrictive (b/c e' is myocardial relaxation)
85
Normal or what grade of dysfunction?
Normal
86
Normal or what grade of dysfunction?
Grade I
87
Normal or what grade of dysfunction?
Grade 2 (pseudo normal)
88
What can u do to show E/a reversal in a pseudonormal pattern ?
Valsalva (it will show E/A reversal
89
What are the 2 types of diastolic dysfxn that will show E/A reversal on valsalva?
Type 2 (pseudonormal)
90
Restrictive (very high E)
91
Normal or what grade of dysfxn?
Grade 3 (fixed restrictive)
92
Normal or abnormal diastolic fxn?
Normal
93
Early closure of MV and diastolic MV fluttering (M-mode) indicate what?
AR
94
What does SAM of MV indicate?
Dynamic subaortic outflow obstruction
95
Diastolic flattening of IVS means?
RV volume overload
96
Systolic flattening of IVS means?
RV pressure overload (RVSP)
97
TVI x CSA = ?
SV
98
What do u see in hepatic vein with severe TR?
Systolic flow reversal
99
Anatomic variants of mass in LA
Pectinate muscles
100
Anatomic variants of mass in RA
Crista terminalis
101
Majority of primary cRdiac tumors are malignant or benign?
Benign
102
Most common primary cardia tumor
Sarcoma
103
Where exactly do most myxomas live?
LA near fossa ovalis
104
Most common tumor to involve valves?
Papillary fibroelastoma
105
Most common malignant cardiac tumor
Sarcoma
106
Where are sarcomas usually found?
RA
107
What are the 2 most commonly encountered tumor mets to heart?
Breast and lung CA
108
What CA has highest propensity for mets to heart?
Melanoma
109
Thick calcified leaflet at base with tips spared; Dx?
Radiation
110
If u see prox septal WMA, what Dz should u think of?
Sarcoidosis
111
Mild MR and Severe MR by Jet area
112
Severity of MR by vena contracta?
113
MR Vol/MR TVI = ?
ERO
114
Regurgitant Fraction of MR equation
RF= MR vol/MV stroke vol
115
Mild and severe MR by MR volume
Mild-
116
Mild and Sev MR by Regurgitant Fraction
Mild
117
Mild and sev MR by ERO
Mild
118
What part of MV is affected by rheumatic dz?
Leaflet tips
119
Can MV doming happen in rheumatic MS?
Yes
120
What MVA is mild MS? Sev MS?
Mild >1.5cm2
121
MVA= ?/DT
MVA= 750/DT
122
If LV stiffness increases, what happens to DT?
Decreases (faster)
123
4 variables used to decide echo score of MS morphology before valvuloplasty
Mobility
124
What echo score predicts success for percutaneous mitral valvuloplasty?
125
6 contraindications to mitral valvuloplasty
Calcific MS
126
What SV index indicates low cardiac output?
127
What theory is continuity eq'n based on?
Conservation of mass
128
3 criteria to index AVA
Height
129
AVA Index >.85 and DVI >.5, mild or sev AS?
Mild
130
AVA Index
Sev
131
Vpeak, Mean gradient, AVA in mild AS
Vpeak
132
Vpeak, Mean Gradient, AVA in sev AS
Vpeak >4m/s
133
For AS when is pressure recovery relevant?
AVA .8-1.2cm2 on Doppler
134
When can u do stress test on pt with AS?
Asymptomatic
135
Which AS patients do you do a dobutamine stress on? What are u looking for?
Low flow low gradient AS
136
TVA= ?/PHT
TVA= 190/PHT
137
continuity eq'n for TVA
(LVOT CSA x LVOT V1)/Vmax of TV inflow
138
What nyquist limit do u set for TR by PISA?
28cm/s
139
What radius is mild and severe for TR by PISA (nyquist limit 28)
Mild
140
Is hepatic vein reversal after atrial contraction (p wave) normal?
Yes!
141
Is hepatic vein reversal during systole normal?
No
142
Vena contracta width in severe TR
> .7 cm
143
Jet area in mild and sev TR
Mild
144
PISA radius in mild and sev TR
Mild
145
Appearance of jet density in severe TR
dense, triangular, early peaking
146
Peak velocities in mild and sev PS
Mild
