High Yield PTEexam Review part 27-29

Question 1

What does the mitral valve inflow velocities show with a-fib?

Answer 1

No a-wave

Question 2

What is the property of Medtronic Hall valve?

Answer 2

Large central jet through central aperture

Question 3

What is a property of the Saint Jude Bileaflet Mechanical valves?

Answer 3

Convergent washing jets

Question 4

What is the property of On-X bileaflet mechanical valve?

Answer 4

Divergent Washing jets

Question 5

What is the property of Starr Edwards valve?

Answer 5

No washing jets

High gradients

Very durable

High thrombotic risk (Fallen out of favor)

Question 6

What is the property of Bjork-Shiley valve?

Answer 6

Single tilt disc valve

Embolized

Taken off market

Question 7

What is the property of Medtronic Freestyle valve?

Answer 7

Entire porcine root

Question 8

What is the property of Pericardial valve (Carpentier-Edwards) valve?

Answer 8

Small Struts

Central Gap

Thick Leaflets

Question 9

Where would perimembranous and Subpulmonic VSD be found?

Answer 9

Question 10

Least common location for myxoma?

Answer 10

Aortic Valve

Question 11

Are myxoma more common in men or women?

Answer 11

Women

Question 12

What age group are myxoma most common?

Answer 12

30-60 years old

Question 13

What % of cardiac tumors are:

Benign vs. Malignant?

Answer 13

Benign = 75%

Malignant = 25%

Question 14

After myxoma, what are the most common benign cardiac tumors?

Answer 14

Lipomas (8%)

Papillary Fibroelastoma (7.9%)

Rhabdomyomas (6.8%)

Question 15

What is the most and least common malignant cardiac tumors? (Broad categories)

Answer 15

95% sarcoma

5% lymphoma

Question 16

If the valves are not a possible answer for least common location for myoxma, what is the least common location (Excluding valves)?

Answer 16

LV/RV = 2%

Question 17

What is a way you can tell a sinus of valsalva rupture vs. VSD?

Answer 17

1. SoV rupture = Higher diastolic flow than VSD
2. Jet location

Question 18

You are given peak velocity of 3.58 m/s with subpulmonic VSD. BP is 100/60. What is the RVSP?

Answer 18

LVSP - RVSP = 4 (V)2

Question 19

VSD flow dominates during systole or diastole?

Answer 19

Systole

Question 20

What is a Gerbode defect?

Answer 20

LV to RA defect (communication)

Question 21

When does a gerbode defect occur?

Answer 21

Aortic valve abscess

AV repair with close communication

Question 22

What is the expected gradient of Gerbode?

Answer 22

120/12 - 8 = 112 mmHg

Question 23

What is the expected gradient of TR jet?

Answer 23

25 - 8 (See pressures in systole)

= ~17 mmHg

Question 24

What are the expected gradient of VSD?

Answer 24

120 - 25 (95 mmHg)

Question 25

What are the expected gradient of **ASD**?

Answer 25

10 - 8 = **2 mmHg**

Question 26

What are the expected gradient of **MR**?

Answer 26

120 - 10 mmHg = **110 mmHg**

Question 27

What are the expected gradient of **A.I.**?

Answer 27

80 - 12 = 68 mmHg

Question 28

What are the expected gradient of **PDA**?

Answer 28

120 - 25 = **95 mmHg**

Question 29

When would flow dominate with **TR jet**?

Answer 29

Systole

Question 30

When would flow dominate with MRR?

Answer 30

Systole

Question 31

When would flow dominate with **VSD**?

Answer 31

Systole

Question 32

When would flow dominate with ASD?

Answer 32

**Diastole** (Depending on compliance difference)

Question 33

When would flow dominate with **PDA**?

Answer 33

Both systole and diastole but dominates during systole

Question 34

What is this?

Answer 34

Sinus of Valsalva Aneurysm

Question 35

What is the difference in genetic penetrance vs. expressivity? What cardiac disease is this seen?

Answer 35

**Penetrance** is used to describe whether or not there is a clinical expression of the genotype in the individual. **Expressivity** is the term that describes the differences observed in the clinical phenotype between two individuals with the same genotype. ***_Disease = HOCM_***

Question 36

Why do you have a late peaking "Dagger" shape to CWD profile in HOCM?

Answer 36

**Early** = No obstruction because **LV is full** **Late** = More obstruction and **more empty** therefore the obstruction occurs later in the CWD profile

Question 37

What is at the arrows?

Answer 37

Septal Perforators after septal myectomy

Question 38

How do you tell a septal perforator from VSD after septal myectomy?

Answer 38

**Septal Perforator flow** = **Diastolic** blood flow (Seen in picture) *_VSD flow*_ = _*Systolic_* blood flow

Question 39

What wall is always spared in HOCM?

Answer 39

Basal inferolateral wall

Question 40

What is the correct distance of an impella device placement through the AV into the LV?

Answer 40

3.5 to 4 cm

Question 41

**What type of artifact is seen here? (2 names)** *_What is this due to?_*

Answer 41

**Ring down artifact** **AKA Comet Tail** *_Due to Reverberation_*

Question 42

This was found after bypass and then went away after surgical manipulation. What is the diagnosis?

Answer 42

**If it went away** its an **inverted LAA**