Pericardial Disease and Cardiac Tumors Flashcards

1
Q
A thickened, inflamed, adherent or calcific pericardium is associated with:
A. Cardiac tamponade
B. Mitral stenosis
C. Constrictive pericarditis
D. Pulmonary embolism
A

C. Constrictive pericarditis

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2
Q
A patient with chronic systemic HTN presents to the echo lab. The PW doppler mitral inflow data is acquired: E:A ratio is 0.66, decal time 290msec, isovolumic relaxation time is 132msec. The doppler data suggests the diastolic filling grade of Grade:
A. IV
B. I
C. III
D. II
A

B. I

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3
Q
The most common intracardiac tumor in adults is (the):
A. Myxoma
B. Metastatic
C. Rhabdomyoma
D. Angiosarcoma
A

B. Metastatic

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4
Q

All of the following ae associated M-mode/2D echo findings for cardiac tamponade EXCEPT:
A. RV systolic collapse
B. RA diastolic collapse
C. Pericardial effusions (usually moderate-large)
D. IVC plethora

A

A. RV systolic collapse

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5
Q
All of the following are possible etiologies of constrictive pericarditis EXCEPT:
A. Atherosclerosis
B. Tuberculosis
C. Prior pericardiotomy
D. Radiation therapy to the chest region
A

A. Atherosclerosis

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6
Q
All of the following may result in secondary pulmonary hypertension EXCEPT:
A. LV failure
B. Coronary artery disease
C. Tricuspid regurgitation
D. Mitral stenosis
A

C. Tricuspid regurgitation

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7
Q
Echocardiographic signs associated with constrictive pericarditis include all of the following EXCEPT:
A. IVC plethora
B. railroad track sign
C. septal bound
D. increased EPSS
A

D. Increased EPSS

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8
Q
An anterior clear space is noted in the PLAX view. The diagnosis is most likely:
A. Pericardial effusion
B. Adipose tissue
C. Constrictive pericarditis
D. Cardiac tamponade
A

B. Adipose tissue

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9
Q
Secondary findings associated with systemic hypertension include all of the following EXCEPT:
A. increased LV mass
B. LVH
C. LAE
D. increased main pulmonary artery
A

D. increased main pulmonary artery

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10
Q
The most common primary benign valvular tumor in adults is the:
A. Fibroelastoma 
B. Angiosarcoma
C. Rhabdomyoma
D. Myxoma
A

A. Fibroelastoma

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11
Q
The tissue doppler finding for constrictive pericarditis is mitral valve annulus:
A. Normal E' wave peak velocity
B. E'/A' ratio reversal
C. Increased S' wave peak velocity
D. Absent A' wave
A

A. normal E’ wave peak velocity

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12
Q
Complications of a right atrial thrombus include:
A. Pulmonary embolism
B. Patent foramen ovale
C. Valvular prolapse
D. Interatrial septal aneurysm
A

A. Pulmonary embolism

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13
Q
The most common presenting symptom of acute pericarditis is:
A. Fatigue
B. Cachexia
C. Hemoptysis
D. Chest pain
A

D. Chest pain

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14
Q

Cardiac catheterization findings for constrictive pericarditis include:
A. Increased “v” wave
B. Absent “a” wave
C. Increased peak-to-peak pressure gradient
D. Dip-and-plateau

A

D. Dip-and-plateau

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15
Q

All of the following are associated findings for pericarditis EXCEPT:
A. Tachycardia
B. Pericardial friction rub
C. Pericardial effusion by echocardiography
D. Fever

A

C. Pericardial effusion by echocardiography

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16
Q
Possible echocardiographic findings for pulmonary hypertension include all of the following EXCEPT:
A. RVH
B. Abdominal aortic aneurysm 
C. Tricuspid regurgitation
D. Dilated main pulmonary artery
A

B. Abdominal aortic aneurysm

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17
Q

The best guideline for differentiating pericardial effusion from pleural effusion by 2D echo is:
A. Pericardial seen as a posterior clear space; pleural seen as an anterior clear space
B. Pericardial seen as an anterior clear space; pleural seen as a posterior clear space
C. Pericardial located anterior to DA; pleural seen posterior to DA
D. Pericardial present posterior to DA; pleural present anterior to DA

A

C. Pericardial effusion is located anterior to the descending aorta; pleural effusion is present posterior to the descending aorta

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18
Q
Fibrin within the pericardial effusion most likely indicates:
A. Long-standing pericardial effusion
B. Cardiac tamponade
C. Constrictive pericarditis
D. Acute myocardial infarction
A

A. Long-standing pericardial effusion

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19
Q

Pulsed-wave doppler evidence of constrictive pericarditis includes:
A. Increased peak velocity across the MV with expiration
B. Increased peak velocity across the AV with inspiration
C. Increased peak velocity across the TV with expiration
D. Increased peak velocity across the MV with inspiration

A

A. Increased peak velocity across the MV with expiration

20
Q
A posterior echo-free space is detected during the systolic phase only by M-mode/2D echo. This is considered a:
A. Normal finding
B. Large pericardial effusion
C. Moderate pericardial effusion
D. Small pericardial effusion
A

A. Normal finding

21
Q

A 2D echo finding associated with pulmonary hypertension is:
A. Interventricular MI
B. Hyperkinetic IVS motion
C. Flattening of the IVS during ventricular systole
D. Atrial septal aneurysm

A

C. Flattening of the IVS during ventricular systole

22
Q
The combination of pericardial effusion and constrictive pericarditis is called:
A. Effusive-constrictive pericarditis
B. Libman-Sacks
C. Pericardial cyst
D. Cardiac tamponade
A

A. Effusive-constrictive pericarditis

23
Q
An unattached freely moving thrombus within the left atrium is referred to as a:
A. Sessile thrombus
B. Ball-valve thrombus
C. Pedunculated thrombus
D. Myxoma
A

B. Ball-valve thrombus

24
Q
M-mode findings associated with pulmonary hypertension include:
A. Paradoxical "a" dip of the PV
B. Deep "a" dip of the PV
C. Absent or shallow "a" dip of the PV
D. Reverse "a" dip of the PV
A

C. Absent or shallow “a” dip of the PV

25
Q
The swinging heart syndrome is associated with:
A. Cardiac trauma
B. Pericardial effusion
C. Constrictive pericarditis
D. Mitral valve prolapse
A

B. Pericardial effusion

26
Q
As the mean pulmonary artery pressure increases, the right ventricular outflow tract acceleration time:
A. Decreases
B. Remains unchanged
C. Increases
D. Depends upon patient age
A

A. Decreases

27
Q
A 44 year old female presents with dyspnea, no history of smoking or cardiac disease and significantly increased pulmonary artery pressures. The most likely explanation is:
A. Tricuspid regurgitation
B. Grade I diastolic function
C. Pulmonary regurgitation
D. Primary pulmonary hypertension
A

D. Primary pulmonary hypertension

28
Q
PW doppler evidence of cardiac tamponade from diastolic hepatic vein flow is:
A. Inspiratory reversal
B. Expiratory increase
C. Expiratory decrease
D. Inspiratory increase
A

C. Expiratory decrease

29
Q
Doppler evidence of constrictive pericarditis from diastolic hepatic vein flow is:
A. Expiratory increase
B. Expiratory decrease
C. Systolic flow reversal
D. Inspiratory Increase
A

B. Expiratory decrease

30
Q

All of the following may be used to calculate pulmonary artery pressure by doppler EXCEPT:
A. Pulmonary regurgitation
B. Mitral regurgitation
C. Right ventricular outflow tract acceleration time
D. Tricuspid regurgitation

A

B. Mitral regurgitation

31
Q
The most common etiology of systemic hypertension is:
A. Idiopathic processes
B. Renal disease
C, Pheochromocytoma
D. Coarctation of the aorta
A

A. Idiopathic processes

32
Q
The most effective treatment for cardiac tamponade is:
A. Aspirin
B. bed rest
C. pericardiocentesis
D. Pericardiectomy
A

C. Pericardiocentesis

33
Q
The tissue doppler finding of the mitral annulus is constrictive pericarditis is called:
A. Kussmaul's sign
B. Annulus paradoxus
C. Beck's triad
D. Pulsus paradoxus
A

B. Annulus paradoxus

34
Q
The pulse associated with cardiac tamponade is:
A. pulsus paradoxus
B. pulsus bisferiens
C. pulsus alternans
D. pulsus parvus et tardus
A

A. pulsus paradoxus

35
Q

A late peaking dagger shaped LVOT CW doppler flow pattern in obtained in a patient with systemic hypertension. The most likely explanation is:
A. LV systolic gradient
B. Hypertrophic obstructive cardiomyopathy
D. Coarctation of the aorta

A

A. LV systolic gradient

36
Q
The most common primary begnin intracardiac tumor found in children is:
A. Rhabdomyocarcoma
B. Myxoma
C. Papilloma
D. Rhabdomyoma
A

D. Rhabdomyoma

37
Q
The most common location for pericardial cyst is the:
A. Hilum
B. Left costophrenic angle
C. Right costophrenic angle
D. Superior mediastinum
A

C. Right costophrenic angle

38
Q
The most common primary malignant intracardiac tumor in adults is the:
A. Angiosarcoma
B. Myxoma
C. Fibroma 
D. Papillary fibroelastoma
A

A. Angiosarcoma

39
Q
A dumbbell-shaped configuration of the IAS is associated with:
A. Lipomatous hypertrophy
B. Amyloidosis
C. Sarcoma
D. Sarcoidosis
A

A. Lipomatous hypertrophy

40
Q
Air in the pericardial sac is known as:
A. Cardiac tamponade
B. Pneumopericardium
C. Hemopericardium
D. Effusive-constrictive pericardium
A

B. Pneumopericardium

41
Q
The two layers of the pericardium are:
A. myocardium; parietal pericardium
B. Visceral pericardium; myocardium
C. Epicardium; fibrous pericardium
D. epicardium; endocardium
A

C. Epicardium; fibrous pericardium

42
Q
The most likely PW doppler mitral flow pattern in constrictive pericarditis is:
A. impaired relaxation
B. restrictive
C. normal for age
D. pseudonormal
A

B. restrictive

43
Q
An echo finding for congenital absence of the pericardium is volume overload of the:
A. left ventricle
B. right ventricle
C. right atrium
D. left atrium
A

B. right ventricle

44
Q

PW doppler evidence of cardiac tamponade includes:
A. systolic flow reversal in pulmonary veins
B. systolic flow reversal in the hepatic veins
C. inspiratory increase in peak velocity across the MV with an inspiratory decrease in the TV
D. inspiratory decrease in peak velocity across the MV with an inspiratory increase in peak velocity across the TV

A

D. inspiratory decrease in peak velocity across the MV with an inspiratory increase in peak velocity across the TV

45
Q
The primary PW doppler MC flow pattern associated with systemic HTN is grade:
A. II
B. I
C. III
D. IV
A

B. I