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PTE Masters + A Practical Approach to Transesophageal Echocardiography > High Yield PTEexam Review part 27-29 > Flashcards

High Yield PTEexam Review part 27-29 Flashcards

1
Q

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

A

No a-wave

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2
Q

What is the property of Medtronic Hall valve?

A

Large central jet through central aperture

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3
Q

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

A

Convergent washing jets

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4
Q

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

A

Divergent Washing jets

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5
Q

What is the property of Starr Edwards valve?

A

No washing jets

High gradients

Very durable

High thrombotic risk (Fallen out of favor)

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6
Q

What is the property of Bjork-Shiley valve?

A

Single tilt disc valve

Embolized

Taken off market

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7
Q

What is the property of Medtronic Freestyle valve?

A

Entire porcine root

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8
Q

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

A

Small Struts

Central Gap

Thick Leaflets

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9
Q

Where would perimembranous and Subpulmonic VSD be found?

A
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10
Q

Least common location for myxoma?

A

Aortic Valve

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11
Q

Are myxoma more common in men or women?

A

Women

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12
Q

What age group are myxoma most common?

A

30-60 years old

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13
Q

What % of cardiac tumors are:

Benign vs. Malignant?

A

Benign = 75%

Malignant = 25%

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14
Q

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

A

Lipomas (8%)

Papillary Fibroelastoma (7.9%)

Rhabdomyomas (6.8%)

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15
Q

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

A

95% sarcoma

5% lymphoma

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16
Q

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

A

LV/RV = 2%

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17
Q

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

A
  1. SoV rupture = Higher diastolic flow than VSD
  2. Jet location
18
Q

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

A

LVSP - RVSP = 4 (V)2

19
Q

VSD flow dominates during systole or diastole?

A

Systole

20
Q

What is a Gerbode defect?

A

LV to RA defect (communication)

21
Q

When does a gerbode defect occur?

A

Aortic valve abscess

AV repair with close communication

22
Q

What is the expected gradient of Gerbode?

A

120/12 - 8 = 112 mmHg

23
Q

What is the expected gradient of TR jet?

A

25 - 8 (See pressures in systole)

= ~17 mmHg

24
Q

What are the expected gradient of VSD?

A

120 - 25 (95 mmHg)

25
Q

What are the expected gradient of ASD?

A

10 - 8 = 2 mmHg

26
Q

What are the expected gradient of MR?

A

120 - 10 mmHg = 110 mmHg

27
Q

What are the expected gradient of A.I.?

A

80 - 12 = 68 mmHg

28
Q

What are the expected gradient of PDA?

A

120 - 25 = 95 mmHg

29
Q

When would flow dominate with TR jet?

A

Systole

30
Q

When would flow dominate with MRR?

A

Systole

31
Q

When would flow dominate with VSD?

A

Systole

32
Q

When would flow dominate with ASD?

A

Diastole (Depending on compliance difference)

33
Q

When would flow dominate with PDA?

A

Both systole and diastole but dominates during systole

34
Q

What is this?

A

Sinus of Valsalva Aneurysm

35
Q

What is the difference in genetic penetrance vs. expressivity?

What cardiac disease is this seen?

A

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

36
Q

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

A

Early = No obstruction because LV is full

Late = More obstruction and more empty therefore the obstruction occurs later in the CWD profile

37
Q

What is at the arrows?

A

Septal Perforators after septal myectomy

38
Q

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

A

Septal Perforator flow = Diastolic blood flow (Seen in picture)

VSD flow* = *Systolic blood flow

39
Q

What wall is always spared in HOCM?

A

Basal inferolateral wall

40
Q

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

A

3.5 to 4 cm

41
Q

What type of artifact is seen here? (2 names)

What is this due to?

A

Ring down artifact

AKA Comet Tail

Due to Reverberation

42
Q

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

A

If it went away its an inverted LAA

PTE Masters + A Practical Approach to Transesophageal Echocardiography (55 decks)

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