High Yield PTEeXAM Review Part 21-23

Question 1

What are who aspects that increase significance of pressure recovery?

Answer 1

1. Increased Aortic Stenosis severity
2. Decrease in aortic root size (Women and children)

Question 2

When you are performing a cath-derived peak pressure, how does that comprae to doppler derived gradients?

Answer 2

Pressure Recovery

CWD > Cath

Cath derived are measured distl to areaa of “low” pressure yielding lower pressure graadients than the actual peaka

Question 3

What is the doppler equation?

Answer 3

Change in F = V cos (angle) 2 Ft / C

Question 4

What is a normal MPI (Myocardial Performance Index)?

Answer 4

< 0.35

Question 5

What is a MPI (Myocardial Performance Index) that represents LV dysfunction?

Answer 5

>0.5

Question 6

Does MPI (Myocardial Performance Index) a measure of systolic or diastolic function?

Answer 6

BOTH

Question 7

Is MPI (Myocardial Performance Index) load dependent?

Answer 7

NOT load dependent

Question 8

What is the MPI (Myocardial Performance Index) equation?

Answer 8

[IVRT + IVCT] /ET

Question 9

What TEE view do you need to obtain MPI (Myocardial Performance Index)?

Answer 9

TG Deep 5 chamber

Question 10

What is the answer to the photo?

Answer 10

B = Isovolumetric Contraction Time

Question 11

A RV MPI above WHAT was found to be predictive of hemodynamic instability and mortality afater cardiac valvular surgery?

Answer 11

0.5

Question 12

What view is needed to get RV MPI values?

Answer 12

Deep TG RV outflow

Question 13

What ultrasound modality allows us to see movement not speed or direction?

Answer 13

Power Doppler

Question 14

What is the velocity of sound in units (mm/microsecond)?

Answer 14

1.54 mm / microsecond

1540 m/sec is other units

Question 15

How does the PWD shift if you move the cursor from the distal LA to the MV annulus?

1. Peak E wave change?
2. Deceleration time change?

Answer 15

1. Peak E wave increases
2. Deceleration time decreases

Question 16

What is the neck of a true anuerysm of the LV?

Answer 16

Wide

Question 17

What is the neck of a pseudoanuerysm of the LV?

Answer 17

Narrow Neck

Question 18

What is the neck/aneurysm diameter of a pseudoanuerysm of the LV?

Answer 18

<0.5

Question 19

What is the neck/aneurysm diameter of a true aneurysm of the LV?

Answer 19

Neck/Aneurysm size >0.5

Question 20

What does the myocardial to aneurysm transition look like for aneurysm vs. pseudoaneurysm?

Answer 20

Aneurysm = Gradual transition

Pseudoaneurysm = Abrupt transition

Question 21

What does the angle between normal myocardium and aneurysm look like for aneurysm vs. pseudoaneurysm?

Answer 21

Aneurysm = Wide angle

Pseudo = Narrow angle

Question 22

If you are given RAP and Peajk velocity of AV, what other information is needed to calculate LAP?

Answer 22

Peak PFO velocity

Question 23

If you are given RAP and BP, what other information is needed to calculate LAP?

Answer 23

Peak MR velocity

LVSP - LAP = Delta P = (V_MR)²

Question 24

For MHz (Mega Hz), this is one cycle per what unit of time?

Answer 24

1 cycle = 1 microsecond

Question 25

For MHz (Mega Hz), how many cycles are in one second?

Answer 25

1 million cycle / second

Question 26

What tricuspid valve leaflets are seen here?

Answer 26

Left = Septal / Posterior leaflet Right = Anterior

Question 27

What is the least likely location of a myxoma?

Answer 27

Attached to aortic valve

Question 28

What is the most common location of primary cardiac myxoma?

Answer 28

LA attached to interatrial septum

Question 29

What is the formula for fractional area change?

Answer 29

[*_End distolic area - End systolic area*_] / _*End Diastolic area_*

Question 30

Rank the following media in order of increasing ultrasound velocity (highest velocity medium last) Air Bone Fat Lung Soft Tissue

Answer 30

Air \< Lung \< Fat \< Soft Tissue \< Bone

Question 31

What are the echocardiographic inclusion criteria for Mitraclip for: ## Footnote **Coaptation length**

Answer 31

Coaptation Length \> 2mm

Question 32

What are the echocardiographic inclusion criteria for Mitraclip for: ## Footnote **Coaptation Depth**

Answer 32

## Footnote **Coaptation Depth \<11 mm**

Question 33

What are the echocardiographic inclusion criteria for Mitraclip for: ## Footnote **Flail Gap**

Answer 33

Flail Gap \< 10 mm

Question 34

What are the echocardiographic inclusion criteria for Mitraclip for: ## Footnote **Flail Width**

Answer 34

Flail width \< 15 mm

Question 35

What are the anatomic inclusion criteria for Mitraclip for: ## Footnote **MR jet associated with what two leaflets?**

Answer 35

A2 and P2 segments

Question 36

What hasa to be absent of the mitral valve in order to be considered for a MitraClip?

Answer 36

**Absent:** 1. Severe Mitral Calcification 2. Leaflet calcificaation in the grasping area 3. Significant cleft or leaflet perforation 4. Restricted Posterior Leaflet

Question 37

What are the anatomic inclusion criteria for Mitraclip for: ## Footnote **LVEF has to be above what?**

Answer 37

**LVEF \>20%** in order to get a MitraClip

Question 38

What are the anatomic inclusion criteria for Mitraclip for: ## Footnote **Leaflet thickness**

Answer 38

Leaflet thickness **\<5 mm**

Question 39

What are the anatomic inclusion criteria for Mitraclip for: ## Footnote **LV End Diastolic dimension?**

Answer 39

**LV End Diastolic dimension \< 60 mm**

Question 40

What are the anatomic inclusion criteria for Mitraclip for: Mitral Valve area?

Answer 40

**MVA \> 4 cm²** to get a MitraClip

Question 41

Answer 41

**Answer = A** Relaxation is impaired LAP is low or normal