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Echo Registry Review > Wk 3 Terry Reynolds *Ischemic Heart Disease & Stress Echo > Flashcards

Wk 3 Terry Reynolds *Ischemic Heart Disease & Stress Echo Flashcards

1
Q
  1. A common echocardiographic postoperative finding in a cardiac surgery patient is:

A. Paradoxical septal motion
B. Pleural effusion
C. Valvular prolapsed
D. Valvular stenosis

A

A

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2
Q
  1. A wall segment of the heart that is without motion is best described as:
    A. Akinetic
    B. Dyskinetic
    C. Hyperkinetic
    D. Hypokinetic
A

A. Akinetic

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3
Q
  1. Medications that may be used to perform stress echocardiography include all the following EXCEPT:
    A. Adenosine
    B. Dipyridamole
    C. Dobutamine
    D. Propranolol
A

D. Propranolol

*note: Beta blocker

It can treat high blood pressure, chest pain (angina), and uneven heartbeat (atrial fibrillation). It can also treat tremors and proliferating infantile hemangioma. In addition, it can prevent migraine headaches.

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4
Q
  1. While examining a patient with Kawasaki disease, the echocardiographer should be careful to rule out:

A. Aortic root dilatation
B. Coronary artery aneurysm
C. Coronary artery atherosclerosis
D. Mitral valve prolapse

A

B. Coronary artery aneurysm

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5
Q
  1. The principle echocardiographic/Doppler abnormalities of right ventricular infarction include all the following EXCEPT:

A. Abnormal motion of the right ventricular free wall
B. Right ventricular dilatation
C. Right ventricular hypertrophy
D. TR

A

C Right ventricular hypertrophy

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6
Q
  1. Possible mechanisms in the development of mitral regurgitation following an acute myocardial infarction include all the following EXCEPT:

A. Fibrosis of the papillary muscle
B. Incomplete closure of the mitral valve
C. Mitral valve prolapsed
D. Papillary muscle rupture

A

C. Mitral valve prolapsed

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7
Q
  1. An area of diseased myocardium is resected and the remaining healthy tissue is sutured together. This surgical procedure is called:

A. Aneurysmectomy

B. Myectomy
C. Myotomy
D. Pericardiectomy

A

A. Aneurysmectomy - a surgical procedure performed to repair a weak area in the aorta

*note: resected - (of tissue or part of an organ) cut out.

Myectomy - a surgical procedure performed to reduce heart muscle thickening in patients with hypertrophic cardiomyopathy (HCM).

myotomy includes cutting of the muscular layer of the lower part of the esophagus and the upper part of the stomach to completely open the lower esophageal sphincter and relieve dysphagia

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8
Q
  1. The infarction most commonly associated with left ventricular aneurysm is:
    A. Anterior
    B. Inferior
    C. Lateral
    D. True posterior
A

A. Anterior

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9
Q
  1. The correct term for describing decreased ventricular wall motion is:
    A. Akinetic
    B. Dyskinetic
    C. Hyperkinetic
    D. Hypokinetic
A

D. Hypokinetic

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10
Q
  1. Echocardiographic findings in the post -myocardial infarction patient include:

A. Mitral annular calcification
B. Mural thrombus
C. Valvular Stenosis
D. Ventricular septal aneurysm

A

B. Mural thrombus

A mural thrombus is an organizing blood clot attached to the wall of a blood vessel or the endocardium of the heart

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11
Q
  1. The echocardiographic appearance of necrotic myocardium secondary to myocardial infarction includes all the following EXCEPT:

A. Akinetic myocardial wall
B. Echogenic wall segment
C. Ground-glass appearance
D. Thin ventricular wall

A

C. Ground-glass appearance

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12
Q
  1. Coronary artery perfusion occurs from:

A. Endocardium to epicardium

B. Epicardium to endocardium

C. Epicardium to myocardium

D. Myocardium to endocardium

A

B. Epicardium to endocardium

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13
Q
  1. The normal response of non-infarcted myocardium in a patient with acute myocardial infarction is:

A. A.Akinesis
B. Dyskinesis
C. Hyperkinesis
D. Hypokinesis

A

C. Hyperkinesis

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14
Q
  1. In determining the size of myocardial infarction, echocardiography generally:

A. Is unpredictable
B. Overestimates recent myocardial infarction and underestimates old myocardial infarction
C. Predicts the exact size of infarct
D. Underestimates recent myocardial infarction and overestimates old myocardial infarction

A

B. Overestimates recent myocardial infarction and underestimates old myocardial infarction

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15
Q
  1. Stress echocardiography methods may be used to detect stunned or hibernating myocardium include:

A. Cold pressure
B. Handgrip
C. Low-dose dobutamine
D. Treadmill

A

C. Low-dose dobutamine

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16
Q
  1. Hibernating myocardium is:

A. Myocardium that is hyperkinetic post-myocardial infarction
B. Reperfused viable myocardium that is not functioning
C. Viable myocardium at rest but not functioning with exercise
D. Viable myocardium that is nonfunctioning because of chronic ischemia

A

D. Viable myocardium that is nonfunctioning because of chronic ischemia

17
Q
  1. The definition of stunned myocardium is:

A. Myocardium after cardiopulmonary resuscitation
B. Myocardium after electrical cardioversion
C. Myocardium that is hyperkinetic post-myocardial infarction
D. Reperfused viable myocardium that is not functioning

A

D. Reperfused viable myocardium that is not functioning

18
Q
  1. A wall motion score of 3 assigned to a certain segment of left ventricular muscle indicates:

A. Akinetic wall motion
B. Dyskinetic wall motion
C. Hypokinetic wall motion
D. Normal wall motion

A

A. Akinetic wall motion

*systolic wall thickening <10%

19
Q

A wall motion score of 5 assigned to a certain segment of left ventricular muscle indicates:

A. Akinetic wall motion
B. Dyskinetic wall motion
C. Hypokinetic wall motion
D. Aneurysmal

A

D. Aneurysmal

*fixed defect

20
Q

A wall motion score of 4 assigned to a certain segment of left ventricular muscle indicates:

A. Akinetic wall motion
B. Dyskinetic wall motion
C. Hypokinetic wall motion
D. Aneurysmal

A

B. Dyskinetic wall motion

*Systolic wall thinning with
myocardial segment moving
outward during systole

21
Q
  1. Tardokinesis is a delay in:

A. Left ventricular filling
B. Right ventricular filling
C. Valve opening
D. Wall motion

A

D. Wall motion

*Tardokinesia is an abnormal slowness of contraction of a region of the left ventricular (LV) wall. This concept was stated in quantitative terms and used for analyzing LV regional wall motion

22
Q
  1. The most specific echocadiographic findings for ischemic muscle is:

A. Abnormal diastolic wall motion at the ischemic segment
B. Alterations In systolic thickening
C. Normal diastolic wall motion
D. Normal systolic wall motion

A

B. Alterations In systolic thickening

23
Q
  1. Angina occurring at rest that is not preceded by exercise or an increase in heart rate is called:

A. Labile
B. Prinzmetal’s

C. Stable
D. Unstable

A

B. Prinzmetal’s

*Prinzmetal’s angina is:

  • rare (representing about two out of 100 cases of angina)
  • usually occurs in younger patients

Prinzmetal angina (vasospastic angina or variant angina) is a known clinical condition characterized by chest discomfort or pain at rest with transient electrocardiographic changes in the ST segment, and with a prompt response to nitrates. These symptoms occur due to abnormal coronary artery spasm

24
Q

MI Type

MI occurs secondary to an acute imbalance in myocardial oxygen supply and demand without atherothrombosis

A

type 2

25
Q
  1. The most common etiology for ischemic heart disease is coronary artery:

A. Aneurysm
B. Atherosclerosis

C. Embolus
D. Spasm

A

B. Atherosclerosis

26
Q

MI type

MI is a primary coronary arterial event attributable to atherothrombotic plaque rupture or erosion

A

type 1

27
Q

MI type

Sudden unexpected cardiac death often with symptoms suggestive of myocardial ischemia

*this type of MI continues the concept that there may be an occasional patient who has characteristic symptoms of myocardial ischemia but whose cTn values have not become elevated because the patient succumbs before values are measured or who is stricken by sudden death with evidence of MI by autopsy

A

type 3

28
Q

MI type

MI associated with cardiac surgery (i.e. CABG)

A

type 5

29
Q

MI type

MI associated with PCI (percutaneous coronary intervention)

A

Type 4a

30
Q

MI type

MI associated with in-stent thrombosis

A

type 4b

31
Q

complication of MI

A

DARTH VADER

D-eath

A-arrythmia

R-upture

T-amponade

H-eart failure

V-alve disease

A-neurysm of ventricles

D-ressler’s syndrom

E-mbolism

R-eccurence/MR

32
Q

ECG MI

ST elevation & T inversion indicate….

A

myocardial injury

33
Q

pathologic Q wave indicates

A

myocardial necrosis

Pathologic Q waves are a sign of previous myocardial infarction. They are the result of absence of electrical activity. A myocardial infarction can be thought of as an elecrical ‘hole’ as scar tissue is electrically dead and therefore results in pathologic Q waves. Pathologic Q waves are not an early sign of myocardial infarction, but generally take several hours to days to develop. Once pathologic Q waves have developed they rarely go away.

34
Q

an imaging test to see how your heart pumps blood. It measures a percentage called ejection fraction (EF). Your healthcare provider may order this test to check for conditions such as heart failure.

A

MUGA (multigated aquisition radionuclide angiography)

35
Q

___________ is inflammation of the pericardium (pericarditis). It’s believed to occur as the result of the immune system responding to damage to heart tissue or damage to the pericardium. The damage can result from a heart attack, surgery or traumatic injury

A

Dressler syndrome

Echo Registry Review (25 decks)

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