Semester Pool Flashcards
A communication between the ascending aorta and the main pulmonary artery is called:
-Patent ductus arteriosus
-Coarctation of the aorta
-Aortopulmonary window
-Supracristal ventricular septal defect
Aortopulmonary window
A complete atrioventricular septal defect is ostium primum atrial septal defect with:
- Canal (inlet)-type ventricular septal defect, common atrioventricular valve
-Cleft mitral valve
-Canal (inlet)-type ventricular septal defect, patent ductus arteriosus
-Coarctation of the aorta
Canal (inlet)-type ventricular septal defect, common atrioventricular valve
A congenital malformation of the tricuspid valve in which one, two or all three leaflets are displaced downward from the annulus with right ventricular dysplasia (atrialization) is known as:
-Tricuspid stenosis
-Tricuspid atresia
-Epstein-Barr anomaly
-Ebstein’s anomaly
Ebstein’s anomaly
A defect is found in the central portion of the inter-atrial septum. The type of atrial septal defect present is:
-Coronary sinus
-Sinus venosus
-Ostium secundum
-Ostium primum
Ostium secundum
A membrane stretching from the left side of the interventricular septum to the right side of the anterior leaflet of the mitral valve is called:
-Aortic dissection
-Hourglass aortic stenosis
-“Strand” aorta
-Discrete subaortic stenosis
Discrete subaortic stenosis
A patient with a long-standing history of systemic hypertension is sent to the emergency room after developing chest pain that radiated to the back. The electrocardiogram demonstrated left ventricular hypertrophy and the chest roentgenogram revealed a widening of the superior mediastinum. A possible diagnosis is:
-Pericarditis
-Acute severe mitral regurgitation
-Mitral stenosis
-Aortic dissection
Aortic dissection
A possible etiology for aortic aneurysm is:
-Marfan syndrome
-Coronary artery disease
-Dilated cardiomyopathy
-Aortic regurgitation
Marfan syndrome
A potential complication of patent foramen ovale is:
-Congestive heart failure
-Mitral valve stenosis
-Valvular stenosis
-Paradoxical embolus
Paradoxical embolus
A redundancy of the mid-portion of the atrial septum which may result in an inter-atrial shunt is called:
-SAM
-DSS
-ASH
-ASA
ASA
A two-dimensional echocardiographic finding for an aortic intimal flap indicates aortic:
-Stenosis
-Regurgitation
-Aneurysm
-Dissection
Dissection
All of the following are associated echocardiographic findings for atrial septal defect EXCEPT:
-Paradoxical interventricular septal motion
-Left ventricular enlargement
-Right ventricular enlargement
-Right atrial enlargement
Left ventricular enlargement
All of the following are associated with pulmonary stenosis EXCEPT:
-Systolic doming of the pulmonary valve
-Right ventricular hypertrophy
-Pulmonary regurgitation
-Coarctation of the aorta
Coarctation of the aorta
All of the following are true concerning supravalvular aortic stenosis EXCEPT:
-Left ventricular volume overload
-Hourglass type associated with Williams syndrome
-Parasternal long-axis view allows visualization
-Associated with proximal coronary artery dilatation
Left ventricular volume overload
All of the following surgical repairs for congenital heart disease are correctly matched EXCEPT:
-Fontan: Single ventricle repair
-Modified Glenn: Superior vena cava to the right pulmonary artery
-Blalock-Taussig: Right subclavian artery to the right
pulmonary artery
-Ross: Surgical ligation of a patent ductus arteriosus
Ross: Surgical ligation of a patent ductus arteriosus
An intimal flap in the aorta is discovered in the parasternal long-axis view, suprasternal long-axis view of the aorta and subcostal long-axis of the abdominal aorta. The type of aortic dissection is DeBakey type:
II
I
B
III
I
Associated anomalies of sinus of Valsalva aneurysm include all of the following EXCEPT:
-Coarctation of the aorta
-Atrial septal defect
-Bicuspid aortic valve
-Ventricular septal defect
Atrial septal defect
Congenital heart defects strongly associated with Ebstein’s anomaly include:
-Parachute mitral valve
-Atrial septal defect
-Coarctation of the aorta
-Discrete subaortic stenosis
Atrial septal defect
Defects associated with tetralogy of Fallot in approximately 30% of cases include:
-Overriding pulmonary artery
-Right aortic arch
-Tricuspid atresia
-Bicuspid aortic valve
Right aortic arch
Echocardiographic criteria for the diagnosis of aortic dissection include all of the following EXCEPT:
-Pericardial effusion
-Pleural effusion
-Recognition of an intimal flap within the aorta
-Decrease in aortic dimension
Decrease in aortic dimension
Eisenmenger’s syndrome may be associated with all of the following EXCEPT:
-Bicuspid aortic valve
-Atrial septal defect
-Patent ductus arteriosus
-Ventricular septal defect
Bicuspid aortic valve
For an agitated saline contrast exam, where will contrast appear proving the patient has an atrial septal defect?
-Main pulmonary artery
-Right ventricle
-Left atrium
-Right atrium
Left atrium
Important factors in evaluating post-surgical repair of tetralogy of Fallot include all of the following EXCEPT:
-Evaluate right and left ventricular function
-Rule out shunting at the margins of the ventricular septal defect repair
-Rule out residual right ventricular outflow tract obstruction
-Rule out residual shunting at the margins of the atrial septal defect repair
Rule out residual shunting at the margins of the atrial septal defect repair
In a patient with ventricular septal defect the blood pressure is 120/80 mm Hg and the peak systolic velocity of the ventricular septal defect is 5 m/s. The right ventricular systolic pressure and systolic pulmonary artery pressure is:
120 mm Hg
110 mm Hg
30 mm Hg
20 mm Hg
20 mm Hg
In coarctation of the aorta blood pressure in the legs:
-Is higher than in the right arm
-Is lower than the right arm
-Is equal to blood pressure in the right arm
-Cannot be compared with blood pressure in the right arm
Is lower than the right arm
Narrowing of the aortic isthmus is:
-Patent ductus arteriosus
-Aortic arch aneurysm
-Coarctation of the aorta
-Aortic dissection
Coarctation of the aorta
Patent ductus arteriosus results in
-Left ventricular pressure overload
-Right ventricular pressure overload
-Right ventricular volume overload
-Left ventricular volume overload
Left ventricular volume overload
Possible complications of aortic dissection include all of the following EXCEPT:
-Pericardial effusion
-Progressive enlargement of the aorta
-Left ventricular inflow tract obstruction
-Aortic regurgitation
Left ventricular inflow tract obstruction
Prime characteristics of tetralogy of Fallot include all of the following EXCEPT:
-Right ventricular outflow tract obstruction
-Right ventricular hypertrophy
-Atrial septal defect
-Malalignment ventricular septal defect
Atrial septal defect
The Doppler finding associated with patent ductus arteriosus is:
-Decreased pressure half-time of the mitral valve
-Holodiastolic flow reversal in the descending thoracic aorta
-Increased flow velocity at the aortic isthmus
-Systolic flow reversal in the pulmonary veins
Holodiastolic flow reversal in the descending thoracic aorta
The _____________ sinus of Valsalva is the most common sinus involved in sinus of Valsalva aneurysm.
-Right
-All three are equally involved in sinus of Valsalva aneurysm
-Non-coronary
-Left
Right
The cardiac chambers that are enlarged in ventricular septal defect initially are:
-Left atrium; left ventricle
-Right atrium; left atrium
-Right ventricle; left ventricle
-Right atrium; right ventricle
Left atrium; left ventricle
The cardiovascular abnormalities seen with Marfan syndrome include all of the following EXCEPT:
-Aortic dissection
-Dilatation of the aortic root, sinuses of Valsalva, ascending aorta
-Mitral valve prolapse
-Mitral supravalvular ring
Mitral supravalvular ring
The congenital heart defect most often associated with Down syndrome (trisomy 21) is:
-Atrioventricular septal defect
-Coarctation of the aorta
-Peripheral pulmonary stenosis
-Tetralogy of Fallot
Atrioventricular septal defect
The four defects that make up tetralogy of Fallot are right ventricular outflow tract obstruction (e.g., pulmonary stenosis), ventricular septal defect, right ventricular hypertrophy and:
-Deviation of the aorta
-Coarctation of the aorta
-Cleft mitral valve
-Atrial septal defect
Deviation of the aorta
The most common location for aneurysm of the aorta is the:
-Ascending aorta
-Transverse aorta
-Descending thoracic aorta
-Abdominal aorta
Abdominal Aorta
The most common type of ventricular septal defect is:
-Outlet (supracristal)
-Trabecular
-Perimembranous
-Inlet
Perimembranous
The normal Qp/Qs ratio is:
50%
1:1
1:2
2:1
1:1
The peak velocity across a patent ductus arteriosus is 4 m/s and the blood pressure is 90/60 mm Hg. The systolic pulmonary artery pressure is:
36 mm Hg
26 mm Hg
64 mm Hg
4 mm Hg
26 mm Hg
The physical finding of cyanosis is most common in:
-Patent foramen ovale
-Pulmonary regurgitation
-Mitral valve prolapse
-Eisenmenger’s syndrome
Eisenmenger’s syndrome
The type of ventricular septal defect most often associated with ventricular septal aneurysm is:
-Perimembranous
-Outlet
-Trabecular
-Inlet
Perimembranous
The typical murmur associated with patent ductus arteriosus is:
-Continuous murmur
-Holosystolic murmur
-Decrescendo diastolic murmur
-Late systolic murmur
Continuous murmur
The view of choice when examining a patient with secundum atrial septal defect is:
-Apical four-chamber
-Parasternal long-axis
-Parasternal short-axis of the aortic valve
-Subcostal four-chamber
Subcostal four-chamber
Types of supravalvular aortic stenosis include all of the following EXCEPT:
-Hypertrophic
-Dissected
-Tunnel
-Hourglass
Dissected
Uhl’s anomaly is:
-Right ventricular dysplasia
-Ostium primum atrial septal defect with cleft mitral valve
-Abnormal displacement of the tricuspid valve
-Left atrium aneurysm
Right ventricular dysplasia
Valvular lesions with which coarctation of the aorta is strongly associated include:
-Bicuspid aortic valve
-Tricuspid atresia
-Aortic valve vegetation
-Aortic valve flail
Bicuspid aortic valve
When evaluating atrial septal defect flow with color Doppler, the sonographer should:
-Reduce the color velocity scale
-Increase the color Doppler filter
-Invert the color flow map
-Invert the color flow map
Reduce the color velocity scale
A common echocardiographic finding in a cardiac surgery patient is:
-Paradoxical interventricular septal motion
-Valvular stenosis
-Valvular prolapse
-Pleural effusion
Paradoxical interventricular septal motion
A common two-dimensional echocardiographic finding in patients with chronic renal failure is:
-Aortic dissection
-Mitral valve prolapse
-Pulmonary hypertension
-Pericardial effusion
Pericardial effusion
A dilated coronary sinus is visualized in the parasternal long-axis. An agitated saline contrast study is performed and contrast is noted to appear in the coronary sinus before entering the right atrium. The diagnosis is most likely:
-Inlet ventricular septal defect
-Persistent left superior vena cava
-Normal
-Inlet ventricular septal defect
Persistent left superior vena cava
A left atrial volume is determined to be 44 ml/m^2. The left atrium is:
-Enlarged
-Thrombosed
-Hyperdynamic
-Normal
Enlarged
A membrane is visualized in the left atrium and appears to be superior to the fossa ovalis. This finding suggests:
-Supravalvular mitral ring
-Tetralogy of Fallot
-Cor triatriatum
-Mitral stenosis
Cor triatriatum
A membrane located at the level of the mitral valve annulus is mitral valve:
-Ring
-Flail
-Annular calcification
-Prolapse
Ring
A string-like structure is seen in the apex of the left ventricle. This finding may be called all of the following EXCEPT:
-False tendon
-Ectopic chordae
-Moderator band
-Chordal web
Moderator band
All of the following are associated echocardiographic/Doppler finding for the Marfan syndrome EXCEPT:
-Aortic root dilatation
-Aortic dissection
-Mitral stenosis
-Valvular regurgitation
Mitral stenosis
All of the following are associated findings for pulmonary embolism EXCEPT:
-Tricuspid regurgitation
-D-shaped left ventricle
-Left ventricular hypertrophy
-Right ventricular dilatation
Left ventricular hypertrophy
All of the following are expected echocardiographic/Doppler finding in the elderly EXCEPT:
-Mitral annular calcification
-Mitral valve E/A ratio of 1.5
-Aortic valve sclerosis
-Mild left atrial dilatation
Mitral valve E/A ratio of 1.5
All of the following are expected echocardiographic/Doppler findings for atrial fibrillation EXCEPT:
-Normal mitral valve E/A ratio
-Pulmonary vein absent atrial reversal wave
-Reduced left atrial appendage peak velocity
-Biatrial dilatation
Normal mitral valve E/A ratio
All of the following are findings for ankylosing spondylitis EXCEPT:
-Acute myocardial infarction
-formula
-Dilatation of the sinuses of Valsalva
-Dilatation of the aortic annulus
Acute myocardial infarction
All of the following are most likely to mimic the findings of mitral stenosis EXCEPT:
-Cor triatriatum
-Parachute mitral valve
-Infective endocarditis
-Left atrial myxoma
Infective endocarditis
All of the following are normal characteristics of a normal athlete’s heart EXCEPT:
-Tissue Doppler E’ peak velocity > 8 cm/s
-Normal E/A mitral ratio
-Concentric hypertrophy (< 17 mm)
-Left atrial dilatation
Left atrial dilatation
All of the following are normal findings in cardiac transplantation patients EXCEPT:
-Biatrial dilatation
-Paradoxical interventricular septal motion
-Reduced global ventricular systolic function
-Mild tricuspid regurgitation
Reduced global ventricular systolic function
All of the following are possible echocardiographic/Doppler findings for Ehlers-Danlos EXCEPT:
-Ventricular septal defect
-Ascending aortic aneurysm
-Valvular prolapse
-Mitral stenosis
Mitral stenosis
All of the following are possible sources of systemic embolism EXCEPT:
-Left atrial myxoma
-Left ventricular apical thrombus
-Aortic atherosclerotic plaque
-Aortic regurgitation
Aortic regurgitation
An aortic arteritis associated with marked intimal proliferation and fibrous scarring is:
-Marfan’s syndrome
-Libman-Sacks
-Takayasu’s disease
-Shone’s complex
Takayasu’s disease
Dilated coronary sinus has been associated with all of the following EXCEPT:
-Coronary atrioventricular fistula with drainage into the coronary sinus
-Right atrial hypertension
-Mitral regurgitation
-Persistent left superior vena cava
Mitral regurgitation
Electrical pacing of the right ventricle mimics the electrocardiographic and echocardiography findings of:
-Right bundle branch block
-Wolff-Parkinson-White syndrome
-Complete atrioventricular block
-Left bundle branch block
Left bundle branch block
In normal young patients most ventricular filling occurs during:
-During the PR interval
-Diastasis
-Early ventricular diastole
-Atrial systole
Early ventricular diastole
In the parasternal short-axis of the mitral valve two separate mitral valve orifices are seen during ventricular diastole. This suggests:
-Double orifice mitral valve
-Flail mitral valve
-Cleft mitral valve
-Mitral valve prolapse
Double orifice mitral valve
Osler-Weber-Rendu disease is associated with pulmonary arteriovenous fistula. The preferred echocardiographic/Doppler technique to determine the presence of this finding is:
-M-mode
-Color flow Doppler
-Agitated saline contrast
-Two-dimensional
Agitated saline contrast
Papillary muscle dysfunction usually results from:
-Rheumatic heart disease
-Infective endocarditis
-Ischemic heart disease
-Dressler’s syndrome
Ischemic heart disease
Penetrating aortic ulcer is considered to be:
-Congenital
-Aortopulmonary window
-Idiopathic
-Aortic dissection
Aortic dissection
Pulmonary vein stenosis may result in:
-Left atrial enlargement
-Mitral regurgitation
-Pulmonary hypertension
-Left ventricular hypertrophy
Pulmonary hypertension
Rupture of the vasa vasorum into the media of the aortic wall may result in:
-Aortic aneurysm
-Coarctation of the aorta
-Supravalvular aortic stenosis
-Intramural hematoma
Intramural hematoma
The classic echocardiographic finding for Pompe’s disease is:
-Aortic stenosis
-Mitral stenosis
-Left ventricular hypertrophy
-Coarctation of the aorta
Left ventricular hypertrophy
The classic echocardiographic findings for Noonan syndrome is:
-Dysplastic pulmonary valve
-Bicuspid aortic valve
-Dilated cardiomyopathy
-Ventricular septal defect
Dysplastic pulmonary valve
The combination of left ventricular inflow tract obstruction and left ventricular outflow tract obstruction is called:
-Takayasu’s disease
-Uhl’s anomaly
-Shone’s complex
-Ebstein’s anomaly
Shone’s complex
The echocardiographic/Doppler findings for Friedreich ataxia include:
-Left ventricular hypertrophy
-Thickened mitral valve
-Libman-Sacks endocarditis
-Aortic stenosis
Left ventricular hypertrophy
The echocardiographic/Doppler findings for cor pulmonale are very similar to:
-Hypertrophic cardiomyopathy
-Ischemic heart disease
-Pulmonary hypertension
-Hemochromatosis
Pulmonary hypertension
The echocardiographic/Doppler findings for diabetes include:
-Dilated cardiomyopathy
-Restrictive cardiomyopathy
-Arrhythmogenic right ventricular cardiomyopathy
-Hypertrophic cardiomyopathy
Dilated cardiomyopathy
The echocardiographic/Doppler findings for hyperthyroidism is:
-Enhanced global left ventricular systolic function
-Significant valvular regurgitation
-Mitral stenosis
-Aortic stenosis
Enhanced global left ventricular systolic function
The echocardiographic/Doppler findings for pheochromocytoma include all of the following EXCEPT:
-Segmental wall motion abnormalities
-Aortic aneurysm
-Acute myocarditis
-Concentric left ventricular hypertrophy
Aortic aneurysm
The echocardiographic/Doppler findings in hypothyroidism include:
-Thickened mitral valve
-Reduced global left ventricular systolic function
-Pericardial effusion
-Coarctation of the aorta
Reduced global left ventricular systolic function
The expected echocardiographic finding for Fabry’s disease is mitral valve:
-Prolapse
-Stenosis
-Flail
-Vegetation
Prolapse
The expected echocardiographic/Doppler findings for cocaine ingestion include all of the following EXCEPT:
-Hypertrophic cardiomyopathy
-Reduced global ventricular systolic function
-Acute aortic dissection
-Acute myocardial infarction
Hypertrophic cardiomyopathy
The most common echocardiographic/Doppler finding for scleroderma is:
-Mitral stenosis
-Pericardial effusion
-Pulmonary stenosis
-Ebstein’s anomaly
Pericardial effusion
The most common echocardiographic/Doppler finding in systemic lupus erythematosus is:
-Pericardial effusion
-Left atrial myxoma
-Aortic stenosis
-Coarctation of the aorta
Pericardial effusion
The most common reason for congestive heart failure in the United States is:
-Reduced global systolic function due to coronary artery disease
-Volume overload (e.g., significant mitral regurgitation)
-Diastolic dysfunction
-Pressure overload (e.g., systemic hypertension)
Reduced global systolic function due to coronary artery disease
The motion of a congenitally stenotic aortic valve can be described as:
-Fluttering
-Doming
-Hypokinetic
-Flail
Doming
The principal echocardiographic feature of left bundle branch block is:
-Hyperkinesis of the lateral wall of the left ventricle
-Early systolic dip of the interventricular septum
-Posterior motion of the interventricular septum
-Hyperkinesis of the interventricular septum
Early systolic dip of the interventricular septum
Thickening of the aortic valve leaflets with normal systolic excursion with a Doppler peak velocity of less than 2 m/s is the definition for aortic valve:
-Prolapse
-Sclerosis
-Stenosis
-Flail
Sclerosis
Tuberous sclerosis is associated with:
-Rhabdomyoma
-Myxoma
-Fibroma
-Angiosarcoma
Rhabdomyoma
Turner syndrome is associated with:
-Coarctation of the aorta
-Rhabdomyoma
-Aortic dissection
-Mitral valve prolapse
Coarctation of the aorta
Two ventricular pacing wires are implanted with one placed in the right ventricle and one placed at the left ventricular free wall region via the coronary sinus. This is a description of (a):
-Holter monitor
-Left ventricular assist device
-Conventional pacemaker therapy
-Cardiac resynchronization therapy
Cardiac resynchronization therapy
Which of the following is NOT associated with concentric left ventricular hypertrophy?
-Aortic stenosis
-Discrete subaortic stenosis
-Supravalvular aortic stenosis
-Cor pulmonale
Cor pulmonale
Which of the following is strongly associated with syncope?
-Carcinoid heart disease
-Rheumatic fever
-Left ventricular outflow tract obstruction
-Perimembranous ventricular septal defect
Left ventricular outflow tract obstruction
Which of the following is the most likely finding in Chagas disease?
-Aortic stenosis
-Mitral stenosis
-Dilated cardiomyopathy
-Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Which of the following mitral valve PW Doppler parameters suggests increased left heart filling pressures in a patient with atrial fibrillation?
-Decreased mitral valve E velocity
-Reduced mitral valve deceleration time (< 130 msec)
-Absent mitral valve A wave
-Increased mitral valve A duration
Reduced mitral valve deceleration time (< 130 msec)
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:
-Pulmonary regurgitation
-Primary pulmonary hypertension
-Grade I diastolic dysfunction
-Tricuspid regulation
Primary pulmonary hypertension
A dumbbell-shaped configuration of the inter-atrial septum is associated with
-Lipomatous hypertrophy
-Amyloidosis
-Sarcoidosis
-Sarcoma
Lipomatous hypertrophy
A late peaking dagger shaped left ventricular outflow tract continuous-wave Doppler flow pattern is obtained in a patient with systemic hypertension. The most likely explanation is:
-Hypertrophic obstructive cardiomyopathy
-Left ventricular systolic gradient
-Coarctation of the aorta
-Discrete subaortic stenosis
Left ventricular systolic gradient
A patient with chronic systemic hypertension presents to the echocardiography laboratory. The following pulsed-wave Doppler mitral inflow data is acquired: E:A ratio 0.66, deceleration time 290 msec, isovolumic relaxation time 132 msec. The Doppler data suggests the diastolic filling grade of Grade:
I
IV
II
III
I
A posterior echo-free space is detected during the systolic phase only by M-mode/two-dimensional echocardiography. This is considered a:
-Large pericardial effusion
-Small pericardial effusion
-Moderate pericardial effusion
-Normal finding
Normal finding
A thickened, inflamed, adherent or calcific pericardium is associated with:
-Pulmonary embolism
-Cardiac tamponade
-Constrictive pericarditis
-Mitral stenosis
Constrictive pericarditis
A two-dimensional echocardiographic finding associated with pulmonary hypertension is:
-Atrial septal aneurysm
-Flattening of the interventricular septum during ventricular systole
-Interventricular myocardial infarction
-Hyperkinetic interventricular septal motion
Flattening of the interventricular septum during ventricular systole
Air in the pericardial sac is known as:
-Effusive-constrictive pericardium
-Cardiac tamponade
-Pneumopericardium
-Hemopericardium
Pneumopericardium
All of the following are associated M-mode/two-dimensional echocardiography findings for cardiac tamponade EXCEPT:
-Right ventricular systolic collapse
-Inferior vena cava plethora
-Right atrial diastolic collapse
-Pericardial effusion (usually moderate to large)
Right ventricular systolic collapse
All of the following are associated findings for pericarditis EXCEPT:
-Fever
-Pericardial effusion by echocardiography
-Pericardial friction rub
-Tachycardia
Pericardial effusion by echocardiography
All of the following are possible etiologies of constrictive pericarditis EXCEPT:
-Atherosclerosis
-Radiation therapy to the chest region
-Tuberculosis
-Prior pericardiotomy
Atherosclerosis
All of the following may be used to calculate pulmonary artery pressure by cardiac Doppler EXCEPT:
-Right ventricular outflow tract acceleration time
-Mitral regurgitation
-Pulmonary regurgitation
-Tricuspid regurgitation
Mitral regurgitation
All of the following may result in secondary pulmonary hypertension EXCEPT:
-Tricuspid regurgitation
-Coronary artery disease
-Mitral stenosis
-Left ventricular failure
Tricuspid regurgitation
An anterior clear space is noted in the parasternal long-axis view. The diagnosis is most likely:
-Adipose tissue
-Constrictive pericarditis
-Pericardial effusion
-Cardiac tamponade
Adipose tissue
An echocardiographic finding for congenital absence of the pericardium is volume overload of the:
-Right ventricle
-Left ventricle
-Right atrium
-Left atrium
Right ventricle
An unattached freely moving thrombus within the left atrium is referred to as a:
-Myxoma
-Pedunculated thrombus
-Ball-valve thrombus
-Sessile thrombus
Ball-valve thrombus
As the mean pulmonary artery pressure increases, the right ventricular outflow tract acceleration time:
-Decreases
-Depends upon patient age
-Remains unchanged
-Increases
Decreases
Cardiac catheterization findings for constrictive pericarditis include:
-Increased peak-to-peak pressure gradient
-Absent “a” wave
-Dip-and-plateau
-Increased “v” wave
Dip-and-plateau
Complications of a right atrial thrombus include:
-Pulmonary embolism
-Patent foramen ovale
-Valvular prolapse
-Interatrial septal aneurysm
Pulmonary embolism
Doppler evidence of constrictive pericarditis from diastolic hepatic vein flow is:
-Inspiratory increase
-Systolic flow reversal
-Expiratory increase
-Expiratory decrease
Expiratory decrease
Echocardiographic signs associated with constrictive pericarditis include all of the following EXCEPT:
-Septal bound
-Inferior vena cava plethora
-Increased EPSS
-Railroad track sign
Increased EPSS
Fibrin within the pericardial effusion most likely indicates:
-Long-standing pericardial effusion
-Cardiac tamponade
-Acute myocardial infarction
-Constrictive pericarditis
Long-standing pericardial effusion
M-mode findings associated with pulmonary hypertension include:
-Absent or shallow “a” dip of the pulmonary valve
-Deep “a” dip of the pulmonic valve
-Paradoxical “a” dip of the pulmonic valve
-Reverse “a” dip of the pulmonic valve
Absent or shallow “a” dip of the pulmonary valve
Possible echocardiographic findings for pulmonary hypertension include all of the following EXCEPT:
-Abdominal aortic aneurysm
-Tricuspid regulation
-Right ventricular hypertrophy
-Dilated main pulmonary artery
Abdominal aortic aneurysm
Pulsed-wave Doppler evidence of cardiac tamponade from diastolic hepatic vein flow is:
-Inspiratory reversal
-Expiratory increase
-Inspiratory increase
-Expiratory decrease
-Expiratory decrease
Pulsed-wave Doppler evidence of cardiac tamponade includes:
-Inspiratory decrease in peak velocity across the mitral valve with an inspiratory increase in peak velocity across the tricuspid valve
-Inspiratory increase in peak velocity across the mitral valve with an inspiratory decrease in the tricuspid valve
-Systolic flow reversal in the hepatic veins
-Systolic flow reversal in the pulmonary veins
Inspiratory decrease in peak velocity across the mitral valve with an inspiratory increase in peak velocity across the tricuspid valve
Pulsed-wave Doppler evidence of constrictive pericarditis includes:
-Increased peak velocity across the mitral valve with expiration
-Increased peak velocity across the aortic valve with inspiration
-Increased peak velocity across the mitral valve with inspiration
-Increased peak velocity across the tricuspid valve with expiration
Increased peak velocity across the mitral valve with expiration
Secondary findings associated with systemic hypertension include all of the following EXCEPT:
-Increased main pulmonary artery
-Increased left ventricular mass
-Left atrial enlargement
-Left ventricular hypertrophy
Increased main pulmonary artery
The best guideline for differentiating pericardial effusion from pleural effusion by two-dimensional echocardiography is:
-Pericardial effusion is usually seen as a posterior clear space; pleural effusion is usually seen as an anterior clear space.
-Pericardial effusion is usually seen as an anterior clear space; pleural effusion is usually seen as a posterior clear space.
-Pericardial effusion is present posterior to the descending aorta; pleural effusion is located anterior to the descending aorta.
-Pericardial effusion is located anterior to the descending aorta; pleural effusion is present posterior to the descending aorta.
Pericardial effusion is located anterior to the descending aorta; pleural effusion is present posterior to the descending aorta.
The combination of pericardial effusion and constrictive pericarditis is called:
-Cardiac tamponade
-Libman-Sacks
-Pericardial cyst
-Effusive-constrictive pericarditis
Effusive-constrictive pericarditis
The most common etiology of systemic hypertension is:
-Coarctation of the aorta
-Idiopathic processes
-Renal disease
-Pheochromocytoma
Idiopathic processes
The most common intracardiac tumor in adults is (the):
-Rhabdomyoma
-Metastatic
-Angiosarcoma
-Myxoma
Metastatic
The most common location for a pericardial cyst is the:
-Hilum
-Left costophrenic angle
-Right costophrenic angle
-Superior mediastinum
Right costophrenic angle
The most common presenting symptom of acute pericarditis is:
-Chest pain
-Fatigue
-Cachexia
-Hemoptysis
Chest pain
The most common primary benign intracardiac tumor found in children is:
-Rhabdomyoma
-Myxoma
-Papilloma
-Rhabdomyosarcoma
Rhabdomyoma
The most common primary benign valvular tumor in adults is the:
-Angiosarcoma
-Myxoma
-Rhabdomyoma
-Fibroelastoma
Fibroelastoma
The most common primary malignant intracardiac tumor in adults is the:
-Angiosarcoma
-Fibroma
-Myxoma
-Papillary fibroelastoma
Angiosarcoma
The most effective treatment for cardiac tamponade is:
-Pericardiocentesis
-Aspirin
-Bed rest
-Pericardiectomy
Pericardiocentesis
The most likely pulsed-wave Doppler mitral flow pattern in constrictive pericarditis is:
-Restrictive
-Pseudonormal
-Normal for age
-Impaired relaxation
Restrictive
The primary pulsed-wave Doppler mitral valve flow pattern associated with systemic hypertension is Grade:
IV
II
I
III
I
The pulse associated with cardiac tamponade is:
-Pulsus alternans
-Pulsus parvus et tardus
-Pulsus bisferiens
-Pulsus paradoxus
Pulsus paradoxus
The swinging heart syndrome is associated with:
-Constrictive pericarditis
-Pericardial effusion
-Cardiac trauma
-Mitral valve prolapse
Pericardial effusion
The tissue Doppler finding for constrictive pericarditis is mitral valve annulus:
-Increased S’ wave peak velocity
-Normal E’ wave peak velocity
-Absent A’ wave
-E’/A’ ratio reversal
Normal E’ wave peak velocity
The tissue Doppler finding of the mitral annulus in constrictive pericarditis is called:
-Pulsus paradoxus
-Annulus paradoxus
-Beck’s triad
-Kussmaul’s sign
Annulus paradoxus
The two layers of the pericardium are:
-Myocardium; parietal pericardium
-Epicardium; fibrous pericardium
-Visceral pericardium; myocardium
-Epicardium; endocardium
Epicardium; fibrous pericardium
A common late complication associated with dilated cardiomyopathy is:
-Infective endocarditis
-Mitral regurgitation
-Ventricular gallop
-Systemic emboli
Systemic emboli
A common mitral valve finding in dilated cardiomyopathy in two-dimensional echocardiography is:
-Decreased E-septal separation
-Incomplete closure of the mitral valve
-Reversed diastolic doming
-Premature closure of the mitral valve
Incomplete closure of the mitral valve
A hallmark M-mode aortic valve finding in patients with hypertrophic obstructive cardiomyopathy is aortic valve:
-Diastolic flutter
-Fine systolic flutter
-Vegetation
-Mid-systolic notching
Mid-systolic notching
A more appropriate name for idiopathic hypertrophic cardiomyopathy (IHSS) is:
-Subaortic hourglass deformity
-Discrete subaortic stenosis (DSS)
-Hypertrophic cardiomyopathy
-Aortic tunnel disease (ATD)
Hypertrophic cardiomyopathy
A speckled or ground-glass appearance of the interventricular septum seen on two-dimensional echocardiography is found is:
-Dilated cardiomyopathy
-Mitral stenosis
-Constrictive pericarditis
-Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
A systolic high-velocity, late-peaking, dagger-shaped continuous-wave Doppler signal is obtained. The most likely diagnosis is:
-Hypertrophic obstructive cardiomyopathy
-Mitral regurgitation
-Tricuspid regurgitation
-Valvular aortic stenosis
Hypertrophic obstructive cardiomyopathy
All of the following are considered possible pharmacologic treatment for hypertrophic obstructive cardiomyopathy EXCEPT:
-Disopyramide
-Calcium-channel blocker (e.g., Verapamil)
-Digitalis
-Beta-blockers
Digitalis
All of the following maneuvers may induce or enhance the obstruction in hypertrophic cardiomyopathy EXCEPT:
-Leg raising
-Inhalation of amyl nitrate
-Supine to standing
-v
Leg raising
All of the following may be used to treat hypertrophic obstructive cardiomyopathy EXCEPT:
-Septal myectomy
-Aspirin
-Dual chamber pacemaker
-Alcohol-induced septal ablation
Aspirin
Characteristic findings in patients with dilated cardiomyopathy include all of the following EXCEPT:
-Dilated, poorly contracting left ventricle
-Low cardiac output
-Asymmetric septal hypertrophy
-Increased intracardiac pressures
Asymmetric septal hypertrophy
Common two-dimensional echocardiographic findings in hypertrophic obstructive cardiomyopathy include all of the following EXCEPT:
-Asymmetric interventricular septal hypertrophy
-Left ventricular enlargement
-Systolic anterior motion of the mitral valve
-Left atrial enlargement
Left ventricular enlargement
Early in the disease stage the usual pulsed-wave Doppler flow of the mitral valve in patients with dilated cardiomyopathy demonstrates a Grade:
II
IV
III
I
I
Echocardiographic findings in dilated cardiomyopathy include all of the following EXCEPT:
-Preserved ejection fraction
-Enlarged atrial cavities
-Apical mural thrombus
-Dilated ventricular cavities
Preserved ejection fraction
Functional classifications of cardiomyopathy include all the following EXCEPT:
-Restrictive
-Dilated
-Non-dilated
-Hypertrophic
Non-dilated
M-mode findings associated with hypertrophic cardiomyopathy include all of the following EXCEPT:
-Systolic anterior motion of the mitral valve (SAM)
-Asymmetric septal hypertrophy (ASH)
-Mid-systolic notching of the pulmonary valve
-Mid-systolic notching of the aortic valve
Mid-systolic notching of the pulmonary valve
Persistent intramyocardial sinusoids located in the left ventricle are found in:
-Noncompaction cardiomyopathy
-Hypertrophic cardiomyopathy
-Dilated cardiomyopathy
-Restrictive cardiomyopathy
Noncompaction cardiomyopathy
Possible causes of restrictive cardiomyopathy include all of the following EXCEPT:
-Hemochromatosis
-Sarcoidosis
-Amyloidosis
-Alcohol
Alcohol
Possible echocardiographic findings for sarcoid heart disease include:
-Asymmetric septal hypertrophy
-Concentric left ventricular hypertrophy
-Infero-basal aneurysm
-Dilatation of the ascending aorta
Infero-basal aneurysm
Pulsed-wave Doppler and color flow Doppler are useful in hypertrophic cardiomyopathy in all of the following ways EXCEPT:
-Quantitate the severity of the left ventricular outflow tract obstruction
-Help distinguish left ventricular outflow tract flow from mitral regurgitation
-Aid in guiding the continuous-wave Doppler beam
-Determine the presence and severity of mitral regurgitation
Quantitate the severity of the left ventricular outflow tract obstruction
The cardiac involvement associated with acquired immunodeficiency syndrome (AIDS) is:
-Hypertrophic cardiomyopathy
-Dilated cardiomyopathy
-Arrhythmogenic right ventricular cardiomyopathy
-Restrictive cardiomyopathy
Dilated cardiomyopathy
The cardiomyopathy described as presenting with four-chamber enlargement with poor global ventricular systolic function is:
-Hypertrophic
-Uhl’s
-Dilated
-Restrictive
Dilated
The cardiomyopathy with which cardiac hemochromatosis is most commonly associated with is:
-Idiopathic
-Hypertrophic
-Arrhythmogenic right ventricular cardiomyopathy
-Dilated
Dilated
The echocardiographic features of amyloidosis include all of the following EXCEPT:
-Increased ventricular wall thickness
-Dilatation of the ascending aorta
-Multivalvular regurgitation
-Pericardial effusion
Dilatation of the ascending aorta
The mitral valve finding most strongly associated with hypertrophic obstructive cardiomyopathy is mitral valve:
-Flail leaflet
-Aneurysm
-Fenestration
-Systolic anterior motion
Systolic anterior motion
The most common regurgitation found in patients with dilated cardiomyopathy is:
-Pulmonary regurgitation
-Aortic regurgitation
-Tricuspid regurgitation
-Mitral regurgitation
Mitral regurgitation
The primary cause of endomyocardial fibrosis is:
-Hypereosinophilia
-Alcohol
-Intravenous drug abuse
-Chemotherapy
Hypereosinophilia
The progressive replacement of right ventricular myocardium with fatty and fibrous tissue is called
-ARVC
-HCM
-DSS
-IHSS
ARVC
The pulsed-wave Doppler mitral flow pattern most often associated with hypertrophic cardiomyopathy is grade:
II
III
IV
I
I
All of the following are true statements concerning pulsed-wave (PW) Doppler EXCEPT:
-Aliasing is a primary disadvantage
-Preferred modality to evaluate diastolic function
-Range resolution (range discrimination) is the primary advantage
-Utilizes two elements
Utilizes two elements
A maneuver that will result in tachycardia and a transient decrease in blood pressure is:
-Inhalation of amyl nitrite
-Straight leg raising
-Standing to supine
-Squatting
Inhalation of amyl nitrite
A maneuver which results in a decrease in venous return is:
-Straight leg raising
-Squatting
-Valsalva
-Inspiration
Valsalva
A swirling of transpulmonary contrast is noted at the apex of the left ventricle. The sonographer should:
-Call the nurse
-Decrease the transmit gain
-Inject the contrast at a slower rate
-Use respiratory maneuvers
Decrease the transmit gain
Agitated saline contrast may be used to evaluate all of the following EXCEPT:
-Tricuspid regurgitation
-Patent foramen ovale
-Left to right atrial septal defect
-Aortic regurgitation
Aortic regurgitation
All of the following are primary advantages of transesophageal echocardiography EXCEPT:
-Preferred test for infective endocarditis
-Absence of lung and rib artifact
-Preferred test for mitral valve stenosis
-Superior resolution with high transmit frequencies
Preferred test for mitral valve stenosis
All of the following are true statements concerning M-mode echocardiography EXCEPT:
-Excellent axial resolution
-Standard sweep speed is 50 mm/s
-Primary method currently of determining the presence and severity of cardiac pathology
-Excellent temporal resolution
Primary method currently of determining the presence and severity of cardiac pathology
All of the following are true statements concerning color flow Doppler EXCEPT:
-Pulsed-wave Doppler technique
-Mean velocity displayed
-Normal flow does not alias
-Multigate
Normal flow does not alias
All of the following are ways in which the sonographer can improve the lateral resolution while imaging EXCEPT:
-Increase the number of focuses
-Increase the transducer diameter
-Utilize harmonic imaging
-Increase the transmit frequency
Increase the transducer diameter
All of the following are ways to increase the color flow Doppler frame rate and improve temporal resolution EXCEPT decrease:
-Line density
-Image depth
-Color gain
-Field of view
Color gain
All of the following cardiac pathologies are best evaluated with cardiac Doppler in the apical views EXCEPT:
-Atrial septal defect
-Aortic stenosis
-Mitral stenosis
-Mitral regurgitation
Atrial septal defect
All of the following decrease with increasing transmit frequency EXCEPT:
-Depth of penetration
-Attenuation
-Beam width
-Spatial pulse length and pulse duration
Attenuation
All of the following may be evaluated using the apical window EXCEPT:
-Mitral valve prolapse
-Left atrial volume
-Pulmonary vein flow
-Isovolumic relaxation time
Mitral valve prolapse
All of the following may be evaluated with cardiac Doppler in the apical five-chamber view EXCEPT:
-Valvular aortic stenosis
-Discrete subaortic stenosis
-Hypertrophic cardiomyopathy
-Patent foramen ovale
Patent foramen ovale
All of the following two-dimensional views may be useful when evaluating for the presence of perimembranous ventricular septal defect EXCEPT:
-Subcostal four-chamber
-Apical five-chamber
-Parasternal long-axis
-Parasternal short-axis of the aortic valve
Subcostal four-chamber
All of the following will increase the frame rate and improve temporal resolution EXCEPT decreasing the:
-Field of view
-Image depth
-Transmit gain
-Number of focuses
Transmit gain
Increasing the pulsed-wave Doppler sample gate length will result in:
-Increased peak velocity
-Better determination of laminar flow
-Lower frame rates
-Increased spectral broadening
Increased spectral broadening
Left ventricular opacification may be accomplished by all of the following contrast agents EXCEPT:
-Optison
-Definity
-Agitated saline
-Imagent
Agitated saline
Multiple echoes equally spaced are called:
-Refraction
-Side lobes
-Propagation speed error
-Reverberation
Reverberation
Of all of the resolutions, which resolution is most difficult for the sonographer to improve during an examination?
-Contrast
-Elevational
-Temporal
-Spatial (axis resolution; lateral resolution)
Elevational
Possible pharmacologic treatments for hypertrophic obstructive cardiomyopathy include:
-Dobutamine
-Epinephrine
-Lasix
-Propranolol
Propranolol
The Doppler high-pass filter eliminates:
-Peak velocity flow
-Spectral broadening
-Window fill-in
-Strong amplitude signals
Strong amplitude signals
The four acoustic windows for transthoracic echocardiography are:
-Parasternal, long-axis, short-axis, subcostal
-Apical, subcostal, short-axis, parasternal
-Parasternal, apical, subcostal, suprasternal
-Long-axis, short-axis, four-chamber, suprasternal
Parasternal, apical, subcostal, suprasternal
The image artifact associated with displaying double images of a structure due to the change in the direction of the sound beam is called:
-Reverberation
-Acoustic shadowing
-Range ambiguity
-Refraction
Refraction
The image artifact which may cause the sonographer to fail to detect prosthetic mitral valve regurgitation from the apical window is:
-Enhancement
-Comet tail
-Grating lobes
-Shadowing (flow masking)
Shadowing (flow masking)
The measurement of the left ventricular outflow tract diameter during early ventricular systole is an important measurement in all of the following calculations EXCEPT:
-Right ventricular systolic pressure
-Mitral valve area
-Stroke volume
-Aortic valve area
Right ventricular systolic pressure
The preferred two-dimensional view for determining the presence of bicuspid aortic valve is the:
-Apical five-chamber
-Apical long-axis
-Parasternal long-axis
-Parasternal short-axis of the aortic valve
Parasternal short-axis of the aortic valve
The primary advantage of continuous-wave (CW) Doppler is:
-Range resolution
-Aliasing will not occur
-Range discrimination
-Range ambiguity
Aliasing will not occur
The sonographer may avoid pulsed-wave Doppler aliasing by all of the following techniques EXCEPT:
-Decrease the Doppler transmit gain
-Decrease the image depth
-Increase the velocity scale
-Shift the zero baseline
Decrease the Doppler transmit gain
The three two-dimensional planes used to examine the heart with transthoracic echocardiography are:
-Long-axis, short-axis, four-chamber
-Long-axis, short-axis, apical
-Long-axis, short-axis, five-chamber
-Parasternal, apical, subcostal
Long-axis, short-axis, four-chamber
The two-dimensional view of choice for evaluating the inferior vena cava and hepatic veins is the:
-Parasternal long-axis
-Apical four-chamber
-Parasternal short-axis of the aortic valve
-Subcostal four-chamber
Subcostal four-chamber
The two-dimensional view of choice for the evaluation of coarctation of the aorta is the:
-Apical five-chamber
-Parasternal long-axis
-Suprasternal long-axis of the aorta
-Parasternal short-axis of the aortic valve
Suprasternal long-axis of the aorta
Tissue harmonic imaging improves all of the following EXCEPT:
-Frame rate
-Side lobe artifacts
-Depth of penetration
-Beam width
Frame rate
What is the standard sweep speed for M-mode echocardiography and cardiac Doppler?
25 mm/s
100 mm/s
50 mm/s
150 mm/s
50 mm/s
Which Doppler intercept angle will result in the maximum flow velocity?
30
0
90
60
0
Which color flow Doppler map will display the color green to indicate turbulent flow?
-Variance
-Directional
-Intensity
-Hue
Variance
Which instrument control directly affects the dynamic range?
-Compression
-Transmit gain
-Image depth
-TGC
Compression
Which of the following may lead to a misdiagnosis for the presence of aortic dissection with transesophageal echocardiography?
-Linear Artifact
-Thickened mitral valve
-Mirror-Image
-Aberrant right subclavian artery
Linear Artifact
Mirror-Image
Aberrant right subclavian artery
Which transmit frequency would most likely be useful for an adult echocardiogram?
7.5 MHz
2.5 MHz
5.0 MHz
3.5 MHz
2.5 MHz
Which two-dimensional view is likely to be LEAST useful when evaluating for atrial septal defect with cardiac Doppler?
-Subcostal four-chamber
-Apical two-chamber view
-Apical four-chamber with color flow Doppler
-Parasternal short-axis of the aortic valve with color flow Doppler
Apical two-chamber view
Which two-dimensional view would be most useful to use when evaluating pulmonary stenosis and pulmonary regurgitation?
-Parasternal short-axis at the aortic valve
-Suprasternal long-axis
-Parasternal long-axis of the left ventricle
-Apical four-chamber
Parasternal short-axis at the aortic valve
A patient with a history of intravenous drug abuse presents to the echocardiography laboratory with complaints of fever, night sweats and weight loss. The most likely explanation is:
-Coronary artery disease
-Kawasaki disease
-Congestive heart failure
-Infective endocarditis
Infective endocarditis
A prosthetic heart valve that is associated with a relatively high rate of outlet strut fracture and disc embolism is the:
-Carpentier-Edwards
-Starr-Edwards
-Bjork-Shiley
-Omniscience
Bjork-Shiley
A pulmonic valve relocated to the aortic valve position is called a(n):
-Autograft
-Allograft
-Xenograft
-Heterograft
Autograft
Abnormal rocking motion of a prosthetic valve by two-dimensional echocardiography indicates prosthetic valve:
-Dehiscence
-Vegetation
-Thrombus
-Stenosis
Dehiscence
All of the following are bioprosthetic (tissue) valves EXCEPT:
-Hancock
-Edwards Perimount
-Medtronic Intact
-Starr-Edwards
Starr-Edwards
All of the following are mechanical valves EXCEPT:
-Hancock
-Starr-Edwards
-CarboMedics
-St. Jude
Hancock
All of the following are true statements concerning prosthetic valves EXCEPT:
-Prosthetic valve peak velocities are generally higher as compared to normal native valves
-A baseline study should be obtained post-surgery
-Prosthetic valve regurgitation is always abnormal
-Velocities depend upon the size and type of prosthetic valve
Prosthetic valve regurgitation is always abnormal
All of the following are types of prosthetic valve types EXCEPT:
-Bioprosthetic (tissue)
-Homograft (allograft)
-Mechanical (metal)
-Native
Native
All of the following should be determined when evaluating a prosthetic valve with cardiac Doppler EXCEPT:
-Peak velocity
-Mean pressure gradient
-Shunt ratio
-Effective orifice area
Shunt ratio
Cardiac Doppler evaluation of a prosthetic mitral valve should include all of the following EXCEPT:
-Pressure half-time
-Peak mitral valve A wave velocity
-Peak and mean pressure gradients
-Effective orifice area
Peak mitral valve A wave velocity
Complications associated with prosthetic valve dysfunction include all of the following EXCEPT:
-Thrombosis
-Dehiscence
-Tumor
-Leaflet degeneration
Tumor
Infective endocarditis is a greater risk in patients with:
-Coronary artery disease
-Atrial fibrillation
-Prosthetic heart valve
-Left ventricular aneurysm
Prosthetic heart valve
The best Doppler formula for calculating the effective orifice area (EOA) in a patient with mitral valve replacement is:
4 x (V2)2
4 x (V22 – V12)
220 ÷ pressure half-time
(CSALVOT x VTILVOT) ÷ VTIMV
(CSALVOT x VTILVOT) ÷ VTIMV
The best Doppler method for evaluating aortic valve replacement is probably:
-Maximum peak instantaneous pressure gradient
-Deceleration slope
-Pressure half-time
-Velocity ratio
Velocity ratio
The classic manifestation of infective endocarditis is cardiac valve:
-Doming
-Tumor
-Vegetation
-Sclerosis
Vegetation
The complications of infective endocarditis include all of the following EXCEPT:
-Valve ring abscess
-Congestive heart failure
-Embolization
-Annular calcification
Annular calcification
The determination of prosthetic mitral valve regurgitation and prosthetic tricuspid valve regurgitation is made difficult by the artifact called:
-Enhancement
-Shadowing
-Mirroring
-Slice thickness
Shadowing
The essential two-dimensional echocardiographic finding of valve ring abscess secondary to infective endocarditis may be best described as:
-Mural
-Pedunculated
-Echolucent
-Sessile
Echolucent
The excessive ingrowth of tissue for a prosthetic valve is called:
-Vegetation
-Dehiscence
-Pannus
-Thrombus
Pannus
The most common ball and cage valve is the:
-Medtronic-Hall
-St. Jude
-Starr-Edwards
-Omniscience
Starr-Edwards
The most common bileaflet tilting disc valve is the:
-St. Jude
-Medtronic-Hall
-Starr-Edwards
-Omniscience
St. Jude
The most common symptom of infective endocarditis is:
-Chest pain
-Dyspnea
-Orthopnea
-Fever
Fever
The primary disadvantage of the bioprosthetic (tissue) valve is:
-Lack of durability
-Pannus formation
-Dehiscence
-Thrombus formation
Lack of durability
The primary disadvantage of the mechanical valve is:
-Thrombogenicity
-Durability
-Dehiscence
-Pannus ingrowth
Thrombogenicity
The test of choice for diagnosing the presence of vegetation and the complications of infective endocarditis is:
-Transthoracic echocardiography
-Transesophageal echocardiography
-Cardiac catheterization
-Cardiac magnetic resonance imaging
Transesophageal echocardiography
The usual site of attachment for vegetations on the mitral valve and tricuspid valve is the:
-Ventricular surface of the valve leaflets
-Papillary muscles
-Annulus
-Atrial side of the valve leaflets
Atrial side of the valve leaflets
The vegetation diameter as determined by two-dimensional echocardiography that is most often associated with systemic emboli is:
5 mm
3 mm
7 mm
10 mm
10 mm
Valve ring abscess is usually caused by:
-Infective endocarditis
-Valvular regurgitation
-Rheumatic fever
-Valvular prolapse
Infective endocarditis
Which of the following pressures can be predicted when measuring the pulmonary regurgitation end-diastolic velocity?
-Mean pulmonary artery pressure
-Systolic pulmonary artery pressure
-Pulmonary artery end-diastolic pressure
-Right ventricular systolic pressure
Pulmonary artery end-diastolic pressure
Which of the following pressures may be calculated when measuring the peak velocity of pulmonary regurgitation?
-Systolic pulmonary artery pressure
-Pulmonary wedge pressure
-Right ventricular systolic pressure
-Mean pulmonary artery pressure
Mean pulmonary artery pressure
Which two cardiac valves need to be evaluated carefully in a patient with the Ross procedure?
-Mitral valve; aortic valve
-Aortic valve; pulmonary valve
-Mitral valve; tricuspid valve
-Aortic valve; tricuspid valve
Aortic valve; pulmonary valve
A pericardial effusion develops in a patient two weeks post-myocardial infarction. This suggests ______ syndrome.
-Down
-Williams
-Dressler’s
-Marfan
Dressler’s
A positive stress echocardiogram consists of:
-Normal left atrial dimension peak exercise
-Normal wall motion to akinesis
-Normal wall motion pre and post exercise
-Improved ejection fraction
Normal wall motion to akinesis
A possible etiology for pericardial effusion is:
-Acute myocardial infarction
-Mitral valve stenosis
-Pulmonary regurgitation
-Mitral valve prolapse
Acute myocardial infarction
A pulsed-wave Doppler tracing of the mitral valve inflow at the leaflet tips is obtained with the following information: E/A ratio is 0.7; deceleration time is 320 msec; a tissue Doppler at the mitral annulus demonstrated an E’ peak velocity of 6 cm/s and an E/E’ ratio is calculated to be 7. The diastolic grade is:
Normal diastolic function
III or IV
I
II
I
A pulsed-wave Doppler tracing of the mitral valve inflow at the leaflet tips is obtained with the following information: E/A ratio is 2.3, deceleration time is 123 msec, Valsalva maneuver demonstrated no change in the E/A ratio, tissue Doppler of the mitral valve annulus demonstrates an E’ wave peak velocity of 3 cm/s and an E/E’ ratio of 33 is calculated. The diastolic grade is grade:
I
III
II
IV
IV
A pulsed-wave Doppler tracing of the mitral valve inflow at the leaflet tips is obtained with the following information: E/A ratio is 1.2, deceleration time is 200 msec, tissue Doppler of the mitral annulus peak E’ wave velocity is 7 cm/s, E’/A’ ratio is .6 and a E/E’ ratio of 12 is calculated. The diastolic grade is Grade:
II
IV
I
III
II
A systolic wall motion score of 3 is assigned to a certain segment of left ventricular muscle indicates:
-Akinetic
-Hypokinetic
-Dyskinetic
-Normal
Akinetic
A thrombus shape that is associated with embolization is:
-Flat
-Spherical
-Pedunculated
-Eccentric
Pedunculated
A wall segment of the heart that is without systolic wall thickening is best described as:
-Akinetic
-Hypokinetic
-Hyperkinetic
-Dyskinetic
Akinetic
An ejection fraction of 42% is determined with two-dimensional echocardiography. This indicates _________ global left ventricular systolic function.
-Normal
-Mildly abnormal
-Severely abnormal
-Moderately abnormal
Moderately abnormal
An increased mitral valve E point to septal-separation (EPSS) may indicate:
-Reduced ejection fraction
-Pulmonary hypertension
-Left atrial myxoma
-Increased left ventricular end-diastolic pressure
Reduced ejection fraction
Echocardiographic findings in the post-myocardial infarction patient include:
-Mural thrombus
-Ventricular septal aneurysm
-Valvular stenosis
-Mitral annular calcification
Mural thrombus
Echocardiography differentiates a pseudoaneurysm from a true ventricular aneurysm by the:
-Diastolic motion of the aneurysm
-Width of the neck of the aneurysm
-Width of the border of the aneurysm
-Length of the aneurysm
Width of the neck of the aneurysm
For exercise echocardiography the images post-exercise need to be acquired within ______ from the time the patient exercise is completed.
-5 minutes
-3 hours
-60 minutes
-60 seconds
60 seconds
Hibernating myocardium is:
-Viable myocardium at rest but not functioning with exercise
-Viable myocardium that is nonfunctioning because of chronic ischemia
-Myocardium that is hyperkinetic post-myocardial infarction
-Reperfused viable myocardium that is functioning
Viable myocardium that is nonfunctioning because of chronic ischemia
In determining the size of myocardial infarction echocardiography generally:
-Predicts the exact size of infarct
-Underestimates recent myocardial infarction and overestimates old myocardial infarction
-Overestimates recent myocardial infarction and underestimates old myocardial infarction
-Is unpredictable
Overestimates recent myocardial infarction and underestimates old myocardial infarction
In patients with dilated cardiomyopathy, the index of myocardial performance (IMP) will be:
-Decreased
-Dependent on blood pressure
-Increased
-Normal
Increased
Patients with increased diastolic filling pressures post-exercise will demonstrate:
-Normal mitral E/A ratio
- E/E’ ratio > 10
-Increased mitral deceleration time
-Normal tricuspid regurgitation peak velocity
E/E’ ratio > 10
Possible mechanisms in the development of mitral regurgitation following acute myocardial infarction include all of the following EXCEPT:
-Papillary muscle rupture
-Incomplete closure of the mitral valve
-Fibrosis of the papillary muscle
-Mitral valve stenosis
Mitral valve stenosis
Stress echocardiography methods that may be used to detect hibernating myocardium include:
-Cold pressure
-Handgrip
-Treadmill
-Low-dose dobutamine
Low-dose dobutamine
The correct term for describing decreased ventricular systolic wall thickening is:
-Dyskinetic
-Hypokinetic
-Hyperkinetic
-Akinetic
Hypokinetic
The definition of stunned myocardium is:
-Myocardium after electrical cardioversion
-Reperfused viable myocardium that is not functioning
-Myocardium that is hyperkinetic post-myocardial infarction
-Myocardium after cardiopulmonary resuscitation
Reperfused viable myocardium that is not functioning
The echocardiographic appearance of necrotic myocardium secondary to myocardial infarction includes all of the following EXCEPT:
-Echogenic wall segment
-Wall motion score of 1
-Akinetic wall segment
-Thin ventricular wall
Wall motion score of 1
The expected Doppler finding in a patient with ventricular septal rupture is:
-Turbulent high-velocity flow in diastole on the right side of the septum
-Laminar high-velocity flow in diastole on the right side of the septum
-Turbulent high-velocity flow in systole on the right side of the interventricular septum
-Laminar low-velocity flow during diastole on the left side of the interventricular septum
Turbulent high-velocity flow in systole on the right side of the interventricular septum
The formula used to determine ejection fraction is:
(EDV – ESV) ÷ EDV x 100
EDV – ESV
CSA x VTI
(EDD – ESD) ÷ EDD x 100
(EDV – ESV) ÷ EDV x 100
The formula used to determine fractional shortening is:
EDV – ESV
(EDD – ESD) ÷ EDD x 100
CSA x VTI
(EDV – ESV) ÷ EDV x 100
(EDD – ESD) ÷ EDD x 100
The formula used to determine stroke volume by Doppler is:
(EDD – ESD) ÷ EDD x 100
(EDV – ESV) ÷ EDV x 100
EDV – ESV
CSA x VTI
CSA x VTI
The four most common two-dimensional views acquired during a stress echocardiogram are the parasternal long-axis, parasternal short-axis of the left ventricle at the level of the papillary muscles, the apical four-chamber view and the:
-Subcostal short-axis at the cardiac base
-Apical five-chamber
-Apical two-chamber
-Apical long-axis
Apical two-chamber
The infarction most commonly associated with left ventricular aneurysm is:
-True posterior
-Anterior
-Inferior
-Lateral
Anterior
The most common etiology for ischemic heart disease is coronary artery:
-Atherosclerosis
-Spasm
-Embolus
-Aneurysm
Atherosclerosis
The most common medication used in performing pharmacological stress echocardiography is:
-Adenosine
-Dipyridamole
-Propranolol
-Dobutamine
Dobutamine
The most specific echocardiographic finding for ischemic heart muscle is:
-Abnormal diastolic wall motion at the ischemic segment
-Normal diastolic wall motion
-Alterations in systolic wall thickening
-Normal systolic wall motion
Alterations in systolic wall thickening
The normal response of non-infarcted myocardium in a patient with acute myocardial infarction is:
-Hypokinesis
-Hyperkinesis
-Dyskinesis
-Akinesis
Hyperkinesis
The primary indication for stress echocardiography is:
-Diagnosis of shunt lesions
-Assessment of cardiac valve abnormalities
-Evaluation of ejection fraction
-Evaluation for coronary artery disease
Evaluation for coronary artery disease
The principal echocardiographic/Doppler findings of right ventricular infarction include all of the following EXCEPT:
-Tricuspid regurgitation
-Right ventricular dilatation
-Right ventricular hypertrophy
-Abnormal motion of the right ventricular free wall
Right ventricular hypertrophy
The rate at which the left ventricular pressure rises in ventricular systole is referred to as:
dP/dt
dt/dP
dd/tP
dv/dt
dP/dt
The type of myocardial infarction which most often involves the right ventricle is:
-Inferior
-Lateral
-Anterior
-Anterolateral
Inferior
Which maneuver is most useful to use when trying to determine the presence of Grade II (pseudonormalization) or when determining between Grade III (reversible restrictive) and Grade IV (fixed restrictive):
-Squatting
-Valsalva
-Leg raising
-Mueller
Valsalva
Which of the following methods is recommended to determine left ventricular volumes?
-Teichholtz
-Biplane area-length
-Cubed
-Biplane Simpson’s method of discs
Biplane Simpson’s method of discs
Which of the following mitral valve flow patterns provides risk stratification post-myocardial infarction?
-Normal for age
-Pseudonormal (grade II)
-Restrictive (Grade III-IV)
-Impaired relaxation (Grade I)
Restrictive (Grade III-IV)
Which of the following pharmacologic agents increases contractility and increases heart rate?
-Propranolol
-Dobutamine
-Verapamil
-Digitalis
Dobutamine
________ is a direct measure of myocardial contractile function.
- E-F slope
-Strain
-Deceleration time
-EPSS
Strain
