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PTE Masters Ravi > High Yield PTEeXAM Review Part 1 & 2 (a-c) > Flashcards

High Yield PTEeXAM Review Part 1 & 2 (a-c) Flashcards

1
Q

How does color M-mode flow propagation velocity (Vp) change with preload in all patients?

A

Increases Vp with increases in preload in all patients

(Sensitive with loading conditions)

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2
Q

Is the mitral annular tissue doppler early velocity (e’) load dependent or load independent?
Is this for all patients, or selected only for diastolic dysfunction?

A

Load independent

Only in patients with diastolic dysfunction

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3
Q

What is the normal e’ velocity?

A

e’ >10 cm/sec

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4
Q

When is E/e’ unreliable?

A

Normal patients

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5
Q

What is seen here?

A

Septal Tricuspid Valve Leaflet

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6
Q

What is the most load independent of systolic function?

A

End Systolic Elastance

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7
Q

Other than End-Systolic elastance, name 3 other relatively load independent indexes of contractility.

A

1. Preload recuitable stroke work

2. Strain rate

3. Preload adjusted max power

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8
Q

What is the end systolic elastance?

A

The slope of a line through the end-systolic pressure-volume point (the left upper corner of the P-V loop) is termed End-Systolic Elastance (Ees) and is a measure of ventricular contractility.

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9
Q

What is the slope of the line where you have

Y-axis = Stroke Work

X-axis = End Diastolic Volume

A

Preload Recruitable Stroke Work = True Index of contractility

Y-axis = Stroke Work

X-axis = End Diastolic Volume

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10
Q

What is the formula for Preload Adjusted Max Power?

(Hint; There are 2 of them)

A

Preload Adjusted Max Power = Stroke Work / EDV2

Preload Adjusted Max Power = Stroke Work / EDA(3/2)

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11
Q

Preload Adjusted Max Power

Load dependent or load independent?

A

Load independent

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12
Q

How do you obtain tissue doppler peak systolic velocity?

A

Put PWD gate on the lateral annulus of the 4 chamber view

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13
Q

What are the 4 measures of systolic function that are load independent?

A
  1. End Systolic Elastance
  2. Preload Recruitable Stroke Work
  3. Strain Rate
  4. Preload Adjusted Max Power
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14
Q

What is the formula for Strain?

A

Strain = (L2-L1) / L1

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15
Q

What is the formula for Strain Rate?

A

Strain / Change in time = [(L2-L1) / L1] / Change in time

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16
Q

How do you logistically measure strain ratae of the LV on Echo?

A

Measure V1 Tissue Doppler

Measure V2 Tissue Doppler

measure “x” = Distance between the 2 velocities

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17
Q

Is speckle tracking angle independent or dependent?

A

Speckle Tracking = Angle Independent

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18
Q

What is strain rate dependent on?

(Reason why people don’t use this)

A

Angle

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19
Q

What is the normal value for strain rate of the LV or RV?

A

Anything more negative than -20.

Anything that is “more positive” than -20, is abnormal

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20
Q

What is this?

A

Papillary Fibroelastoma

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21
Q

Where do fibroelastomas develop (Be specific)?

A

Downstream side of the Valve

(LV side of the MV or Aortic side of the AV)

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22
Q

What is the function of the backing material in an ultrasound transducer?

A

Decreases the quality factor

23
Q

Draw an ultrasound transducer with these three pieces of equipment.

1. Backing material

2. Matching Layer

3. Piezoelectric Crystal

A

Matching layer in front

PZT crytals behind

Backing material in back of that

24
Q

What is the Q factor?

A

Unitless number that represents the transducers ability to emit a clean ultrasound pulse with a narrow bandwidth

25
What is the Q factor formula?
Resonance frequency / Bandwidth
26
What is the optimal thickness of **matching layer** to the wavelength?
1/4 of wavelength thickness
27
What is the purpose of the matching layer?
**Facilitates transfer of ultrasound through the tissues** Prevents a large echo interface of the transducer and the body
28
What is the optimal thickness of **the crystal** relative to the wavelength?
1/2 of wavelength
29
How does the backing material improve axial resolution
1. Functions to **shorten SPL** (Shorter pulse) **Prevents excess vibration of the crystals** **- Less vibration = Shorter SPL = Improved axial resolution** 2. **Equation** Axial resolution = 1/2 SPL therefore if you decrease this, you improve axial resolution *_Decreases ringing of the crystal_* *_"Cloth that covers a wine glass" - DINGGGGGGG then you grab it with a cloth_*
30
What material is the piezoelectric crystal made out of ?
Lead Zirconate Titanate
31
What is the piezoelectric effect?
Conversion of sound to electrical signal
32
What is the reverse piezoelectric effect?
Conversion of electrical signal to sound
33
What is another term for backing material?
Damping element
34
What is bandwidth of an ultrasound?
**Range**, or differences between the highest and lowest frequencies in the pulse
35
A transducer has a main frequency of 5 MHz. The range of frequncies is from 2 to 8 MHz. ## Footnote **What is the bandwith?**
Bandwidth = 8-2 MHz = **6 MHz**
36
How does the backing material affect: 1. Bandwidth 2. Q factor?
Higher bandwidth Lower Q factor
37
What is a duty factor? And relate it to an drawing illustration.
**Fraction of time which an ultrasound transmits a wave** Ex: CWD Duty factor = 100%
38
What is the expected Mitral E/A Ratio for : Normal diastolic function?
\>/= 0.8
39
What is the expected Mitral E/A Ratio for : Grade I diastolic dysfunction?
= 0.8
40
What is the expected Mitral E/A Ratio for : Grade II diastolic dysfunction?
\>0.8 to \<2
41
What is the expected Mitral E/A Ratio for : Grade 3 diastolic dysfunction?
\>2
42
What is the expected E/e' for : Normal Diastology Function?
\< 10
43
What is the expected E/e' for : Grade 1 Diastology Dysfunction?
\<10 e/e'
44
What is the expected E/e' for : Grade II Diastolic Dysfunction?
10 - 14
45
What is the expected E/e' for : Grade III Diastology Dysfunction?
\>14
46
What is the expected Peak TR Velocity (m/sec) for : Normal Diastology Function?
\< 2.8 m/s
47
What is the expected Peak TR Velocity (m/sec) for : Grade I Diastolic Dysfunction?
\< 2.8 m/sec
48
What is the expected Peak TR Velocity (m/sec) for : Grade II Diastolic Dysfunction?
\> 2.8 m/sec
49
What is the expected Peak TR Velocity (m/sec) for : Grade III Diastolic Dysfunction?
\> 2.8 m/s
50
What is a normal deceleration time for normal diastolic dysfunction?
\<220 ms
51
What is a deceleration time for Grade I Diastolic Dysfunction?
\>220 ms
52
What is a deceleration time for Grade II Diastolic Dysfunction?
150 - 200 ms
53
What is a deceleration time for Grade III Diastolic Dysfunction?
\<150 ms

PTE Masters Ravi (45 decks)

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