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Fetal Echo 2022 > Fetal Echo 2022 > Flashcards

Fetal Echo 2022 Flashcards

1
Q

Name the 3 shunts of the fetal circulation

A

Ductus venosus
Foramen ovale
Ductus arteriosus

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2
Q

The first step in beginning a fetal echocardiogram is to determine

A

Fetal position

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3
Q

The ascending aorta and the main pulmonary artery are derived embryologically from a spiral division of the

A

Truncus arteriosus

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4
Q

In complete transposition of the great arteries the pulmonary artery arises from the morphologic

A

Left ventricle

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5
Q

Which heart defect is most commonly associated with trisomy 21

A

AVSD

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6
Q

In congenitally corrected transposition of the great arteries, the aorta arises from the morphologic

A

Right ventricle

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7
Q

The left atrial appendage is described as having a _______________ appearance

A

Finger like

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8
Q

Hypoplasia of the right ventricle would be indicative of which of

A

Pulmonary atresia

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9
Q

Ebstein anomaly is characterized by

A

Atrialization of the right ventricle

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10
Q

Which of the following has the highest association with 22q 11 deletion syndrome, aka di George

A. mitral stenosis

B. persistent, left superior vena cava

C. VSD

D. TOF

A

TOF

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11
Q

Severe levocardia is most likely to be seen with which of the following
A. Ebstein anomaly
B. TOF
C. HLHS
D. DORV

A

Ebstein anomaly

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12
Q

An AVSD with CHB is most likely to be seen in a fetus with
A. DiGeorge syndrome
B. Heterotaxy
C. Down Syndrome
D. Hydrops

A

Heterotaxy

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13
Q

The congenital heart defect most commonly associated with mesocardia is

A

Congenitally corrected transposition of the great arteries

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14
Q

Which of the following carries the highest risk of having CHD
A. isolated dextrocardia
B. dextrocardia with situs inversus
C. isolated dextroposition.
D. Dextroposition with situs inversus.

A

Isolated dextrocardia

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15
Q

The most common type of Ectopia cordis is

A

Thoracic

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16
Q

Pentalogy of Cantrell is associated with

A

Ectopia cordis

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17
Q

What vessels are seen on the three vessel view?

A

Pulmonary
Aorta
SVC

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18
Q

The normal velocity for the aortic valve would be

A

<_120 cm/sec

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19
Q

What is the best view to interrogate the aortic valve with spectral Doppler

A

Apical five chamber view

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20
Q

To access the pulmonary artery for valvular insufficiency your sample volume will need to be placed in the

A

Right ventricle

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21
Q

Which of the following would be indicative of an abnormal tricuspid efficiency?
A. retrograde flow occurring in early diastole
B. Holocystic flow occurring in diastole
C. Retrograde flow occurring in early systole.
D. Holosystolic flow occurring in systole.

A

Holosystolic flow occurring in systole

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22
Q

Which one of the following would most likely cause abnormal prominence of the A wave in the pulmonary veins?

A. Mitral stenosis
B. tricuspid stenosis
C. transposition of the great arteries
D. truncus arteriosus

A

Mitral stenosis

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23
Q

Pulsed Doppler should be used to interrograte all valves proximally for

A

Insufficiency

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24
Q

To assess a fetal dysrhythmia, the m mode cursor should be placed simultaneously through which structures

A

An atrial and ventricular wall

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25
Q

The normal direction of blood flow through the foramen ovale

A

From the right atrium to the left atrium

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26
Q

All of the following are indications for performing a fetal echo except
A. Mother with lupus
B. mother with diabetes
C. Mother with cytomegalovirus
D. mother with influenza

A

Mother with influenza

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27
Q

Which of the following chromosomal abnormalities carries the highest risk of an associated congenital heart defect
A. Trisomy 21
B. Trisomy 18
C. 22q11 deletion
D. 45x

A

Trisomy 18

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28
Q

Trisomy 18 is also known as

A

Edwards

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29
Q

22q 11 deletion is also known as

A

Di George

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30
Q

45X is also known as

A

Turner’s syndrome

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31
Q

Most common type of congenital heart disease found in the abortuses and stillbirths is an

A

VSD

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32
Q

The most appropriate view to interrogate the interventriular septum is the

A

Subcostal 4 chamber view

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33
Q

Per the AIUM guidelines a fetal echo should be performed at approximately what gestational age

A

18-22 weeks

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34
Q

The apex of the heart normally points towards the

A

Left

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35
Q

The angle of the heart compared to the midline is normally approximately

A

45 degrees

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36
Q

The normal position of the heart is termed

A

Levoposition

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37
Q

The normal fetal heart should occupy
______ of the chest

A

1/3

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38
Q

The apical four chamber view is obtained when the septate of the heart is parallel to the

A

Angle of insonation

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39
Q

The apical 4 chamber view is not the best view to evaluate the

A

Interventricular septum

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40
Q

The moderator band can be found in the

A

Right ventricle

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41
Q

On a short axis view of the great vessels, the main pulmonary artery is often seen bifurcating into

A

Ductus arteriosus, and right pulmonary artery

42
Q

Most common location for an in-utero coarctation to occur is the

A

Aortic isthmus

43
Q

The ductal arch is comprised of all the following EXCEPT
A. descending aorta
B. pulmonary artery
C. Ascending aorta
D. ductus arteriosus

A

Ascending aorta

44
Q

A fetus is at a highest risk of having congenital heart defect if

A

The mother of the fetus has a heart defect

45
Q

Best view to interrogate the mitral valve spectral Doppler would be

A

Apical 4 chamber view

46
Q

The majority of oxygenated fetal blood bypasses the liver via the

A

Ductus venosus

47
Q

Pulmonary vein blood flow normally flows

A

Into the left atrium

48
Q

Oxygenated blood flows from the placenta to the fetus via the

A

Umbilical vein

49
Q

Which of the following is NOT a shunt present in the fetus?
A. Ductus venosum.
B. Foremen ovale
C. Ductus arteriosus
D. umbilical vein

A

Umbilical vein

50
Q

An atrialventricular septal defect includes abnormal development of all the following except the
A. aortic arch
B. interatrial septum
C. Interventricular septum
D. atrioventricular valves

A

Aortic arch

51
Q

In hypoplastic left heart syndrome the left ventricle becomes hypoplastic due to

A

Decrease blood flow into or out of the left ventricle

52
Q

In HLHS blood flow through the ascending aorta is usually

A

Absent or reversed

53
Q

AVSD’s are commonly associated with

A

Asplenia

54
Q

The following chromosomal abnormality is most commonly associated with an a AVSD

A

Trisomy 21

55
Q

Which of the following will be present with a hypoplastic right ventricle

A. small or atretic aortic valve
B. Small or artetic pulmonary valve
C. small aorta
D. small,pulmonary veins

A

Small or artetic pulmonary valve

56
Q

Which of the following would not be visualized with a hypoplastic right ventricle?

A. retrograde flow through the foramen ovale
B. Large left heart.
C. Decrease flow through the pulmonary artery.
D. Dilated aortic root.

A

Retrograde flow through the foramen ovale

57
Q

Coarctation of the aorta is defined as

A

Narrowing of the aorta

58
Q

All of the following are signs of coarctation of the aorta EXCEPT

A. Enlarged right ventricle.
B. Enlarged left ventricle
C. Increase velocities in the aorta.
D. A narrowing of the aorta.

A

Enlarged left ventricle

59
Q

Coarctation of the aorta is most common in which genetic condition

A

45X

60
Q

Ebstein anomaly is

A

Inferior displacement of the tricuspid valve

61
Q

Truncus arteriosus can be mistaken for which other anomaly

A

TOF

62
Q

Which of the following defects is not seen in a newborn with TOF

A. VSD.
B. Overriding aorta
C. Aortic stenosis.
D. Right ventricular hyper trophy.

A

Aortic stenosis

63
Q

The great vessels of the aortic arch, in order of origin are

A

Brachiocephalic
Left common carotid
Left subclavian artery

64
Q

when the apex of the heart is pointed towards the right side, it is termed

A

Dextrocardia

65
Q

Azygous continuation of the IVC is most commonly seen with

A

Polysplenia

66
Q

A dilated coronary sinus is often present with a

A

Persistent left superior vena cava

67
Q

In a fetus with a cystic hygroma, the most likely CHD would be

A. HLHS
B. Hypoplastic, right ventricle
C. Coarctation
D pulmonary stenosis

A

Coarctation

68
Q

In a fetus with a left-sided cystic adenomatoid malformation the most common cardiac position would be
A. Dextroposition.
B. Dextrocardia
C. Mesocardia
D. Levoposition

A

Dextroposition

69
Q

The order of the vessels normally seen on a three vessel view from left to right are

A

Pulmonary artery, aorta, superior, vena cava

70
Q

The anterior wall of the aorta should be continuous with which cardiac structure

A. Interventricular septum
B. Interatrial septum
C. Tricuspid valve
D. Mitral valve

A

Intraventricular septum

71
Q

In a short access view of the great vessels which cardiac chamber will be closest to the anterior chest wall
A. Left atrium
B. left ventricle
C. Right atrium
D. Right ventricle

A

Right ventricle

72
Q

Which anomaly will always be present with an aberrant left subclavian artery

A. Double aortic arch.
B. Right sided aortic arch.
C. Coarctation of the aorta
D. Aortic atresia

A

Right sided aortic arch

73
Q

If the tricuspid valve is abnormally, located on the left side of the heart, which structure must also be abnormally located on the left

A

The right ventricle

74
Q

The ratio of a E:A points of the mitral valve should normally be

A.<1
B.<1.5
C.<2
D.<2.5

A

<1

75
Q

If significant tricuspid regurgitation is seen in a fetal heart, which of the following should be suspected
A. Tricuspid atresia
B. Pulmonary stenosis
C. Mitral atresia
D. Aortic stenosis

A

Pulmonary stenosis

76
Q

Which of the following can cause early reversal of the E and A points of the tricuspid valve
A. IUGR
B. Fetal anemia
C. Macrosomia
D. Trisomy, 21

A

IUGR

77
Q

Pulsatile flow in the umbilical artery is normal before

A

12 weeks gestation

78
Q

All of the following might cause a prominent A wave in the ductus venosus except
A. Hypoplastic right ventricle
B. Heart rate above 190 bpm
C . Tricuspid atresia
D. Persistent left superior vena cava.

A

Persistent left superior vena cava

79
Q

A normal S/D ratio of the umbilical artery after 30 weeks gestation would be

A

<_3

80
Q

The most common arrhythmia seen in fetuses is

A

Premature atrial contraction, also known as PACs

81
Q

An atrial rate greater than 400 bpm would be consistent with

A

Atrial fibrillation

82
Q

Which of the following is not associated with Fetal PACs?
A. Maternal caffeine ingestion
B. Maternal smoking
C. Maternal diabetes
D. Redundant foramenal flap

A

Maternal diabetes

83
Q

Complete heart block in a fetus is associated with

A

Maternal lupus

84
Q

If a fetal heart exhibited a ventricular rate of 60 bpm in an atrial rate of 120 bpm, the most likely diagnosis would be
A. Superventricular tachycardia
B. Second-degree heart block
C. Premature atrial contraction
D. Complete heart block

A

Second-degree heart block

85
Q

The most common type of an ASD is

A

Ostium secundum

86
Q

The most common type of a VSD is

A

Membranous

87
Q

Approximately what percent of VSDs are isolated abnormalities
A. 40%
B. 50%
C. 60%
D. 70%

A

60%

88
Q

An AVSD with a single multi leaflet AV valve, would be classified as
A. Complete
B. partial
C. Intermediate
D. Balanced

A

Complete

89
Q

The most commonly diagnosed type of Univentricular heart consist of
A. A single ventricle.
B. A morphologic left ventricle with a rudimentary right chamber.
C. A morphological, right ventricle with a rudimentary left chamber.
D. A rudimentary right and left ventricle

A

A morphologic left ventricle with a rudimentary right chamber

90
Q

Persistent, truncus arteriosus has a strong association with

A

22Q 11 deletion also known as Di George

91
Q

If a confluence of all four pulmonary veins is identified posterior to the left atrium, the most likely diagnosis is

A

Total anomalous pulmonary venous return

92
Q

Which of the following is least likely to warrant immediate surgery following birth
A. Coarctation of the aorta
B.TAPVR
C. Tetralogy of Fallot.
D. Persistent left superior vena cava

A

Persistent left superior vena cava

93
Q

By definition, a double outlet, right ventricle is present when at least what percent of both great vessels arise from the right ventricle

A

50%

94
Q

Which of the following carries a strong association with rhabdomyoma’s
A. Trisomy, 13.
B. Muscular dystrophy
C. Polysplenia
D. Tuberous sclerosis

A

Tuberous sclerosis

95
Q

Left atrial isomerism is associated with all the following, EXCEPT
A. Arrhythmia
B. Polysplenia
C. Complete transposition of the great arteries.
D. Right sided fetal stomach.

A

Complete transposition of the great vessels

96
Q

The most common cardiac anomaly seen in TTTS is

A

Pulmonary stenosis

97
Q

The heart can be displaced to the right side of the chest due to all the following EXCEPT

A. Tricuspid insufficiency
B. Diaphragmatic hernia
C. Cystic adenomatiod malformation
D. Hypoplastic right lung.

A

Tricuspid insufficiency

98
Q

And rare instances premature atrial contractions, can evolve into

A

Superventricular tachycardia

99
Q

All of the following might cause an enlarged right atrium EXCEPT
A. Ebstein anomaly
B. HLHS
C. Tricuspid insufficiency
D.PLSVC

A

Persistent, left superior vena cava

100
Q

Which of the following is most commonly seen in the fetus of a diabetic mother
A. Dilated cardiomyopathy
B. Hypertrophic cardiomyopathy
C. Restrictive cardiomyopathy
D. Congestive cardiomyopathy.

A

Hypertrophic cardiomyopathy

101
Q

Which of the following is most likely seen in the fetus of a diabetic mother
A. Tetralogy of Fallot.
B.HLHS
C.TAPVR
D. Coarctation of the aorta

A

TOF

102
Q

A normal fetal heart rate is between

A

100 -180bpm

Fetal Echo 2022 (7 decks)

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