Wk 3 Quiz Flag Questiuons Flashcards
Doppler evidence of cardiac tamponade from diastolic hepatic vein flow is:
A. Expiratory decrease
B. Expiratory increase
C. Inspiratory increase
D. Inspiratory reversal
A. Expiratory decrease
*hepatic vein flow in cardiac tamponade mimics the flow changes of the TV. The hepatic vein will have a reduction in diastolic forward flow with expiration
*Note: An exaggerated expiratory decrease in diastolic forward flow and increase in reverse flow in the hepatic vein also were characteristic of patients with cardiac tamponade
An echocardiographic finding in congenital absent pericardium is volume overload of the:
A. Left atrium
B. Left ventricle
C. Right atrium
D. Right ventricle
D. Right ventricle
*congenital absence of the pericardium usually involves the left side if the pericardium. Because of the shift of the heart to the left, the right ventricular cavity is more prominent and ventricular septal motion is abnormal. This condition is associated with BAV, ASD, and bronchogenic cyst
The most reliable M-mode indicator for pulmonary hypertension is:
A. Deep “a” wave of the pulmonic valve
B. Mid-systolic notching of the pulmonic valve
C. Shallow “a” dip of the pulmonic valve
D. Systolic flutter of the pulmonic valve
B. Mid-systolic notching of the pulmonic valve
*Mid-systolic notch/closure (flying W) is one of the more reliable signs of PHTN
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The square root sign is commonly found in:
A. Aortic valve stenosis
B. Constrictive pericarditis
C. Pericardial effusion
D. Pulmonary hypertension
B. Constrictive pericarditis
*Note: the equalization of diastolic pressure in all four cardiac chambers causes a dip and plateau in the cardiac catherterization pressure tracing of the ventricles. This is called the square root sign
- A possible etiology for pericardial effusion is:
A. Acute MI
B. Chronic AI
C. Chronic MR
D. Mitral valve stenosis
A. Acute MI
*Note: PE is common after acute MI, occurring in about 25% of these patients
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- The expected convetional Doppler finding in a patient with an acquired ventricular septal defect is:
A. Laminar-flow velocity flow during diastole on the left side of the interventricular septum
B. Laminar high velocity flow during diastole on the left side of the interventricular septum
C. Turbulent high velocity flow in diastole on the right side of the septum
D. Turbulent high velocity flow in systole on the right side of the
interventricular septum
D. Turbulent high velocity flow in systole on the right side of the
interventricular septum
*Doppler echo is an excellent means of detecting a ruptured IVS. Turbulent, high-velocity flow can be detected in systole on the right side of the IVS in both the 4 chamber and the PSAX views. Such a study can be reliable and specific for VSD
Which is an associated finding on M mode with HOCM?
- mid-systolic closure of the AV
- early-systolic notching of the AV
- mid-systolic notching of the PV
- enlarged LV cavity size
- early-systolic notching of the AV
*early-systolic notching cased by early-systolic closure
*Note: in HOCM, there is altered diastolic function, with slow left ventricle relaxation and left atrial (LA) emptying; the aortic (Ao) root diastolic motion is altered so that early rapid posterior motion is not seen until atrial contraction. This pattern is the counterpart of the a-wave dominant diastolic pattern seen by Doppler. The net forward motion of the Ao is adequate, but the timing and distribution have changed. The initial opening of the aortic valve (AV) is normal but shows a prominent midsystolic closure or notch, which coincides with the onset of subaortic obstruction induced by the systolic contact of the mitral valve with the septum; the AV often reopens for the second half of systole
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A 37 year-old soccer player who is status post sinus infection presents with a new systolic crescendo decrescendo murmur, chills, dizziness, and says that he can no longer keep ip on the field; what is most likely his diagnosis?
- AR due to AOV veg
- AS due to AOV veg
- AS/AR due to rheumatic heart disease
- degenerative AS/AR
- AS due to AOV veg
*AS caused by AOV veg
Low voltage of the QRS complex throughout the electrocardiogram is often found in:
A. Constrictive pericarditis
B. Mitral stenosis
C. Pericardial effusion
D. Pleural effusion
C. Pericardial effusion
_____ typically occurs early in life and causes the heart to become enlarged and heavily thickened due to excessive glycogen storage issues
Pompes
*typically occurs early in life and causes the heart to become enlarged and heavily thickened due to excessive glycogen in storage in the tissues
