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Cardic Theory I > Fall'23 Cardiac Final > Flashcards

Fall'23 Cardiac Final Flashcards

1
Q

The left anterior descending coronary artery supplies blood to all of the following EXCEPT: Anterior wall of the left ventricle, Inferior wall of the left ventricle, Anterior interventricular septum, Apical cap

A

Inferior wall of the left ventricle

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2
Q

The moderator band is always located in the:

A

right ventricle

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3
Q

The most likely explanation of main pulmonary artery dilatation is: Pulmonary hypertension, Bicuspid aortic valve, Carcinoid heart disease, Truncus arteriosus

A

pulmonary hypertension

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4
Q

The name of the aortic segment located between the left subclavian artery and the insertion of the ligamentum arteriosum is the: Aortic root, Sino-tubular junction, Transverse aorta, Aortic isthmus

A

Aortic isthmus

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5
Q

The most common etiology of pulmonary regurgitation is: Rheumatic heart disease, Infective endocarditis, Pulmonary hypertension, Carcinoid heart disease

A

pulmonary hypertension

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6
Q

The most common etiology of tricuspid stenosis is: Carcinoid heart disease, Right atrial myxoma, Infective endocarditis, Rheumatic fever

A

Rheumatic fever

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7
Q

The murmur of tricuspid regurgitation is best described as a: Pansystolic murmur heard best at the cardiac apex with radiation to the axilla, Pansystolic murmur heard best at the lower left sternal border, Holodiastolic murmur heard best at the lower left sternal border, Systolic ejection murmur heard best at the upper right sternal border

A

Pansystolic murmur heard best at the lower left sternal border

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8
Q

The pulmonary vein atrial reversal wave may be _______ in peak velocity and duration in a patient with severe acute aortic regurgitation.

A

increased

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9
Q

The severity of aortic regurgitation may best be determined with color flow Doppler by all of the following methods EXCEPT: Comparing the aortic regurgitation jet width with the left ventricular outflow tract width in the parasternal long-axis view, Measuring the aortic regurgitation jet aliasing area in the parasternal long-axis view, Determining the presence of holodiastolic flow reversal in the descending thoracic aorta and/or abdominal aorta, Measuring the vena contracta in the parasternal long-axis view

A

Measuring the aortic regurgitation jet aliasing area in the parasternal long-axis view

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10
Q

The typical two-dimensional echocardiographic findings in rheumatic tricuspid stenosis include all of the following EXCEPT: Systolic bowing of the posterior tricuspid valve leaflet, Right atrial dilatation, Diastolic doming of the anterior tricuspid valve leaflet, Leaflet thickening especially at the leaflet tips and chordae tendineae

A

Systolic bowing of the posterior tricuspid valve leaflet

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11
Q

When two-dimensional evaluation of a systolic ejection murmur reveals a thickened aortic valve with normal systolic excursion and a peak velocity across the aortic valve of 1.5 m/s. The diagnosis is most likely aortic valve: Stenosis, Regurgitation, Sclerosis, Prolapse

A

sclerosis

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12
Q

A tricuspid regurgitation peak velocity of 3.0 m/s is obtained. This indicates: Severe tricuspid regurgitation, Mild tricuspid regurgitation, Moderate tricuspid regurgitation, Pulmonary hypertension

A

pulmonary hypertension

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13
Q

All of the following are considered useful quantitative measurements to determine the severity of aortic regurgitation EXCEPT: Peak velocity of aortic regurgitation, Regurgitant volume, Regurgitant fraction, Effective regurgitant orifice

A

peak velocity of aortic regurgitation

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14
Q

All of the following are dilated in significant chronic tricuspid regurgitation EXCEPT: Pulmonary veins, Right atrium, Inferior vena cava, Hepatic veins

A

Pulmonary veins

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15
Q

All of the following color flow Doppler findings indicate significant pulmonary regurgitation EXCEPT: Holodiastolic flow reversal in the main pulmonary artery, Jet width/Right ventricular outflow tract width > 70%Wide jet width at origin, Peak velocity of < 1.0 m/s

A

Peak velocity of < 1.0 m/s

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16
Q

According to the electrocardiogram (EKG), electrical systole is:

A

Onset of the QRS complex to the end of the T wave

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17
Q

All of the following are components of a pulsed-wave Doppler of a pulmonary vein EXCEPT (AR, S2. E, AR, S1):

A

E

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18
Q

All of the following are considered a part of normal ventricular diastole EXCEPT: Early passive filling, Isovolumic relaxation, Ventricular depolarization, Atrial systole

A

Ventricular depolarization

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19
Q

All of the following are true statements concerning the left ventricle EXCEPT: Contains two papillary muscle groups, Heavily trabeculated, Bullet shaped (truncated ellipsoid), Top normal thickness is approximately 1.0 cm

A

Heavily trabeculated

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20
Q

All of the following are true statements concerning the right ventricle EXCEPT :Normal wall thickness is 0.3 to 0.5 cm, Most anterior positioned cardiac chamber, Normally forms the cardiac apex, Heavily trabeculated

A

Normally forms the cardiac apex

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21
Q

All of the following left ventricular wall segments may be evaluated in the parasternal long-axis view EXCEPT: Basal anterior interventricular septum, Cardiac apex, Mid-anterior interventricular septum

A

Cardiac apex

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22
Q

All of the following left ventricular wall segments may be evaluated in the parasternal short-axis of the left ventricle at the level of the papillary muscles EXCEPT: Anterior wall, Anterior interventricular septum, Cardiac apex, Anterolateral

A

Cardiac Apex

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23
Q

All of the following structures are located in the right atrium EXCEPT: Crista terminalis, Eustachian valve, Thebesian valve, Moderator band

A

Moderator band

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24
Q

All of the following ventricular wall segments may be supplied by the right coronary artery EXCEPT: Basal and mid-inferolateral walls of the left ventricle, Basal and mid-anterior interventricular septum, Basal and mid-inferior walls of the left ventricle, Lateral wall of the right ventricle

A

Basal and mid-anterior interventricular septum

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25
Q

All of the following wall segments may be visualized in the apical two-chamber view EXCEPT: Right ventricular outflow tract, Anterior wall, Inferior wall, Cardiac apex

A

Right ventricular outflow tract

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26
Q

All of the following wall segments may be visualized in the apical four-chamber view EXCEPT: Cardiac apex, Lateral wall of the right ventricle, Anterior interventricular septum, Anterolateral wall

A

Anterior interventricular septum

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27
Q

Normal pressure values in millimeters of mercury (mm Hg) for the listed cardiac chambers or great vessels include all of the following EXCEPT: Right ventricle: 15 to 30 systolic; 2 to 8 diastolic Pulmonary artery: 15 to 30 systolic; 2 to 12 mean diastolic Right atrial pressure: 2 to 8 mean Aorta: 100 to 140 systolic; 3 to 12 end-diastolic

A

Aorta: 100 to 140 systolic; 3 to 12 end-diastolic

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28
Q

Structures of the mitral valve apparatus include all of the following EXCEPT: Sinuses of Valsalva, Papillary muscles, Chordae tendineae, Mitral valve annulus

A

Sinuses of Valsalva

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29
Q

The Chiari network is found in the:

A

Right atrium

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30
Q

The boundaries of the functional left ventricular outflow tract are best described as extending from the:

A

Free edge of the anterior mitral valve leaflet to the aortic valve annulus

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31
Q

The coronary sinus can be differentiated from the descending thoracic aorta with pulsed-wave Doppler because coronary sinus flow is predominantly diastolic while aortic flow is:

A

Predominantly systolic

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32
Q

The correct order for the branches of the transverse aorta (aortic arch) is:

A

Right brachiocephalic, left common carotid, left subclavian

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33
Q

The crista terminalis is found in the:

A

Right atrium

34
Q

The eustachian valve is found in the:

A

Right atrium

35
Q

The imaginary boundaries that define the mid-left ventricle are the:

A

Tip of the papillary muscles to the base of the papillary muscles

36
Q

The names of the two left ventricular papillary muscle groups are: Anterior; posterior Superior; inferior Medial; lateral Antero lateral; posteromedial

A

Anterolateral, posteromedial

37
Q

The most common cause of chronic tricuspid regurgitation is: Rheumatic heart disease, Pulmonary hypertension, Tricuspid valve prolapse, Ebstein’s anomaly

A

Pulmonary hypertension

38
Q

All of the following are cardiac Doppler findings for tricuspid valve stenosis EXCEPT: Increased mean pressure gradient. Decreased tricuspid valve area, Decreased pressure half-time, Increased tricuspid valve E wave velocity

A

decreased pressure half-time

39
Q

An intracardiac pressure that may be determined from the continuous-wave Doppler tricuspid regurgitation signal is: Systemic vascular resistance, Mean pulmonary artery pressure, Pulmonary artery end-diastolic pressure, Systolic pulmonary artery pressure

A

systolic pulmonary artery pressure

40
Q

Cardiac Doppler findings associated with significant chronic tricuspid regurgitation include all of the following EXCEPT: Concave late systolic configuration of the regurgitation signal, Systolic flow reversal in the hepatic vein, Systolic flow reversal in the pulmonary vein, Increased E velocity of the tricuspid valve

A

Systolic flow reversal in the pulmonary vein

41
Q

Echocardiographic evidence of severe acute aortic regurgitation includes all of the following EXCEPT:
Premature opening of the aortic valve,
Premature closure of the mitral valve,
Reverse doming of the anterior mitral valve leaflet,
Premature opening of the mitral valve

A

Premature opening of the mitral valve

42
Q

Holodiastolic flow reversal in the descending thoracic aorta and/or the abdominal aorta may be present in each of the following EXCEPT:
Severe mitral regurgitation,
Aortopulmonary window,
Severe aortic regurgitation,
Patent ductus arteriosus

A

severe mitral regurgitation

43
Q

In a patient with severe acute aortic regurgitation the left ventricular end-diastolic pressure increases rapidly. This pathophysiology will affect which of the following?
Closure of the pulmonary valve,
Closure of the mitral valve,
Systolic ejection period,
Left ventricular dimension

A

closure of the mitral valve

44
Q

In significant chronic aortic regurgitation, M-mode and two-dimensional evidence includes all of the following EXCEPT:
Left ventricular dilatation,
Hyperkinesis of the interventricular septum,
Paradoxical interventricular septal motion,
Hyperkinesis of the posterior (inferolateral) wall of the left ventricle

A

Paradoxical interventricular septal motion

45
Q

M-mode and two-dimensional echocardiographic findings for chronic tricuspid regurgitation include:
Protected right ventricle,
Paradoxical interventricular septal motion,
Left ventricular volume overload,
Right ventricular hypertrophy

A

Paradoxical interventricular septal motion

46
Q

Methods for determining the severity of tricuspid regurgitation with pulsed-wave Doppler include all of the following EXCEPT:
Peak velocity of the tricuspid regurgitant jet,
Laminar flow of the tricuspid regurgitant jet,
Increased E wave velocity of the tricuspid valve,
Holosystolic flow reversal of the hepatic vein

A

Peak velocity of the tricuspid regurgitant jet

47
Q

Possible echocardiographic and cardiac Doppler findings in a patient with carcinoid heart disease include all of the following EXCEPT:
Pulmonary regurgitation,
Tricuspid stenosis,
Tricuspid valve prolapse,
Tricuspid regurgitation

A

Tricuspid valve prolapse

48
Q

Posterior displacement of the aortic valve leaflet(s) into the left ventricle outflow tract during ventricular diastole is called aortic valve:
Prolapse
Sclerosis
Stenosis
Perforation

A

Prolapse

49
Q

Premature closure of the mitral valve is associated with all of the following EXCEPT:
First-degree atrioventricular block
Acute severe aortic regurgitation
Acute severe mitral regurgitation
Loss of sinus rhythm

A

Acute severe mitral regurgitation

50
Q

Severe aortic regurgitation is diagnosed with continuous-wave Doppler by all of the following criteria EXCEPT:
Steep deceleration slope
A maximum velocity of 4 m/s
Increased jet density
A pressure half-time of < 200 msec

A

A maximum velocity of 4m/s

51
Q

Significant chronic pulmonary regurgitation is associated with:
Left ventricular volume overload
Right ventricular hypertrophy
Right ventricular volume overload
Right atrial hypertrophy

A

Right ventricular volume overload

52
Q

Signs of significant tricuspid regurgitation include all of the following EXCEPT:
Hepatomegaly
Jugular venous distention
Pulsus paradoxus
Right ventricular heart failure

A

Pulsus paradoxus

53
Q

The M-mode finding that indicates severe acute aortic regurgitation is premature aortic valve:
Closure
Mid-systolic closure
Opening
Systolic flutter

A

Opening

54
Q

The M-mode/two-dimensional echocardiography parameters that have been proposed as an indicator for aortic valve replacement in severe chronic aortic regurgitation are left ventricular:
End-diastolic dimension ≥ 55 mm and fractional shortening ≤ 25%
End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%
End-diastolic dimension ≤ 55 mm and fractional shortening of ≥ 25%
End-diastolic dimension ≥ 70 mm and left atrial dimension ≥ 55 mm

A

End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%

55
Q

The continuous-wave Doppler signal of aortic regurgitation may be differentiated from the continuous-wave Doppler signal of mitral stenosis by the following guideline:
If the diastolic flow pattern commences after mitral valve opening then the signal is due to aortic regurgitation
The Doppler flow velocity pattern of mitral valve stenosis is laminar while the Doppler flow pattern of aortic regurgitation is turbulent.
Cannot be differentiated by continuous-wave Doppler.
If the diastolic flow pattern commences before mitral valve opening then the signal is due to aortic regurgitation

A

If the diastolic flow pattern commences before mitral valve opening then the signal is due to aortic regurgitation

56
Q

The mitral valve pulsed-wave Doppler flow pattern often associated with severe acute aortic regurgitation is grade:
II (pseudonormal)
Normal for age
III or IV (restrictive)
I (impaired relaxation)

A

III or IV (restrictive)

57
Q

All of the following represents possible etiologies for acute aortic regurgitation EXCEPT:
Aortic dissection
Aortic valve sclerosis
Trauma
Infective endocarditis

A

Aortic valve sclerosis

58
Q

An effect of significant aortic valve stenosis on the left ventricle is:
Protected in significant aortic valve stenosis
Asymmetrical septal hypertrophy
Eccentric left ventricular hypertrophy
Concentric left ventricular hypertrophy

A

concentric left ventricular hypertrophy

59
Q

Aortic valve with reduced systolic excursion. On physical examination there was a crescendo-decrescendo systolic ejection murmur and a diastolic decrescendo murmur heard. The most likely diagnosis is aortic valve:
Flail
Stenosis and mitral valve prolapse
Regurgitation
Stenosis and regurgitation

A

stenosis and regurgitation

60
Q

Cardiac magnetic resonance imaging provides all of the following information in a patient with aortic regurgitation EXCEPT:
Detailed resolution of the aortic valve
Left ventricular volumes
Regurgitant volume
Effective regurgitant orifice

A

Detailed resolution of the aortic valve

61
Q

Cardiac Doppler parameters used to assess the severity of valvular aortic stenosis include all the following EXCEPT:
Peak aortic valve velocity
Mean pressure gradient
Aortic pressure half-time
Aortic velocity ratio

A

Aortic pressure half-time

62
Q

Cardiac magnetic resonance imaging provides all of the following information in a patient with aortic regurgitation EXCEPT:
Detailed resolution of the aortic valve
Left ventricular volumes
Regurgitant volume
Effective regurgitant orifice

A

Detailed resolution of the aortic valve

63
Q

In the parasternal long-axis view, severe aortic valve stenosis is defined as an aortic valve leaflet separation that measures:
≤ 12 mm
≤ 8 mm
≤ 10 mm
≥ 14 mm

A

≤ 8 mm

64
Q

Of the transvalvular pressure gradients that can be measured in the echocardiography laboratory, the most useful in examining aortic valve stenosis is probably:
Peak-to-peak gradient
Mean systolic gradient
Mean diastolic gradient
Peak instantaneous pressure gradient

A

Mean systolic gradient

65
Q

Pathologies that may result in a left ventricular pressure overload include all the following EXCEPT:
Mitral valve stenosis
Systemic hypertension
Valvular aortic stenosis
Discrete subaortic stenosis

A

Mitral valve stenosis

66
Q

Possible two-dimensional echocardiographic findings in significant aortic valve stenosis include all the following EXCEPT:
Left ventricular hypertrophy
Post-stenotic dilatation of the ascending aorta
Post-stenotic dilatation of the descending aorta
Aortic valve calcification

A

Post-stenotic dilatation of the descending aorta

67
Q

Reverse diastolic doming of the anterior mitral valve leaflet is associated with:
Severe aortic regurgitation
Rheumatic mitral valve stenosis
Papillary muscle dysfunction
Flail mitral valve

A

severe aortic regurgitation

68
Q

Secondary echocardiographic findings associated with severe valvular aortic stenosis include all the following EXCEPT:
Right ventricular hypertrophy
Left ventricular hypertrophy
Decreased left ventricular systolic function (late in course)
Post-stenotic dilatation of the ascending aorta

A

right ventricular hypertrophy

69
Q

The Doppler maximum peak instantaneous pressure gradient in a patient with aortic stenosis is 100 mm Hg. The cardiac catheterization peak-to-peak pressure gradient will most likely be:
Dependent upon respiration
Higher than 100 mm Hg
Lower than 100 mm Hg
Equal to 100 mm Hg

A

lower than 100mmHg

70
Q

The LEAST common valve regurgitation found in normal patients is:
Pulmonary regurgitation
Mitral regurgitation
Aortic regurgitation
Tricuspid regurgitation

A

Aortic regurgitation

71
Q

The aortic valve area considered severe aortic valve stenosis is:
< 3 cm^2
< 1.5 cm^2
< 2 cm^2
≤ 1.0 cm^2

A

≤ 1.0 cm^2

72
Q

The characteristic M-mode findings for aortic valve stenosis include all the following EXCEPT:
A lack of systolic flutter of the aortic valve leaflets
Thickening of the aortic valve leaflets
Diastolic flutter of the aortic valve leaflets
Reduced leaflet separation in systole

A

Diastolic flutter of the aortic valve leaflets

73
Q

The characteristic feature of the murmur of chronic aortic regurgitation is a:
Diastolic rumble following an opening snap
Diastolic crescendo-decrescendo murmur heard best along the left upper sternal border
Harsh systolic ejection murmur heard best at the right upper sternal border
Diastolic decrescendo murmur heard best along the left sternal border

A

Diastolic decrescendo murmur heard best along the left sternal border

74
Q

The echocardiographer may differentiate between the similar systolic flow patterns seen in coexisting severe aortic valve stenosis and mitral regurgitation by all the following EXCEPT:
Aortic ejection time is shorter that the mitral regurgitation time
Mitral regurgitation flow always lasts until mitral valve opening, whereas aortic valve stenosis flow does not.
Mitral diastolic filling profile should be present during recording of the mitral regurgitation, whereas no diastolic flow is observed in aortic valve stenosis.
Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis.

A

Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis.

75
Q

The hallmark M-mode finding for aortic regurgitation is:
Fine diastolic flutter of the anterior mitral valve leaflet
Coarse diastolic flutter of the anterior mitral valve leaflet
Chaotic diastolic flutter of the mitral valve
Systolic flutter of the aortic valve

A

Fine diastolic flutter of the anterior mitral valve leaflet

76
Q

The most common etiology of chronic aortic regurgitation is:
Marfan’s syndrome
Dilatation of the aortic root and aortic annulus
Trauma
Infective endocarditis

A

Dilatation of the aortic root and aortic annulus

77
Q

The murmur associated with severe aortic regurgitation is:
Still’s
Graham-Steell
Austin-Flint
Carvallo’s

A

Austin-Flint

78
Q

The murmur of aortic stenosis is described as:
Diastolic rumble
Holosystolic murmur heard best at the cardiac apex
Holodiastolic decrescendo murmur heard best at the right sternal border
Systolic ejection murmur heard best at the right upper sternal border

A

Systolic ejection murmur heard best at the right upper sternal border

79
Q

The onset of flow to peak aortic velocity continuous-wave Doppler tracing in severe valvular aortic stenosis is:
Decreased
Increased
Decreased with expiration
Increased with inspiration

A

increased

80
Q

The pulse that is characteristic of significant valvular aortic stenosis is:
Pulsus alternans
Pulsus paradoxus
Pulsus bisferiens
Pulsus parvus et tardus

A

Pulsus parvus et tardus

Cardic Theory I (2 decks)

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