Quiz 5: Module 6-8 review Flashcards
With an increase in afterload, which of the following factors must increase in order to maintain the same stroke volume?
Contractility
Why do we see a reversal of S and D waves with increasing diastolic dysfunction?
The increased LAP does not allow PV flow into the LA during systole
What is the normal fractional area change of the RV?
_>35%
Calculate the RVSP
IVC exp = 20 mm
IVC insp = 14 mm
TR velocity = 3.4 m/sec
54 mmHg
Assess the cine clip below. Name two adjustments the sonographer should make in order to optimize the image?
- Landmarks - the ascending aorta is not seen due to improper probe rotation
- Depth- to shallow- cutting off the descending aorta
- Focus - all the way at the bottom of the screen - should be mid
- TGCs- gain is even, no adjustment needed
Which grade of diastolic dysfunction is associated with E’ velocity and E/e’ velocity ratio in the image above?
Grade 3 diastolic dysfunction
Calculate the aortic valve area given the variables below?
- LVOTd = 19mm
- VTI (LVOT) = 15 cm
- VTI (AV) = 38 cm
AVA = 1.12 cm^2
Using the numbers within the red boxes, calculate the stroke volume?
SV = 106 ml
What is compliance inverse to?
Stiffness
What grade of DD does the patient have given the values below?
- E/A ratio = 2.3
- Average E/e prime ratio = 16
- TR jet velocity = 3.6 m/s
- LAVI = 49 ml/m^2
Grade 3 (restrictive filling)
In the subcostal 4Ch view, which organ does the ultrasound beam intersect before entering the heart?
Liver
Which factor below is most likely to affect early diastolic filling?
Hypovolemia
Why does the MV inflow E wave increase so much with grade 3 diastolic dysfunction?
When the MV opens the high LA pressure drives the blood into the LV faster in early diastole
Which of the following statements best describe “inotropic force”?
The force of contraction
What is the optimal level to adjust the colour scale to when using colour doppler to interrogate the interatrial septum?
Approximately 40 cm/sec
The “crab view” from the suprasternal notch is used to image which of the following structures?
The pulmonary veins and LA
Calculate the aortic valve area (AVA) given the numbers below.
- LVOT diameter = 1.8 cm
- LVOT VTI = 18 cm
- AV VTI = 40 cm
1.14 cm^2
Calculate the fractional shortening based on the images below. Is this a normal value?
35% normal
What grade of DD does the patient have given the values below?
E/A ratio 1.8
Average E/e prime ratio = 13
TR jet velocity = 3.2 m/s
LAVI = 41 ml/m^2
Grade 2 pseudonormal filling
How will excessive mitral regurgitation affect the mitral valve inflow doppler profile?
There will be an increase to the E wave velocity
Which grades of diastolic dysfunction coincides with increased LAP?
Moderate and severe NOT mild
Where does the probe indicator point in order to acquire a standard suprasternal notch long axis view?
1-2 o’clock
A student is taking an online quiz with a time limit. The questions are quite challenging, so they are feeling nervous and anxious.
What effect would this situation have on the students resting heart rate and force contraction?
The heart rate would likely increase due to the sympathetic nervous system
What is the RAP given the image below?
15 mmHg
Which view is best for detecting an ASD with color and spectral doppler?
Subcoastal 4 chamber view
Why is the IVRT prolonged in grade 1 diastolic dysfunction?
The LV pressure decline is slowed during IVRT so it takes longer to fall below that of the LA
Which of the following statements best defines the Frank-starling principle?
- change in pressure is equal to 4 times the velocity squared
- Increased preload leads to increased stroke volume
- Assuming there is no stenosis, the stroke volume through any point in the heart is equal to the stroke volume through any second point through the heart
- Preload and afterload are inversely proportional
Increased preload leads to increased stroke volume
Which of the following terms refers to end diastole?
- The frame after MV closure
- The QRS complex
- The point at which we would measure LVIDd
Calculate the cardiac output given the numbers below
LVOT diameter = 19 mm
LVOT VTI = 23 cm
Heart rate = 85 bpm
5.5 L/min
What is the right atrial pressure estimate based on the parameters below?
IVC during inspiration = 10mm
IVC during expiration = 25mm
8 mmHg
Which of the following statements is true regarding a diseased heart?
- As afterload increases, stroke volume decreases
- As preload increases, afterload decreases
- Afterload increases, preload decreases
- As preload increases, stroke volume increases
As afterload increases, stroke volume decreases
Which of the following statements describes a scenario when Dp/DT would be most useful?
- Severe aortic stenosis
- When systolic and diastolic function need to be assessed together
- Severe LV dysfunction with MR
- On cases where the apical views are limited
severe LV dysfunction with MR
Calculate the cardiac output given the parameters below
EDV = 155 ml
ESV = 64 ml
HR = 70 bpm
Cardiac output = 6.37 L/min
Which of the following terms is a measurement of LV systolic function?
MPI
