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Sonography Theory Final Exam > Sonography Theory Exam Question Pool > Flashcards

Sonography Theory Exam Question Pool Flashcards

1
Q

According to the electrocardiogram (EKG), electrical systole is:

Onset of the QRS to the onset of the T wave
Onset of the T wave to the onset of the P wave
Onset of the QRS complex to the end of the T wave
End of the T wave to the onset of the QRS complex

A

Onset of the QRS complex to the end of the T wave

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2
Q

All of the following are components of a pulsed-wave Doppler of a pulmonary vein EXCEPT:

E
S2
S1
AR

A

E

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3
Q

All of the following are considered a part of normal ventricular diastole EXCEPT:

Ventricular depolarization
Isovolumic relaxation
Early passive filling
Atrial systole

A

Ventricular depolarization

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4
Q

All of the following are true statements concerning the left ventricle EXCEPT:

Heavily trabeculated
Contains two papillary muscle groups
Bullet shaped (truncated ellipsoid)
Top normal thickness is approximately 1.0 cm

A

Heavily trabeculated

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5
Q

All of the following are true statements concerning the right ventricle EXCEPT:

Most anterior positioned cardiac chamber
Normal wall thickness is 0.3 to 0.5 cm
Heavily trabeculated
Normally forms the cardiac apex

A

Normally forms the cardiac apex

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6
Q

All of the following left ventricular wall segments may be evaluated in the parasternal long-axis view EXCEPT:

Cardiac apex
Basal anterior interventricular septum
Mid-anterior interventricular septum

A

Cardiac apex

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7
Q

All of the following left ventricular wall segments may be evaluated in the parasternal short-axis of the left ventricle at the level of the papillary muscles EXCEPT:

Anterolateral
Anterior interventricular septum
Anterior wall
Cardiac apex

A

Cardiac apex

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8
Q

All of the following structures are located in the right atrium EXCEPT:

Crista terminalis
Thebesian valve
Moderator band
Eustachian valve

A

Moderator band

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9
Q

All of the following ventricular wall segments may be supplied by the right coronary artery EXCEPT:

Basal and mid-inferior walls of the left ventricle
Basal and mid-anterior interventricular septum
Basal and mid-inferolateral walls of the left ventricle
Lateral wall of the right ventricle

A

Basal and mid-anterior interventricular septum

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10
Q

All of the following wall segments may be visualized in the apical four-chamber view EXCEPT:

Lateral wall of the right ventricle
Anterolateral wall
Cardiac apex
Anterior interventricular septum

A

Anterior interventricular septum

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11
Q

All of the following wall segments may be visualized in the apical two-chamber view EXCEPT:

Cardiac apex
Right ventricular outflow tract
Inferior wall
Anterior wall

A

Right ventricular outflow tract

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12
Q

Normal pressure values in millimeters of mercury (mm Hg) for the listed cardiac chambers or great vessels include all of the following EXCEPT:

Right atrial pressure: 2 to 8 mean
Right ventricle: 15 to 30 systolic; 2 to 8 diastolic
Pulmonary artery: 15 to 30 systolic; 2 to 12 mean diastolic
Aorta: 100 to 140 systolic; 3 to 12 end-diastolic

A

Aorta: 100 to 140 systolic; 3 to 12 end-diastolic

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13
Q

Structures of the mitral valve apparatus include all of the following EXCEPT:

Chordae tendineae
Mitral valve annulus
Papillary muscles
Sinuses of Valsalva

A

Sinuses of Valsalva

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14
Q

The Chiari network is found in the:

Left ventricle
Right ventricle
Right atrium
Left atrium

A

Right atrium

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15
Q

The boundaries of the functional left ventricular outflow tract are best described as extending from the:

Anterior aortic valve annulus to the posterior aortic valve annulus
Anteromedial position of the tricuspid valve annulus to the pulmonic valve annulus
Free edge of the anterior mitral valve leaflet to the aortic valve annulus
Tips of the left ventricular papillary muscles to the edge of the anterior mitral valve leaflet

A

Free edge of the anterior mitral valve leaflet to the aortic valve annulus

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16
Q

The coronary sinus can be differentiated from the descending thoracic aorta with pulsed-wave Doppler because coronary sinus flow is predominantly diastolic while aortic flow is:

Phasic
Predominantly diastolic
Equiphasic
Predominantly systolic

A

Predominantly systolic

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17
Q

The correct order for the branches of the transverse aorta (aortic arch) is:

Left subclavian, right subclavian, left common carotid
Right brachiocephalic; left brachiocephalic, left common carotid
Sinus of Valsalva, right innominate, left innominate
Right brachiocephalic, left common carotid, left subclavian

A

Right brachiocephalic, left common carotid, left subclavian

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18
Q

The crista terminalis is found in the:

Right atrium
Left atrium
Left ventricle
Right ventricle

A

Right atrium

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19
Q

The eustachian valve is found in the:

Left ventricle
Right atrium
Left atrium
Right ventricle

A

Right atrium

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20
Q

The imaginary boundaries that define the mid-left ventricle are the:

Mitral annulus to the tip of the papillary muscles
Base of the papillary muscles to the cardiac apex
Tip of the papillary muscles to the base of the papillary muscles
Aortic annulus to the edge of the mitral valve

A

Tip of the papillary muscles to the base of the papillary muscles

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21
Q

The left anterior descending coronary artery supplies blood to all of the following EXCEPT:

Anterior wall of the left ventricle
Inferior wall of the left ventricle
Anterior interventricular septum
Apical cap

A

Inferior wall of the left ventricle

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22
Q

The moderator band is always located in the:

Right atrium
Left ventricle
Right ventricle
Left atrium

A

Right ventricle

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23
Q

The most likely explanation of main pulmonary artery dilatation is:

Truncus arteriosus
Bicuspid aortic valve
Pulmonary hypertension
Carcinoid heart disease

A

Pulmonary hypertension

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24
Q

The name of the aortic segment located between the left subclavian artery and the insertion of the ligamentum arteriosum is the:

Aortic root
Transverse aorta
Aortic isthmus
Sino-tubular junction

A

Aortic isthmus

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25
Q

The names of the two left ventricular papillary muscle groups are:

Anterior; posterior
Medial; lateral
Superior; inferior
Anterolateral; posteromedial

A

Anterolateral; posteromedial

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26
Q

The most common cause of chronic tricuspid regurgitation is:

Tricuspid valve prolapse
Ebstein’s anomaly
Rheumatic heart disease
Pulmonary hypertension

A

Pulmonary hypertension

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27
Q

The most common etiology of pulmonary regurgitation is:

Infective endocarditis
Pulmonary hypertension
Rheumatic heart disease
Carcinoid heart disease

A

Pulmonary hypertension

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28
Q

The most common etiology of tricuspid stenosis is:

Right atrial myxoma
Carcinoid heart disease
Rheumatic fever
Infective endocarditis

A

Rheumatic fever

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29
Q

The murmur of tricuspid regurgitation is best described as a:

Pansystolic murmur heard best at the lower left sternal border
Pansystolic murmur heard best at the cardiac apex with radiation to the axilla
Systolic ejection murmur heard best at the upper right sternal border
Holodiastolic murmur heard best at the lower left sternal border

A

Pansystolic murmur heard best at the lower left sternal border

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30
Q

The pulmonary vein atrial reversal wave may be _________ in peak velocity and duration in a patient with severe acute aortic regurgitation.

Reversed
Decreased
Increased
Unchanged

A

Increased

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31
Q

The severity of aortic regurgitation may best be determined with color flow Doppler by all of the following methods EXCEPT:

Measuring the vena contracta in the parasternal long-axis view
Comparing the aortic regurgitation jet width with the left ventricular outflow tract width in the parasternal long-axis view
Measuring the aortic regurgitation jet aliasing area in the parasternal long-axis view
Determining the presence of holodiastolic flow reversal in the descending thoracic aorta and/or abdominal aorta

A

Measuring the aortic regurgitation jet aliasing area in the parasternal long-axis view

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32
Q

The typical two-dimensional echocardiographic findings in rheumatic tricuspid stenosis include all of the following EXCEPT:

Right atrial dilatation
Diastolic doming of the anterior tricuspid valve leaflet
Systolic bowing of the posterior tricuspid valve leaflet
Leaflet thickening especially at the leaflet tips and chordae tendineae

A

Systolic bowing of the posterior tricuspid valve leaflet

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33
Q

When two-dimensional evaluation of a systolic ejection murmur reveals a thickened aortic valve with normal systolic excursion and a peak velocity across the aortic valve of 1.5 m/s. The diagnosis is most likely aortic valve:

Sclerosis
Prolapse
Stenosis
Regurgitation

A

Sclerosis

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34
Q

A tricuspid regurgitation peak velocity of 3.0 m/s is obtained. This indicates:

Pulmonary hypertension
Severe tricuspid regurgitation
Mild tricuspid regurgitation
Moderate tricuspid regurgitation

A

Pulmonary hypertension

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35
Q

All of the following are cardiac Doppler findings for tricuspid valve stenosis EXCEPT:

Decreased tricuspid valve area
Increased tricuspid valve E wave velocity
Increased mean pressure gradient
Decreased pressure half-time

A

Decreased pressure half-time

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36
Q

All of the following are considered useful quantitative measurements to determine the severity of aortic regurgitation EXCEPT:

Effective regurgitant orifice
Peak velocity of aortic regurgitation
Regurgitant fraction
Regurgitant volume

A

Peak velocity of aortic regurgitation

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37
Q

All of the following are dilated in significant chronic tricuspid regurgitation EXCEPT:

Right atrium
Inferior vena cava
Pulmonary veins
Hepatic veins

A

Pulmonary veins

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38
Q

All of the following color flow Doppler findings indicate significant pulmonary regurgitation EXCEPT:

Wide jet width at origin
Holodiastolic flow reversal in the main pulmonary artery
Peak velocity of < 1.0 m/s
Jet width/Right ventricular outflow tract width > 70%

A

Peak velocity of < 1.0 m/s

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39
Q

An intracardiac pressure that may be determined from the continuous-wave Doppler tricuspid regurgitation signal is:

Mean pulmonary artery pressure
Systemic vascular resistance
Pulmonary artery end-diastolic pressure
Systolic pulmonary artery pressure

A

Systolic pulmonary artery pressure

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40
Q

Cardiac Doppler findings associated with significant chronic tricuspid regurgitation include all of the following EXCEPT:

Increased E velocity of the tricuspid valve
Systolic flow reversal in the hepatic vein
Systolic flow reversal in the pulmonary vein
Concave late systolic configuration of the regurgitation signal

A

Systolic flow reversal in the pulmonary vein

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41
Q

Causes of anatomic tricuspid regurgitation include all of the following EXCEPT:

Ebstein’s anomaly
Pulmonary hypertension
Infective endocarditis
Carcinoid heart disease

A

Pulmonary hypertension

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42
Q

Echocardiographic evidence of severe acute aortic regurgitation includes all of the following EXCEPT:

Premature opening of the aortic valve
Premature closure of the mitral valve
Premature opening of the mitral valve
Reverse doming of the anterior mitral valve leaflet

A

Premature opening of the mitral valve

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43
Q

Holodiastolic flow reversal in the descending thoracic aorta and/or the abdominal aorta may be present in each of the following EXCEPT:

Severe aortic regurgitation
Patent ductus arteriosus
Severe mitral regurgitation
Aortopulmonary window

A

Severe mitral regurgitation

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44
Q

In a patient with severe acute aortic regurgitation the left ventricular end-diastolic pressure increases rapidly. This pathophysiology will affect which of the following?

Systolic ejection period
Closure of the mitral valve
Left ventricular dimension
Closure of the pulmonary valve

A

Closure of the mitral valve

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45
Q

In significant chronic aortic regurgitation, M-mode and two-dimensional evidence includes all of the following EXCEPT:

Hyperkinesis of the interventricular septum
Left ventricular dilatation
Paradoxical interventricular septal motion
Hyperkinesis of the posterior (inferolateral) wall of the left ventricle

A

Paradoxical interventricular septal motion

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46
Q

M-mode and two-dimensional echocardiographic findings for chronic tricuspid regurgitation include:

Right ventricular hypertrophy
Protected right ventricle
Paradoxical interventricular septal motion
Left ventricular volume overload

A

Paradoxical interventricular septal motion

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47
Q

Methods for determining the severity of tricuspid regurgitation with pulsed-wave Doppler include all of the following EXCEPT:

Laminar flow of the tricuspid regurgitant jet
Holosystolic flow reversal of the hepatic vein
Peak velocity of the tricuspid regurgitant jet
Increased E wave velocity of the tricuspid valve

A

Peak velocity of the tricuspid regurgitant jet

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48
Q

Possible echocardiographic and cardiac Doppler findings in a patient with carcinoid heart disease include all of the following EXCEPT:

Tricuspid regurgitation
Tricuspid stenosis
Pulmonary regurgitation
Tricuspid valve prolapse

A

Tricuspid valve prolapse

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49
Q

Posterior displacement of the aortic valve leaflet(s) into the left ventricle outflow tract during ventricular diastole is called aortic valve:

Sclerosis
Prolapse
Stenosis
Perforation

A

Prolapse

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50
Q

Premature closure of the mitral valve is associated with all of the following EXCEPT:

Loss of sinus rhythm
Acute severe aortic regurgitation
First-degree atrioventricular block
Acute severe mitral regurgitation

A

Acute severe mitral regurgitation

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51
Q

Severe aortic regurgitation is diagnosed with continuous-wave Doppler by all of the following criteria EXCEPT:

A pressure half-time of < 200 msec
A maximum velocity of 4 m/s
Steep deceleration slope
Increased jet density

A

A maximum velocity of 4 m/s

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52
Q

Significant chronic pulmonary regurgitation is associated with:

Right ventricular volume overload
Right ventricular hypertrophy
Right atrial hypertrophy
Left ventricular volume overload

A

Right ventricular volume overload

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53
Q

Signs of significant tricuspid regurgitation include all of the following EXCEPT:

Jugular venous distention
Pulsus paradoxus
Hepatomegaly
Right ventricular heart failure

A

Pulsus paradoxus

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54
Q

The M-mode finding that indicates severe acute aortic regurgitation is premature aortic valve:

Mid-systolic closure
Systolic flutter
Opening
Closure

A

Opening

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55
Q

The M-mode/two-dimensional echocardiography parameters that have been proposed as an indicator for aortic valve replacement in severe chronic aortic regurgitation are left ventricular:

End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%
End-diastolic dimension ≥ 55 mm and fractional shortening ≤ 25%
End-diastolic dimension ≤ 55 mm and fractional shortening of ≥ 25%
End-diastolic dimension ≥ 70 mm and left atrial dimension ≥ 55 mm

A

End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%

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56
Q

The continuous-wave Doppler signal of aortic regurgitation may be differentiated from the continuous-wave Doppler signal of mitral stenosis by the following guideline:

If the diastolic flow pattern commences after mitral valve opening then the signal is due to aortic regurgitation

If the diastolic flow pattern commences before mitral valve opening then the signal is due to aortic regurgitation

Cannot be differentiated by continuous-wave Doppler.

The Doppler flow velocity pattern of mitral valve stenosis is laminar while the Doppler flow pattern of aortic regurgitation is turbulent.

A

If the diastolic flow pattern commences before mitral valve opening then the signal is due to aortic regurgitation

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57
Q

The mitral valve pulsed-wave Doppler flow pattern often associated with severe acute aortic regurgitation is grade:

II (pseudonormal)
III or IV (restrictive)
Normal for age
I (impaired relaxation)

A

III or IV (restrictive)

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58
Q

All of the following represents possible etiologies for acute aortic regurgitation EXCEPT:

Aortic dissection
Infective endocarditis
Aortic valve sclerosis
Trauma

A

Aortic valve sclerosis

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59
Q

An effect of significant aortic valve stenosis on the left ventricle is:

Concentric left ventricular hypertrophy
Eccentric left ventricular hypertrophy
Asymmetrical septal hypertrophy
Protected in significant aortic valve stenosis

A

Concentric left ventricular hypertrophy

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60
Q

Aortic valve with reduced systolic excursion. On physical examination there was a crescendo-decrescendo systolic ejection murmur and a diastolic decrescendo murmur heard. The most likely diagnosis is aortic valve:

Flail
Stenosis and regurgitation
Regurgitation
Stenosis and mitral valve prolapse

A

Stenosis and regurgitation

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61
Q

Cardiac Doppler parameters used to assess the severity of valvular aortic stenosis include all the following EXCEPT:

Aortic velocity ratio
Mean pressure gradient
Peak aortic valve velocity
Aortic pressure half-time

A

Aortic pressure half-time

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62
Q

Cardiac magnetic resonance imaging provides all of the following information in a patient with aortic regurgitation EXCEPT:

Regurgitant volume
Left ventricular volumes
Detailed resolution of the aortic valve
Effective regurgitant orifice

A

Detailed resolution of the aortic valve

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63
Q

In the parasternal long-axis view, severe aortic valve stenosis is defined as an aortic valve leaflet separation that measures:

≥ 14 mm
≤ 12 mm
≤ 8 mm
≤ 10 mm

A

≤ 8 mm

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64
Q

Of the transvalvular pressure gradients that can be measured in the echocardiography laboratory, the most useful in examining aortic valve stenosis is probably:

Mean systolic gradient
Peak instantaneous pressure gradient
Peak-to-peak gradient
Mean diastolic gradient

A

Mean systolic gradient

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65
Q

Pathologies that may result in a left ventricular pressure overload include all the following EXCEPT:

Mitral valve stenosis
Valvular aortic stenosis
Discrete subaortic stenosis
Systemic hypertension

A

Mitral valve stenosis

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66
Q

Possible two-dimensional echocardiographic findings in significant aortic valve stenosis include all the following EXCEPT:

Post-stenotic dilatation of the descending aorta
Left ventricular hypertrophy
Post-stenotic dilatation of the ascending aorta
Aortic valve calcification

A

Post-stenotic dilatation of the descending aorta

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67
Q

Reverse diastolic doming of the anterior mitral valve leaflet is associated with:

Rheumatic mitral valve stenosis
Papillary muscle dysfunction
Flail mitral valve
Severe aortic regurgitation

A

Severe aortic regurgitation

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68
Q

Secondary echocardiographic findings associated with severe valvular aortic stenosis include all the following EXCEPT:

Left ventricular hypertrophy
Post-stenotic dilatation of the ascending aorta
Right ventricular hypertrophy
Decreased left ventricular systolic function (late in course)

A

Right ventricular hypertrophy

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69
Q

The Doppler maximum peak instantaneous pressure gradient in a patient with aortic stenosis is 100 mm Hg. The cardiac catheterization peak-to-peak pressure gradient will most likely be:

Higher than 100 mm Hg
Dependent upon respiration
Equal to 100 mm Hg
Lower than 100 mm Hg

A

Lower than 100 mm Hg

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70
Q

The LEAST common valve regurgitation found in normal patients is:

Pulmonary regurgitation
Mitral regurgitation
Tricuspid regurgitation
Aortic regurgitation

A

Aortic regurgitation

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71
Q

The aortic valve area considered severe aortic valve stenosis is:

≤ 1.0 cm^2
< 2 cm^2
< 3 cm^2
< 1.5 cm^2

A

≤ 1.0 cm^2

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72
Q

The characteristic M-mode findings for aortic valve stenosis include all the following EXCEPT:

Thickening of the aortic valve leaflets
Diastolic flutter of the aortic valve leaflets
A lack of systolic flutter of the aortic valve leaflets
Reduced leaflet separation in systole

A

Diastolic flutter of the aortic valve leaflets

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73
Q

The characteristic feature of the murmur of chronic aortic regurgitation is a:

Harsh systolic ejection murmur heard best at the right upper sternal border
Diastolic crescendo-decrescendo murmur heard best along the left upper sternal border
Diastolic rumble following an opening snap
Diastolic decrescendo murmur heard best along the left sternal border

A

Diastolic decrescendo murmur heard best along the left sternal border

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74
Q

The echocardiographer may differentiate between the similar systolic flow patterns seen in coexisting severe aortic valve stenosis and mitral regurgitation by all the following EXCEPT:

Aortic ejection time is shorter that the mitral regurgitation time

Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis.

Mitral regurgitation flow always lasts until mitral valve opening, whereas aortic valve stenosis flow does not.

Mitral diastolic filling profile should be present during recording of the mitral regurgitation, whereas no diastolic flow is observed in aortic valve stenosis.

A

Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis.

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75
Q

The hallmark M-mode finding for aortic regurgitation is:

Chaotic diastolic flutter of the mitral valve
Systolic flutter of the aortic valve
Coarse diastolic flutter of the anterior mitral valve leaflet
Fine diastolic flutter of the anterior mitral valve leaflet

A

Fine diastolic flutter of the anterior mitral valve leaflet

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76
Q

The most common etiology of chronic aortic regurgitation is:

Marfan’s syndrome
Dilatation of the aortic root and aortic annulus
Trauma
Infective endocarditis

A

Dilatation of the aortic root and aortic annulus

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77
Q

The murmur associated with severe aortic regurgitation is:

Austin-Flint
Graham-Steell
Still’s
Carvallo’s

A

Austin-Flint

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78
Q

The murmur of aortic stenosis is described as:

Systolic ejection murmur heard best at the right upper sternal border
Holosystolic murmur heard best at the cardiac apex
Diastolic rumble
Holodiastolic decrescendo murmur heard best at the right sternal border

A

Systolic ejection murmur heard best at the right upper sternal border

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79
Q

The onset of flow to peak aortic velocity continuous-wave Doppler tracing in severe valvular aortic stenosis is:

Increased with inspiration
Decreased
Decreased with expiration
Increased

A

Increased

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80
Q

The pulse that is characteristic of significant valvular aortic stenosis is:

Pulsus bisferiens
Pulsus alternans
Pulsus paradoxus
Pulsus parvus et tardus

A

Pulsus parvus et tardus

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81
Q

The severity of aortic valve stenosis may be underestimated if only the maximum velocity measurement is used in the following condition:

Doppler intercept angle of 0°
Low cardiac output
Anemia
Significant aortic regurgitation

A

Low cardiac output

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82
Q

The two-dimensional view which best visualizes systolic doming of the aortic valve leaflets is the:

Subcostal short-axis view of the aortic valve
Parasternal short-axis view of the aortic valve
Parasternal long-axis view
Apical five-chamber view

A

Parasternal long-axis view

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83
Q

Flail mitral valve can be differentiated from severe mitral valve prolapse on two-dimensional echocardiography because flail mitral valve leaflet demonstrates:

Leaflet tip that points toward the left atrium
Chronic mitral regurgitation
Leaflet tip that points toward the left ventricle
A thicker mitral valve

A

Leaflet tip that points toward the left atrium

84
Q

In patients with severe acute mitral regurgitation, the continuous-wave Doppler peak velocity of the regurgitant jet is:

Increased
Decreased
Dependent largely upon left ventricular global systolic function
Unaffected

A

Decreased

85
Q

In patients with significant mitral regurgitation, the continuous-wave Doppler tracing of the regurgitant lesion may demonstrate a(n):

Jet duration of < 85 msec
Jet area of < 20%
Symmetrical shape of the mitral regurgitation flow velocity spectral display
Asymmetrical shape of the mitral regurgitation flow velocity spectral display

A

Asymmetrical shape of the mitral regurgitation flow velocity spectral display

86
Q

In patients with significant mitral regurgitation, the isovolumic relaxation time may be:

Decreased
Affected by respiration
Unaffected
Increased

A

Decreased

87
Q

In patients with significant pure mitral regurgitation, the E velocity of the mitral valve pulsed-wave Doppler tracing is:

Increased
Decreased
Unaffected
Increased with inspiration

A

Increased

88
Q

Mitral valve chordal rupture usually results in:

Tricuspid regurgitation
Pulmonary regurgitation
Mitral regurgitation
Aortic regurgitation

A

Mitral regurgitation

89
Q

On M-mode and two-dimensional echocardiography dense echoes are noted posterior to normal mitral valve leaflets. The probable diagnosis is mitral valve:

Aneurysm
Vegetation
Annular calcification
Papilloma

A

Annular calcification

90
Q

Quantitative approaches to determine the severity of mitral regurgitation include all of the following EXCEPT:

Regurgitant jet area
Regurgitant volume
Regurgitant fraction
Effective regurgitant orifice

A

Regurgitant jet area

91
Q

Secondary causes of mitral valve prolapse include all of the following EXCEPT:

Primary pulmonary hypertension
Cardiac tamponade
Atrial septal defect
Bicuspid aortic valve

A

Bicuspid aortic valve

92
Q

The associated auscultatory findings for mitral valve prolapse include:

Friction rub
Mid-systolic click
Ejection click
Pericardial knock

A

Mid-systolic click

93
Q

The cardinal symptoms of valvular aortic stenosis include all the following EXCEPT:

Syncope
Angina pectoris
Congestive heart failure
Anasarca

A

Anasarca

94
Q

The complications of mitral valve prolapse include all of the
following EXCEPT:

Valvular stenosis
Increased risk of infective endocarditis
Mitral valve repair and replacement
Significant mitral regurgitation

A

Valvular stenosis

95
Q

The effect significant mitral regurgitation has on the pulsed-wave Doppler tracing of the pulmonary veins may be described as:

S wave reverses, D wave increases
S wave increases, D wave decreases
S wave increases, D wave decreases
Unaffected

A

S wave reverses, D wave increases

96
Q

The etiology of aortic valve stenosis includes all the following EXCEPT:

Congenital
Bacterial
Degenerative
Rheumatic

A

Bacterial

97
Q

The gold standard two-dimensional echocardiographic view recommended to diagnose the presence of mitral valve prolapse is:

Parasternal short-axis of the mitral valve
Subcostal five-chamber
Apical four-chamber
Parasternal long-axis

A

Parasternal long-axis

98
Q

The most common symptoms of mitral valve prolapse include all of the following EXCEPT:

Atypical chest pain
Ascites
Palpitations
Syncope

A

Ascites

99
Q

The most likely etiology of aortic valve stenosis in a 47-year-old patient is:

Endocarditis
Annular
Congenital
Degenerative

A

Congenital

100
Q

The peak mitral regurgitation velocity as determined with continuous-wave Doppler reflects the:

Severity of the mitral regurgitation
Maximum pressure difference between the left atrium and left ventricle
Direction of the regurgitant jet
Etiology of the mitral regurgitation

A

Maximum pressure difference between the left atrium and left ventricle

101
Q

The term myxomatous degeneration is associated with mitral valve:

Vegetation
Prolapse
Stenosis
Flail

A

Prolapse

102
Q

There is posterior mitral valve prolapse present. With color flow Doppler on, which direction will the mitral regurgitation jet be baffled?

Posterior
Cephalad
Anterior
Inferior

A

Anterior

103
Q

Which of the following is most commonly associated with mitral valve prolapse?

Right heart volume overload
Right heart pressure overload
Left heart volume overload
Left heart pressure overload

A

Left heart volume overload

104
Q

A Doppler mean pressure gradient of 18 mm Hg is calculated in a patient with valvular aortic stenosis. The severity of the aortic stenosis is:

Severe
Moderate
Moderately severe
Mild

A

Mild

105
Q

All of the following all associated with significant chronic aortic regurgitation EXCEPT:

Holosystolic murmur heard best at the cardiac apex
Wide pulse pressure
Congestive heart failure
Angina pectoris

A

Holosystolic murmur heard best at the cardiac apex

106
Q

All of the following are two-dimensional echocardiography findings in a patient with significant chronic aortic regurgitation EXCEPT:

Left ventricular enlargement
Left atrial enlargement
Abnormal aortic valve or aortic root
Hyperkinetic left ventricular wall motion

A

Left atrial enlargement

107
Q

All of the following may be measured in the cardiac catheterization laboratory when evaluating aortic stenosis EXCEPT:

Peak velocity
Peak-to-peak pressure gradient
Maximum peak instantaneous pressure gradient
Mean pressure gradient

A

Peak velocity

108
Q

Secondary echocardiographic/Doppler findings in patients with rheumatic mitral stenosis include all the following EXCEPT:

Abnormal interventricular septal wall motion
Increased tricuspid regurgitant jet velocity
Left ventricular dilatation
Increase right heart dimensions

A

Left ventricular dilatation

109
Q

Signs and symptoms of mitral stenosis secondary to rheumatic heart disease include:

Angina pectoris
Pulmonary hypertension
Vertigo
Cyanosis

A

Pulmonary hypertension

110
Q

Systolic bowing of the inter-atrial septum toward the right atrium throughout the cardiac cycle may be an indication of:

Mitral regurgitation
Tricuspid regurgitation
Tricuspid stenosis
Tricuspid atresia

A

Mitral regurgitation

111
Q

The abnormal mitral valve pressure half-time for patients with mitral valve stenosis is:

60 to 90 msec
30 to 60 msec
90 to 400 msec
0 to 30 msec

A

90 to 400 msec

112
Q

The cardiac valves listed in decreasing order as they are affected by rheumatic heart disease are:

Mitral, aortic, tricuspid, pulmonic
Tricuspid, mitral, pulmonic, aortic
Pulmonic, aortic, tricuspid, mitral
Aortic, pulmonic, tricuspid, mitral

A

Mitral, aortic, tricuspid, pulmonic

113
Q

The classic cardiac Doppler features of mitral valve stenosis include all the following EXCEPT:

Increased E velocity
Increased mitral valve area
Turbulent flow
Increased pressure half-time

A

Increased mitral valve area

114
Q

The classic description of the murmur of chronic mitral regurgitation is:

Holosystolic murmur heard best at the apex radiating to the axilla
Continuous machinery-like murmur
Diastolic decrescendo murmur heard best at the left sternal border
Systolic ejection murmur heard best at the right upper sternal border

A

Holosystolic murmur heard best at the apex radiating to the axilla

115
Q

The equation used in the cardiac catheterization laboratory to determine mitral valve area and aortic valve area is the:

Bernoulli
Continuity
Doppler
Gorlin

A

Gorlin

116
Q

The most accurate method for determining the severity of mitral valve stenosis is:

Performing planimetry of the mitral valve orifice by two-dimensional echocardiography
Measuring the thickness of the mitral valve leaflets
Measuring the E-F slope of the anterior mitral valve leaflet by M-mode
Determining the maximum velocity across the mitral valve by pulsed-wave Doppler

A

Performing planimetry of the mitral valve orifice by two-dimensional echocardiography

117
Q

The most common etiology of mitral stenosis in adults is:

Congenital
Severe mitral annular calcification
Rheumatic fever
Left atrial myxoma

A

Rheumatic fever

118
Q

The most common presenting symptom of significant chronic mitral regurgitation is:

Ascites
Dyspnea
Hemoptysis
Systemic embolization

A

Dyspnea

119
Q

The most likely heart sound to be heard in patients with significant chronic pure mitral regurgitation is:

Loud S1
S3
Ejection click
Fixed split S2

A

S3

120
Q

Two-dimensional echocardiographic examination reveals thin mobile mitral valve leaflet tips and a Doppler E velocity of 1.8 m/s with a pressure half-time of 180 msec in an elderly patient. The most likely diagnosis is:

Rheumatic mitral stenosis
Abnormal relaxation of the left ventricle
Aortic regurgitation
Moderate to severe mitral annular calcification

A

Moderate to severe mitral annular calcification

121
Q

Two-dimensional echocardiographic findings for rheumatic mitral stenosis include all of the following EXCEPT:

Increased left atrial dimension
Thickened mitral valve leaflets and subvalvular apparatus
Reverse doming of the anterior mitral valve leaflet
Hockey-stick appearance of the anterior mitral valve leaflet

A

Reverse doming of the anterior mitral valve leaflet

122
Q

Typical echocardiographic findings in a patient with isolated rheumatic mitral stenosis include all of the following EXCEPT:

Dilated left ventricle
Left atrial thrombus
D-shaped left ventricle
Left atrial enlargement

A

Dilated left ventricle

123
Q

A color flow Doppler method for semi-quantitating mitral regurgitation is regurgitant jet:

Height
Area
Length
Turbulence

A

Area

124
Q

A common finding associated with a regurgitant murmur in
the elderly is:

Aortic valve stenosis
Mitral annular calcification
Mitral valve vegetation
Mitral valve stenosis

A

Mitral annular calcification

125
Q

A key word that is often used to describe the characteristics of the valve leaflets in mitral valve prolapse is:

Doming
Dense
Sclerotic
Redundant

A

Redundant

126
Q

All of the following are associated with mitral valve prolapse EXCEPT:

Tricuspid valve prolapse
Mitral regurgitation
Pulmonary atresia
Aortic valve prolapse

A

Pulmonary atresia

127
Q

All of the following are true statements concerning mitral regurgitation EXCEPT:

Regurgitant jet area, vena contracta width and proximal isovelocity surface area are recommended when determining severity
Mitral regurgitation may be acute, chronic or intermittent
Mitral regurgitation may result in an increase in preload
Severity of mitral regurgitation is not affected by afterload

A

Severity of mitral regurgitation is not affected by afterload

128
Q

All of the following are useful color-flow Doppler techniques in the evaluation of mitral regurgitation EXCEPT:

Peak velocity
Vena contracta width
PISA diameter
Jet area

A

Peak velocity

129
Q

An accepted method for determining the severity of mitral regurgitation by continuous-wave Doppler is spectral:

Width
Velocity
Jet density
Length

A

Jet density

130
Q

Cardiac Doppler evidence of severe mitral regurgitation includes all of the following EXCEPT:

Dense, triangular continuous-wave Doppler tracing
Regurgitant jet area/left atrial area ratio > 40%
Pulmonary vein systolic flow reversal
Mitral valve E wave velocity < 1.0 m/sec

A

Mitral valve E wave velocity < 1.0 m/sec

131
Q

Diastolic mitral regurgitation is associated with:

Flail mitral valve
Severe tricuspid regurgitation
Severe aortic regurgitation
Mitral valve prolapse

A

Severe aortic regurgitation

132
Q

Echocardiographic characteristics of mitral valve prolapse include all of the following EXCEPT:

Systolic bowing of the mitral valve leaflets towards the left atrium
Thickened, redundant, myxomatous leaflets
Increased mitral valve annulus diameter
Diastolic doming of the mitral valve leaflets

A

Diastolic doming of the mitral valve leaflets

133
Q

The pulsed-wave Doppler mitral valve peak E wave velocity is 100 cm/s. The lateral wall mitral annulus tissue Doppler imaging E’ wave is 5 cm/s. The diastolic filling pressure is assumed to be:

Dependent upon respiration
Decreased
Increased
Normal

A

Increased

134
Q

The simplified Bernoulli equation disregards all of the following factors EXCEPT:

Proximal velocity
Velocity at the site of obstruction
Flow acceleration
Viscous friction

A

Velocity at the site of obstruction

135
Q

The stroke volume is 63 mL. The heart rate is 100 beats per minutes. The cardiac output is:

6.3 bpm
63 mL
63000 Lpm
6.3 Lpm

A

6.3 Lpm

136
Q

The top normal peak velocity for the aortic valve is:

2.0 m/s
0.9 m/s
0.7 m/s
1.7 m/s

A

1.7 m/s

137
Q

The tricuspid regurgitation peak velocity is 2.0 m/s. The right ventricular outflow tract velocity time integral is 20 cm. The pulmonary vascular resistance is:

Normal
Decreased
Equal to the peak velocity of the tricuspid regurgitation
Increased

A

Normal

138
Q

The tricuspid regurgitation peak velocity is determined to be 3.2 m/s. The inferior vena cava is normal in dimension (< 1.7 cm) and collapsed with a sniff by more than 50%. The right ventricular systolic pressure and systolic pulmonary artery pressure is:

41 mm Hg
56 mm Hg
49 mm Hg
44 mm Hg

A

44 mm Hg

139
Q

The use of the continuity equation in patients with aortic stenosis is based on the premise that:

Flow volume in the left ventricular outflow tract equals the flow volume across the aortic valve
Left ventricular outflow tract flow is greater than flow across the aortic valve
As the aortic stenosis progresses, V1 increases
As the aortic stenosis progresses, V2 decreases

A

Flow volume in the left ventricular outflow tract equals the flow volume across the aortic valve

140
Q

When evaluating valvular stenosis all of the following are useful Doppler parameters EXCEPT:

Peak instantaneous pressure gradient
Peak velocity
Chamber dimensions
Mean pressure gradient

A

Chamber dimensions

141
Q

Which of the following represent the lengthened Bernoulli equation?

EDV-ESV
4 x V2 2 – V1 2
4 x V22
CSA x VTI

A

4 x V2 2 – V1 2

142
Q

With aortic valve stenosis and poor global left ventricular systolic function the severity of aortic stenosis by the Doppler pressure gradient may be:

Overestimated
Underestimated
Unaffected
Unpredictable

A

Underestimated

143
Q

With aortic valve stenosis and significant aortic regurgitation the severity of the aortic stenosis by the Doppler pressure gradient may be:

Overestimated
Unaffected
Unpredictable
Underestimated

A

Overestimated

144
Q

A Doppler mean pressure gradient across a stenotic mitral valve of 22 mm Hg is obtained. The severity of the mitral stenosis is:

Moderately severe
Moderate
Severe
Mild

A

Severe

145
Q

A deceleration time of 800 msec was obtained by continuous-wave Doppler in a patient with rheumatic mitral valve stenosis. The pressure half-time is:

800 msec
232 msec
220 msec
400 msec

A

232 msec

146
Q

A strong indication for mitral stenosis on two-dimensional echocardiography is an anterior mitral valve leaflet that exhibits:

Systolic bowing
Reverse doming
Coarse, chaotic diastolic motion
Diastolic doming

A

Diastolic doming

147
Q

All of the following are causes for chronic mitral regurgitation EXCEPT:

Cleft mitral valve
Ruptured papillary muscle
Mitral annular calcification
Rheumatic heart disease

A

Ruptured papillary muscle

148
Q

All of the following are possible etiologies of anatomic mitral regurgitation EXCEPT:

Dilated cardiomyopathy
Ruptured chordae tendineae
Mitral valve prolapse
Mitral annular calcification

A

Dilated cardiomyopathy

149
Q

Cardiac magnetic resonance imaging provides all of the following information in the evaluation of mitral regurgitation EXCEPT:

Left ventricular mass
Detailed visualization of the mitral valve apparatus
Left ventricular volumes
Regurgitant volume

A

Detailed visualization of the mitral valve apparatus

150
Q

Chronic significant mitral regurgitation may result in all of the following EXCEPT:

Left atrial enlargement
Left ventricular enlargement
Left ventricular volume overload pattern
Mitral annular calcification

A

Mitral annular calcification

151
Q

Conditions that may lead to clinical symptoms that mimic those associated with rheumatic mitral stenosis include:

Aortic stenosis
Left atrial myxoma
Pericardial effusion
Ventricular septal defect

A

Left atrial myxoma

152
Q

Congestive heart failure in a patient with significant chronic mitral regurgitation occurs because of increased pressure in the:

Aorta
Right ventricle
Left ventricle
Left atrium

A

Left atrium

153
Q

Critical mitral valve stenosis is said to be present if the mitral valve area is reduced to:

1.5 to 2.5 cm^2
< 1.0 cm^2
1.0 to 1.5 cm^2
2.5 to 3.5 cm^2

A

< 1.0 cm^2

154
Q

M-mode and two-dimensional findings associated with significant chronic mitral regurgitation include all of the following EXCEPT:

Fine diastolic flutter of the mitral valve
Left ventricular volume overload pattern
Left ventricular enlargement
Left atrial enlargement

A

Fine diastolic flutter of the mitral valve

155
Q

Mitral stenosis is considered to be severe by all the following criteria EXCEPT:

Pressure half-time > 220 msec
Mitral valve Doppler A wave peak velocity > 1.3 m/s
Mitral valve area ≤ 1.0 cm^2
Mean pressure gradient ≥ 10 mm Hg

A

Mitral valve Doppler A wave peak velocity > 1.3 m/s

156
Q

Patients with mitral stenosis, left atrial enlargement and atrial fibrillation are at increased risk for the development of:

Left atrial thrombus
Left ventricular dilatation
Left atrial myxoma
Left ventricular thrombus

A

Left atrial thrombus

157
Q

Possible signs and symptoms associated with acute severe mitral regurgitation include:

Hemoptysis
Systemic embolization
Pulmonary edema
Anasarca

A

Pulmonary edema

158
Q

Predict the tissue Doppler imaging E/E’ ratio in a patient with known pseudonormalization of the mitral valve inflow pattern.

Normal E’/A’ ratio
Decreased E’A’ ratio
Increased E’/A’ ratio
Dependent upon respiration

A

Decreased E’A’ ratio

159
Q

Pressure recovery may explain discrepancies between the pressure gradient measurements acquired in the cardiac catheterization laboratory and the pressure gradient measurements acquired in the echocardiography laboratory (e.g., aortic stenosis, prosthetic aortic valve). Pressure recovery occurs at the:

distal to the vena contracta and turbulent region
Turbulent region
Vena contracta
Flow convergence region (PISA)

A

distal to the vena contracta and turbulent region

160
Q

Pulmonary regurgitation as detected by Doppler in structurally normal hearts is:

Dependent upon respiration
An abnormal finding
A common finding
A rare finding

A

A common finding

161
Q

Right ventricular systolic pressure may be calculated when the following condition is present:

Aortic regurgitation
Tricuspid regurgitation
Pulmonary regurgitation
Mitral regurgitation

A

Tricuspid regurgitation

162
Q

The S’ wave of the mitral valve annulus is determined to be 3 cm/s in peak velocity. This suggests:

Reduced global left ventricular systolic function
Hyperdynamic global left ventricular systolic function
Dependent upon respiration
Normal global left ventricular systolic function

A

Reduced global left ventricular systolic function

163
Q

The blood pressure in a patient with a patent ductus arteriosus is 124/68 mm Hg. The peak velocity across the patent ductus arteriosus as determined by continuous-wave Doppler is 5 m/s. The systolic pulmonary artery pressure is:

24 mm Hg
100 mm Hg
34 mm Hg
124 mm Hg

A

24 mm Hg

164
Q

The blood pressure in a patient with a ventricular septal defect is 114/77 mm Hg. The peak velocity across the ventricular septal defect as determined with continuous-wave Doppler is 4 m/s. The right ventricular systolic pressure and systolic pulmonary artery pressure is:

55 mm Hg
64 mm Hg
114 mm Hg
50 mm Hg

A

50 mm Hg

165
Q

The blood pressure is 120/80 mm Hg. The peak velocity of mitral regurgitation is 5 m/s. The left atrial pressure is:

20 mm Hg
5 mm Hg
100 mm Hg
120 mm Hg

A

20 mm Hg

166
Q

The continuous-wave Doppler maximum aortic regurgitation velocity reflects the:

Maximum instantaneous systolic pressure gradient between the aorta and left ventricle
Maximum peak instantaneous diastolic pressure difference between the aorta and the left ventricle
Mean systolic pressure gradient between the aorta and the left ventricle
Mean diastolic pressure gradient between the aorta and left ventricle

A

Maximum peak instantaneous diastolic pressure difference between the aorta and the left ventricle

167
Q

The difference between the transmitted frequency and the reflected frequency is known as the:

Gorlin equation
Bernoulli equation
Doppler shift
Doppler principle

A

Doppler shift

168
Q

The equation which relates the pressure drop across an area of narrowing is the:

Doppler equation
Bernoulli equation
Velocity ratio equation
Continuity equation

A

Bernoulli equation

169
Q

The expected continuous-wave Doppler peak velocity of tricuspid regurgitation assuming normal intracardiac pressures is:

0.5 m/s
1.0 m/s
2.2 m/s
3.3 m/s

A

2.2 m/s

170
Q

The following data is obtained in a patient with a prosthetic mitral valve: left ventricular outflow tract diameter is 2.0 cm, the left ventricular outflow tract velocity time integral is 15 cm and the prosthetic mitral valve velocity time integral is 47 cm. The mitral valve area by the continuity equation is:

2.0 cm2
3.14 cm2
30 cm2
1.0 cm2

A

1.0 cm2

171
Q

The following data is obtained in a patient with aortic stenosis: left ventricular outflow tract diameter is 2.0 cm, peak left ventricular outflow tract velocity integral is 20 cm, the aortic valve time velocity integral is 40 cm. The aortic valve area is:

1.57 cm2
0.75 cm2
0.3 cm2
3.14 cm2

A

1.57 cm2

172
Q

The following data is obtained in a patient with aortic stenosis: left ventricular outflow tract velocity time integral is 20 cm and the aortic valve velocity time integral is 40 cm. The velocity ratio is:

800
20
0.5
40

A

0.5

173
Q

The following data is obtained: left ventricular outflow tract diameter is 2.2 cm, left ventricular outflow tract peak systolic velocity is 1.1 m/s and the peak systolic aortic valve velocity is 5 m/s. The aortic valve area is:

0.83 cm2
0.75 cm2
100 cm2
2.14 cm2

A

0.83 cm2

174
Q

The formula that is used to calculate the peak pressure gradient in coarctation of the aorta is:

4 (V2 2)
220 ÷ PHT
4 (V2 2 – V1 2)
CSA x VTI

A

4 (V2 2 – V1 2)

175
Q

The formula used to estimate left ventricular end-diastolic pressure (LVEDP) from continuous-wave Doppler recording of aortic regurgitation is LVEDP is equal to:

LVEDP, left ventricular end-diastolic pressure; BPs, systolic blood pressure; Vmax, maximum velocity of aortic regurgitation; AR, aortic regurgitation; BPd, diastolic blood pressure; EDV, end-diastolic velocity.

BPd – 4 x EDV AR2
BPd – Vmax AR
BPs – Vmax AR
BPd – 4 x EDV AR

A

BPd – 4 x EDV AR2

176
Q

The laminar core of a turbulent jet is called the:

Flow convergence region (PISA)
Turbulent region
Vena contracta
Relaminarization

A

Vena contracta

177
Q

The left ventricular outflow tract diameter in early ventricular systole as measured in the parasternal long-axis is 2.0 cm. The left ventricular outflow tract time velocity integral is 20 cm. The Doppler stroke volume is:

3.14 cm
20 mL
2 mL
63 mL

A

63 mL

178
Q

The mitral valve area can be determined by Doppler with the following formula:

Deceleration time ÷ pressure half-time
220 ÷ pressure half-time
Pressure half-time ÷ 220
220 ÷ deceleration time

A

220 ÷ pressure half-time

179
Q

The peak velocity across a patent foramen ovale (PFO) is determined to be 1.0 m/s. The right atrial pressure (RAP) is determined to be 5 mm Hg by examination of the characteristics of the inferior vena cava. The left atrial pressure (LAP) is equal to:

1 mm Hg
14 mm Hg
9 mm Hg
4 mm Hg

A

9 mm Hg

180
Q

The peak velocity of pulmonary regurgitation is determined to be 3 m/s. The RAP is 3 mmHg. The mean pulmonary artery pressure is:

3 mm Hg
44 mm Hg
39 mm Hg
9 mm Hg

A

39 mm Hg

181
Q

The pressure drop between two-chambers may be calculated by the formula:

220 ÷ pressure half-time
Transmitted frequency – received frequency
4 x V2^2
CSA x VTI

A

4 x V2^2

182
Q

The pulmonary regurgitation end velocity is determined to be 2.0 m/s. The inferior vena cava is normal in dimension (< 1.7 cm) and collapses with a sniff by greater than 50%. The pulmonary artery end-diastolic pressure is equal to:

7 mm Hg
21 mm Hg
16 mm Hg
19 mm Hg

A

19 mm Hg

183
Q

The normal mitral valve area is:

4 to 6 cm2
3 to 5 cm2
3.5 to 4.5 cm2
5 to 8 cm2

A

4 to 6 cm2

184
Q

The normal volume of clear serous fluid in the pericardial sac is:

10 to 50 mL
200 to 500 L
20 to 50 mL
200 to 500 mL

A

10 to 50 mL

185
Q

The outpouching behind each aortic valve leaflet is called the:

Ligamentum arteriosum
Ductus arteriosus
Aortic isthmus
Sinuses of Valsalva

A

Sinuses of Valsalva

186
Q

The potential space behind the left atrium where pericardial effusion could accumulate is the:

Oblique sinus
Pleural potential space
Transverse sinus
Sinus of Valsalva

A

Oblique sinus

187
Q

The section of the aorta that is located between the diaphragm and the iliac arteries is called the:

Transverse aorta
Aortic isthmus
Descending thoracic aorta
Abdominal aorta

A

Abdominal aorta

188
Q

When should the left atrium be measured?

Early diastole
Diastasis
End systole
Late diastole

A

End systole

189
Q

Which left ventricular wall segment is LEAST likely to be supplied by the circumflex coronary artery?

Basal inferior wall of the left ventricle
Lateral wall of the cardiac apex
Inferolateral wall of the left ventricle
Anterolateral wall of the left ventricle

A

Basal inferior wall of the left ventricle

190
Q

Which two-dimensional view is recommended when measuring the right atrium?

Parasternal short-axis of the aortic valve
Apical four-chamber
Parasternal right ventricular inflow tract
Subcostal four-chamber

A

Apical four-chamber

191
Q

A patient with known aortic stenosis presents for evaluation. The ejection fraction is 22%. The peak velocity across the aortic valve as determined by continuous-wave Doppler is 2.3 m/s. The peak instantaneous pressure gradient is 21 mm Hg. The mean pressure gradient is 14 mm Hg. The severity of the aortic stenosis is:

Severe
Moderate
Requires more information
Mild

A

Requires more information

192
Q

A peak velocity of 2 m/s is obtained in a patient with rheumatic mitral stenosis. The peak (maximum) instantaneous pressure gradient is:

4 mm Hg
16 mm Hg
26 mm Hg
2 mm Hg

A

16 mm Hg

193
Q

All of the following are simplified PISA methods for determining the severity of mitral regurgitation EXCEPT:

PISA, proximal isovelocity surface area; ERO, effective regurgitant orifice; r, radius of PISA; RV, regurgitant volume

≥ 0.9 cm PISA radius that is holosystolic indicates significant mitral regurgitation
RV (mL) = 2 x r2 x aliasing velocity (cm/s)
ERO (cm2) = r2 ÷ 2
220 ÷ pressure half-time

A

220 ÷ pressure half-time

194
Q

As a valve orifice narrows because of stenosis pressure proximal to the stenosis will:

Decrease
Equilibrate
Increase with inspiration, decrease with expiration
Increase

A

Increase

195
Q

Assuming normal intracardiac pressures, predict the peak systolic velocity for a patent ductus arteriosus.

1 m/s
3 m/s
0.5 m/s
5 m/s

A

5 m/s

196
Q

Assuming normal intracardiac pressures, predict the peak velocity of atrial septal defect.

1 m/s
5 m/s
3 m/s
0.5 m/s

A

1 m/s

197
Q

Assuming normal intracardiac pressures, the expected continuous-wave Doppler peak velocity of mitral regurgitation would be:

7 m/s
1 m/s
3 m/s
5 m/s

A

5 m/s

198
Q

Assuming normal intracardiac pressures, the expected peak systolic velocity of a ventricular septal defect would be:

5 m/s
0.5 m/s
3 m/s
1 m/s

A

5 m/s

199
Q

Assuming normal intracardiac pressures, the expected peak velocity of pulmonary regurgitation is:

3 m/s
1 m/s
2 m/s
4 m/s

A

1 m/s

200
Q

Components of the Doppler equation include all the following EXCEPT:

The transmitted ultrasound frequency is an important determinant of the Doppler shift detected.
Propagation speed of sound changes relative to the velocity of the red blood cells.
The angle between the ultrasound beam and the direction of blood flow must be known for accurate measurement of blood flow.
The cosine of 0° is 1 and it is assumed in echocardiography that the recorded velocity has been obtained at a near-parallel intercept angle.

A

Propagation speed of sound changes relative to the velocity of the red blood cells.

201
Q

Determine the Qp/Qs for an atrial septal defect with the following data: RVOTd = 3.0 cm; RVOTVTI = 20 cm; LVOTd = 2.0 cm; LVOTVTI = 10 cm

RVOTd, right ventricular outflow tract diameter; RVOTVTI, right ventricular outflow tract velocity time integral; LVOTd, left ventricular outflow tract diameter; LVOTVTI, left ventricular outflow tract velocity time integral

3.3:1
4.5:1
2:1
10:1

A

4.5:1

202
Q

Determine the mitral effective regurgitant orifice and regurgitant volume using the PISA method:

Radius: 1.0 cm

Aliasing velocity: 40 cm/s

Mitral regurgitation peak velocity: 500 cm/s

Mitral regurgitation velocity time integral: 110 cm

0.50 cm2; 55 mL
1 cm2; 50 mL
0.40 cm2; 110 mL
55 cm2; 50 mL

A

0.50 cm2; 55 mL

203
Q

Determine the mitral regurgitant volume, regurgitant fraction and effective regurgitant orifice using the following information:

LVOT diameter: 2.0 cm, LVOTVTI: 10 cm,
Mitral valve annulus diameter: 3.0 cm,
Mitral valve annulus VTI: 15 cm, Mitral regurgitation VTI: 200 cm
LVOT, left ventricular outflow tract; VTI, velocity time integral

34 mL; 17%; .17 cm2
2 mL; 100%; 2 cm2
200 mL; 50%; .75 cm2
74 mL; .70%; 37 cm2

A

74 mL; .70%; 37 cm2

204
Q

Formulas that may be used to calculate the cross-sectional area of an orifice or vessel through which blood is flowing include all the following EXCEPT:

r, radius; D, diameter

p x (D2 ÷ 4)
p x (D ÷ 2)2
2 x p x r^2
0.785 x D2

A

2 x p x r^2

205
Q

In a patient with aortic stenosis the continuous-wave Doppler recordings demonstrate a maximum peak systolic velocity across the aortic valve of 5 m/s. The peak (maximum) instantaneous pressure gradient is:

100 mm Hg
110 mm Hg
25 mm Hg
5 mm Hg

A

100 mm Hg

206
Q

In patients with aortic valve stenosis the pressure gradients measured by Doppler include:

Peak (maximum) instantaneous pressure gradient
Peak (maximum) instantaneous pressure gradient and peak-to-peak gradient
Peak-to-peak pressure gradient
Peak-to-mean gradient

A

Peak (maximum) instantaneous pressure gradient

207
Q

Minor degrees of tricuspid regurgitation and mitral regurgitation detected by Doppler in structurally normal hearts:

Depend on respiration
Are a common finding
Are a rare finding
Vary greatly from one echocardiography laboratory to another

A

Are a common finding

Sonography Theory Final Exam (1 decks)

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