High Yield PTEeXAM Review Part 18-20 Flashcards

1
Q

What is the cause of persistent left superior vena cava?

A

Persistent left superior vena cava results when the left superior cardinal vein caudal to the innominate vein fails to regress.

Said another way

Failure of the fusion of the cardinal veins

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2
Q

What is the equation for determining pulmonary artery mean pressure? (PAMP)

A

PAMP = 4 (Vearly PI)2 + CVP

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3
Q

What is the equation for determining pulmonary artery diastolic pressure? (PADP)?

A

PAMP = 4 (Vlate PI)2 + CVP

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4
Q

Bicuspid Aortic Valve most common associated with what congenital abnormality?

A

Coarctation of the Aorta

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5
Q

Which bicuspid valve orientation has a greater propensity to develop aortic stenosis?

Vertical* orientation vs. *Horizontal orientation?

A

Horizontal > Vertical to develop aortic stenosis

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6
Q

For Systolic flow reversal in the pulmonary veins

Does the presence rule in severe MR?

Does the absence rule out severe MR?

A

Systolic flow reversal in the pulmonary veins = Specific for MR

Systolic flow reversal in the pulmonary veins = Not sensitive for MR

(You can still have severe MR with no systolic flow reversal in the pulmonary veins)

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7
Q

What is most influential on wave S1 in pulmonary veins?

A

LA relaxation during ventricular systole

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8
Q

What is most influential on wave S2 in pulmonary veins?

A

Left Atrial filling during RV systole

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9
Q

What is S1 wave in pulmonary veins determined by?

A

Left Atrial Relaxation during ventricular systole

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10
Q

What is S2 wave in pulmonary veins determined by?

A

RV stroke volume

LA Compliance

Descent of MV annulus which lowers LA pressure

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11
Q

What is A wave in pulmonary veins due to?

A

Left Atrial Contraction

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12
Q

What is a way using pulmonary vein velocities can you tell Normal Mitral Valve inflow from Pseudonormal?

A

Normal = Systolic Dominant

Pseudonormal = Systolic Blunting

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13
Q

What is a normal value of deceleratime time?

A

< 220 ms

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14
Q

What is a normal tissue doppler ot he lateral annulus of the mitral valve?

A

>8.0 cm/sec

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15
Q

What does the matching layer in the transducer do?

A

Matches acoustic impedence of the skin to increase penetration of sound waves

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16
Q

Which echo index is the most reliable to measure AI severity?

A

Vena Contracta

17
Q

Answer the question below

A
  1. SBP + Pressure across LV = LV pressure
  2. Pressure across LV = Change in P (Peak Velocity across AV)2 = 4 (2)2 = 16 mmHg

Therefore 148 + 16 = 164

  1. Use End Peak Velocity of AI (4 m/s) to get LVEDP
18
Q

What is the equation for MVA when given deceleration time?

A

MVA = 760/DT

19
Q

How do we grade Mitral Stenosis in terms of mean gradient across the valve?

What about pressure half time?

A

Mean Gradients

<5 and >10 is mild and severe

For PHT

30-89 = Normal ,90-150 = Mild, >220 = severe

20
Q

What is the deceleration time actually mean?

A

TIme taken for the pressure to decline to zero from the peak pressure

21
Q

What are 3 ways to decrease aliasing?

A
  1. Increase PRF (Decrease depth of the sample volume)
  2. Decrease Ft, this lowers (Change in Freq) making Change in Freq less than 1/2 PRF
  3. Use CWD
22
Q

What is the difference between normal, excessive, and restrictive leaflet motion?

A

Normal = Central jet with annular dilation

Excessive = Jet that goes away from diseased leaflet

Restrictive = Jet that goes toward diseased leaflet

23
Q

When is Type 3a restrictive?

What is the classic example of Type 3a motion?

A

During systole and diastole

3a = Rheumatic Heart Disease

24
Q

When is Type 3b restrictive?

What is the classic example of Type 3b motion?

A

3b = Restrictive in systole only

Ex: Dilated CM, Ischemic Heart Disease

25
Q

What is billowing of the MV leaflets?

What is prolapse of the MV leaflets?

What is flail of the MV leaflets?

A

Billowing = Leaflet tips are below the annulus

Prolapsed = Leaflet tips are above the annular plane

Flail = Ruptured chord

26
Q

Label the 17 wall segments that the LAD perfuses

A

**NOTE, the IS wall in the TG Mid Pap is the RCA not the LAD per new guideliens**

27
Q

Label the 17 wall segments that the RCA perfuses

A

**NOTE, the IS wall in the TG Mid Pap is the RCA not the LAD per new guideliens**

RCA in Blue

28
Q

Label the 17 wall segments that the LCX perfuses

A

**NOTE, the IS wall in the TG Mid Pap is the RCA not the LAD per new guideliens**

29
Q

What is normal % of radial shortening?

A

>30%

30
Q

What is radial shortening % for mild hypokinesis?

A

10-30%

31
Q

What is radial shortening % for severe hypokinesis?

A

>0% and <10%

32
Q

What radial shortening % is akinesis?

A

0

33
Q

What radial shortening % is dyskinesis?

A

Presence of systolic thinning

34
Q

Answer the question of the photo below

A

C = Pulmonic Infufficiency

35
Q

Answer the question

A

Aortic Stenosis and Aortic Regurgitatation

36
Q

Answer question using the photo below

A

Aortic stenosis

Aortic Regurgitation

Mitral Regurgitation