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PTE Masters + A Practical Approach to Transesophageal Echocardiography > High yield PTEexam review part 33-35 > Flashcards

High yield PTEexam review part 33-35 Flashcards

1
Q

Peak E velocity 46 cm/sec

E/A of 0.6

Lateral mitral annular TDI 6.2 cm/sec

What is patient’s diastolic dysfunction?

A

Relaxation impaired

LAP is low/normal

Grade 1 Diastolic Dysfunction

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2
Q

When is LAP elevated?

A

Above Grade 1 (Grade 2 and 3)

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3
Q

What is 1/2 the spatial pulse length equal to?

A

Axial resolution

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4
Q

What is the best to worst resolution:

Axial

Elevational

Lateral

A

Best = Axial

Lateral

Worst = Elevation

“Think of an ALE (Beer)”

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5
Q

Which valve has divergent washing jets?

A

On-X bileaflet mechanical valve

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6
Q

Which valve has convergent washing jets?

A

St. Jude Bileaflet mechanical valve

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7
Q

Which valve has no washing jets, high gradients and has high durability

A

Starr Edwards

(Ball and cage valve)

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8
Q

What valve has a large central jet through central aperture?

A

Medtronic Hall

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9
Q

What valve has high embolization risk with single tilting disc?

A

Bjork Shiley valve

(Taken off market)

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10
Q

What valve is an entire porcine aortic root?

A

Medtronic freestyle valve

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11
Q

What is a valve that has small struts, central gap and thick leaflets?

A

Pericardial valve (Carpentier-Edwards)

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12
Q

What is that? (At 2)

A

Middle cardiac vein

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13
Q

What is the function of the matching layer of an ultrasound machine?

A

Improves transmission of ultraasound into soft tissue

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14
Q

What would typically be seen of pulmonary vein stenosis? with PWD?

A

Pulmonary PWD has very high systolic and diastolic velocities

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15
Q

What is seen with Mitral Stenosis on PWD of pulmonary veins?

A

Large A wave seen with pulmonaray venous PWD

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16
Q

What is seen with Tricuspid Stenosis on PWD of hepatic veins?

A

Large A wave on Hepatic Venous PWD

17
Q

What is the e’ in RICM?

A

e’ <8 cm/sec

18
Q

What is the e’ of Constrictive Pericarditis?

A

e’ >12 cm /sec

19
Q

What is resonant frequency?

A

(resonant frequency) RF = Velocity / [2(Thickness)]

20
Q

What is the formula for acoustic impedence?

A

Acoustic Impedence (Z) = Density (P) x Velocity (V)

21
Q

What is a Q factor?

A

Q factor = Resonant Frequency / Bandwith

Remember, (resonant frequency) RF = Velocity / [2(Thickness)]

22
Q

What decreases the Q factor?

A

Damping Material will decrease Q factor.

How?

Damping material –> Widens the bandwidth

Remember

Q factor = Resonant Frequency / Bandwith

Remember, (resonant frequency) RF = Velocity / [2(Thickness)]

23
Q

What is the formula for the near field length?

A

(Near Field Length) Ln = r2 / wavelength

24
Q

What type of canal defect is seen in Trisomy 21?

A

Complete AV canal defect

25
Q

What is seen in Barlow’s Syndrome on echo?

A

Bileaflet prolapse

Myxomatous Mitral valve

26
Q

What is seen from CV perspective of DiGeorge Syndrome?

A

Conotruncal Malformations (interrupted aortic aarch 50%)

Persistent truncus arteriosus (34%)

Tetralogy of Fallot

VSD

27
Q

What abnormality is seen with left sided obstruction:

  1. Parachute Mitral Valve
  2. Supramitral Ring
  3. Valvular Aortic Stenosis
  4. Subaortic Stenosis
  5. Aortic Coarctation
A

Shone complex

28
Q

What CV aspects have been seen with Turner Syndrome?

A
  1. Coarctation of Aorta
  2. Bicuspid AV
  3. Aortic Stenosis
  4. Hypoplastic Left Heart Syndrome
29
Q

If you see an oblique sinus, where will the pericardial fluid collect?

A

Adjacent to LAA

30
Q

If you see an transverse sinus, where will the pericardial fluid collect?

A

Transverse Sinus is seen in image “O”

31
Q

When you are providing echo for the structural heart procedures crossing the septum:

  1. What image orients you inferior & superior?
A

Bicaval (Left = Inferior, Right = Superior)

RV inflow Outflow (Determines anterior (near AV) or posterior)

32
Q

What is the most appropriate location for a wire to cross interatrial septum for a LAA closure device?

A

Inferoposterior region

33
Q

How do you differentiate pulmonic insufficiency vs. VSD?

A

PI = Diastolic flow

VSD = Systolic flow

34
Q

What is the maximum Vena Contracta on CFD that is acceptable after watchman?

A

5mm

35
Q

What is an appropriate compression of watchman in the LAA after release?

A

Compressed 80-92% of its size is appropriate compression of the implant

36
Q

For a watchman, what is the appropriate width of the LAA ostium?

For a watchman, what is the appropriate length of the LAA ostium?

A

Width must be 17 - 31 mm

Length must be equal to or greater than the ostium width

37
Q

When would you know if a Watchman implant was too small for the patient?

A

Compressed >92%

38
Q

When would you know if a Watchman implant was too large for the patient?

A

If compressed <80%, then the implant was too large for the patient

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

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