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Echo Registry Review > Wk 4 Quiz Flag Questions > Flashcards

Wk 4 Quiz Flag Questions Flashcards

1
Q
  1. The equation that relates the pressure drop across an area of narrowing is the:

A. Bernoulli equation
B. Continuity equation
C. Doppler equation
D. Velocity ratio equation

A

A. Bernoulli equation

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2
Q
  1. The inability of Doppler ultrasound waves to penetrate prosthetic valves is called flow:

A. Masking
B. Mapping
C. Convergence
D. Reverberation

A

A. Masking

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3
Q
  1. In patients with significant pure mitral regurgitation, the E velocity of the mitral valve pulsed-wave Doppler tracing is:

A. Decreased
B. Increased with inspiration
C. Increased
D. Unaffected

A

C. Increased

*atrial pressure is increased - more pressure gradient btw LA and LV - more flow into LV - increased E wave

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4
Q
  1. A possible pitfall in the pressure half-time (PHT) method of assessing the severity of mitral stenosis is concomitant:

A. Aortic insufficiency
B. MR
C. Pulmonary insufficiency
D. TR

A

A. Aortic insufficiency

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5
Q
  1. A common two-dimensional echocardiographic finding in patients with chronic renal failure is:

A. Pericardial effusion
B. Pulmonary hypertension
C. Valvular regurgitation
D. Valvular stenosis

A

A. Pericardial effusion

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6
Q
  1. The Doppler hemodynamic parameters that should be evaluated inpatients with rheumatic mitral stenosis include all the following EXCEPT:

A. Mitral valve area
B. Pressure half-time
C. Pulmonary artery pressure
D. Regurgitant fraction

A

D. Regurgitant fraction

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7
Q
  1. Turner’s syndrome is strongly associated with:

A. Atrial septal defect
B. Coarctation of the aorta
C. Tetralogy of Fallot
D. Truncus arteriosus

A

B. Coarctation of the aorta

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8
Q

A B notch of the mitral valve on M-mode indicates increased left ventricular:
A. End-diastolic pressure
B. End-systolic pressure
C. Mean pressure
D. Peak-to-peak pressure

A

A. End-diastolic pressure

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9
Q
  1. When compared with angiographic volumes, echocardiographic ventricular volumes are:

A. A.Equal
B. Larger
C. Smaller
D. Variable, depending on the method used to determine echocardiographic volume

A

C. Smaller

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10
Q
  1. The continuous-wave Doppler maximum aortic insufficiency velocity reflects the:

A. Maximum instantaneous systolic pressure gradient between the aorta and the left ventricle
B. Maximum peak instantaneous diastolic pressure difference between the aorta and the left ventricle
C. Mean diastolic pressure gradient between the aorta and the left ventricle
D. Mean systolic pressure gradient between the aorta and the left ventricle

A

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

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11
Q
  1. Types of supravalvular aortic stenosis include:

A. Discrete fibromuscular stenosis
B. Hourglass deformity
C. Hypertrophic obstructive cardiomyopathy
D. Tunnel aortic valve stenosis

A

B. Hourglass deformity

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12
Q
  1. The type of ventricular septal defect most often associated with ventricular septal aneurysm is:

A. Inleft
B. Outlet.
C. Perimembranous .
D. Trabecular

A

C. Perimembranous .

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13
Q
  1. Echocardiographic criteria for the diagnosis of aortic dissection include all the following EXCEPT:

A. Decrease in aortic root dimension
B. Normal aortic leaflet motion
C. Recognition of an intimal flap as an oscillating two-dimensional structure within the aorta
D. Widening of the anterior and posterior aortic root walls

A

A. Decrease in aortic root dimension

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14
Q
  1. Components of the Doppler equation include all the following EXCEPT:

A. The angle between the ultrasound beam and the direction of the blood flow must be known for accurate measurement of blood flow
B. The transmitted ultrasound frequency is an important determinant of the Doppler shift detected
C. Propagation speed of sound changes relative to the velocity of red blood cells
D. 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

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

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15
Q
  1. The simplified Bernoulli equation disregards all the following factors EXCEPT:

A. Flow acceleration
B. Proximal velocity
C. Velocity at the site of stenosis
D. Viscous friction

A

C. Velocity at the site of stenosis

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16
Q
  1. In patients with aortic valve stenosis, the pressure gradients measured by cardiac Doppler include:

A. Maximum peak instantaneous gradient and peak-to-peak gradient
B. Maximum peak instantaneous gradient
C. Peak-to-mean gradient
D. peak-to-peak gradient

A

B. Maximum peak instantaneous gradient

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17
Q

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

A. Anemia
B. Doppler intercept angle of 0°
C. Low cardiac output
D. Significant aortic insufficiency

A

C. Low cardiac output

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18
Q
  1. With aortic valve stenosis and significant aortic insufficiency, the severity of the aortic valve stenosis by the Doppler pressure gradient may be:

A. Overestimated
B. Unaffected
C. Underestimated
D. Unpredictable

A

A. Overestimated

*with AR, more blood backing up in LV which increases LVED pressure = increasing velocity

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19
Q
  1. Right ventricular systolic pressure may be calculated when the following condition is present:

A. Aortic insufficiency
B. MR
C. Pulmonary insufficiency
D. TR

A

D. TR

20
Q
  1. All of the following values increase in patients with mitral valve stenosis during exercise EXCEPT:

A. Left ventricular end diastolic pressure
B. Pressure half-time
C. Systolic pulmonary artery pressure
D. Transvalvular pressure gradient

A

B. Pressure half-time

21
Q
  1. In tricuspid valve stenosis, the Doppler formula used for determining tricuspid valve area (TVA) is:

A. Pressure half-time ÷220
B. 220 ÷ pressure half-time
C. 220 ÷ deceleration time
D. 0.5 ×deceleration time

A

B. 220 ÷ pressure half-time

***190 / PHT

22
Q

403.A pulsed-wave Doppler tracing of the mitral valve inflow is obtained with the following information: E:A RATIO IS 2.3:1, deceleration time is 110 msec, isovolumic relaxation time is 52 msec, and pulmonary vein “a” wave reversal is 44 cm/sec. These findings are consistent with:

A. Normal left ventricular diastolic filling
B. Stage I diastolic filling pattern
C. Stage II diastolic filling pattern
D. Stage III diastolic filling pattern

A

D. Stage III diastolic filling pattern

*Note: E/A ≥2 - instantly you should know grade III (restricted) DD

23
Q
  1. A pulsed-wave Doppler tracing of the mitral valve inflow is obtained with the following information: E:A ratio is 0.7:1, deceleration time is 320 msec, isovolumic relaxation time is 110 msec, and pulmonary vein “a” wave is 22 cm/sec. These findings are most consistent with:

A. Normal diastolic function
B. Stage I diastolic filling pattern
C. Stage II diastolic filling function
D. Stage III diastolic filling pattern

A

B. Stage I diastolic filling pattern

*Note:

  • E/A ratio ≤0.8 - considered NORMAL
  • DT normal value: 150-240 ms thus in this case, abnormal
  • IVRT normal value: 70 +/- 12 (58-82) ms thus in this case, abnormal
  • normal peak AR (atrial reversal) wave value: <35 cm/s thus in this case, normal
24
Q
  1. The sufficient of a bidirectional persistent ductus arteriosus shunt is that it:

A. Is an expected (“normal”) finding
B. Implies elevated systemic pressure
C. Implies elevated pulmonary pressure
D. Negates the simplified Bernoulli equation

A

C. Implies elevated pulmonary pressure

25
Q
  1. The typical murmur associated with patent ductus arteriosus is:

A. Continuous murmur
B. Decreased diastolic murmur
C. Holosystolic murmur
D. Late systolic murmur

A

A. Continuous murmur

26
Q

422: Cardiac chambers that are enlarged in atrial septal defect include all the following EXCEPT:

A. Left atrium.
B. Main pulmonary artery.
C. Right atrium
D. Right ventricle

A

A. Left atrium.

*Note: blood moves from high pressure to low pressure

Initially, ASD affects right side of the heart

27
Q

!!! 425: The cardiac chambers that are enlarged in ventricular septal defect are:

A. Left atrium and left ventricle.
B. Right atrium and left atrium
C. Right atrium and right ventricle.
D. Right ventricle and left ventricle.

A

A. Left atrium and left ventricle.

*Note: with VSD, blood often flows from the left ventricle through the ventricular septal defect to the right ventricle and into the lungs. This extra blood being pumped into the lungs forces the heart and lungs to work harder - because the left ventricle gets more blood than normal.

28
Q
  1. The congenital heart defect most commonly associated with ostium primum atrial septal defect is:
    A. Cleft mitral valve.
    B. Parachute mitral valve.
    C. Partial anomalous pulmonary venous return
    D. total anomalous pulmonary venous return
A

A. Cleft mitral valve.

29
Q

431.The classic M-mode finding for Ebstein’s anomaly is:

A. Delayed closure of the tricuspid valve
B. Flail tricuspid valve leaflet
C. Tricuspid valve prolapse
D. Tricuspid valve stenosis

A

A. Delayed closure of the tricuspid valve

30
Q
  1. The classic M-mode finding for atrial septal defect is:
    A. Left ventricular volume overload.
    B. Right ventricular volume overload.
    C. Left ventricular pressure overload.
    D. Right ventricular pressure overload
A

B. Right ventricular volume overload

*Note: M mode findings

31
Q
  1. Possible complications of aortic dissection include all the following EXCEPT:

A. Aortic insufficiency
B. Left ventricular inflow tract obstruction
C. Pericardial effusion/tamponade
D. Progressive enlargement

A

B. Left ventricular inflow tract obstruction

*Note: LVOT is not a part of aorta

32
Q
  1. The continuous-wave Doppler maximum aortic insufficiency velocity reflects the:

A. Maximum instantaneous systolic pressure gradient between the aorta and the left ventricle
B. Maximum peak instantaneous diastolic pressure difference between the aorta and the left ventricle
C. Mean diastolic pressure gradient between the aorta and the left ventricle
D. Mean systolic pressure gradient between the aorta and the left ventricle

A

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

33
Q
  1. Components of the Doppler equation include all the following EXCEPT:

A. The angle between the ultrasound beam and the direction of the blood flow must be known for accurate measurement of blood flow
B. The transmitted ultrasound frequency is an important determinant of the Doppler shift detected
C. Propagation speed of sound changes relative to the velocity of red blood cells
D. 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

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

34
Q
  1. As a valve orifice narrows because of stenosis, pressure proximal to the stenosis will:

A. Decrease
B. Equilibrate
C. Increase with inspiration, decrease with expiration

D. Increase

A

D. Increase

35
Q

The formula used to calculate ejection fraction is:

A. EDD-ESD
B. EDV-ESV
C. EDD-ESD ÷EDD x 100
D. EDV-ESV ÷ EVD x 100

A

D. EDV-ESV ÷ EVD x 100

36
Q

  1. The formula used to determine percent shortening is:
    A. (EDD-ESD) × 100.
    B. (EDV-ESV) × 100.
    C. (EDD-ESD) ÷ EDD× 100
    D. (EDV-ESV) ÷ EDD×100
A

C. (EDD-ESD) ÷ EDD× 100

*Note: EDD - end diastolic diameter

ESD - end systolic diameter

37
Q
  1. The formula that allows for calculation of mitral valve area by Doppler is the:

A. Bernoulli equation
B. Continuity Equation
C. Gorlin equation
D. Velocity equation

A

B. Continuity Equation

38
Q
  1. The equation that relates the pressure drop across an area of narrowing is the:

A. Bernoulli equation
B. Continuity equation
C. Doppler equation
D. Velocity ratio equation

A

A. Bernoulli equation

39
Q
  1. The Doppler hemodynamic parameters that should be evaluated in patients with rheumatic mitral stenosis include all the following EXCEPT:

A. Mitral valve area
B. Pressure half-time
C. Pulmonary artery pressure
D. Regurgitant fraction

A

D. Regurgitant fraction

*Note: as the severity of MS increases, the PG, PHT, and the PA pressure all increase

40
Q
  1. In patients with aortic valve stenosis, the pressure gradients measured by cardiac Doppler include:

A. Maximum peak instantaneous gradient and peak-to-peak gradient
B. Maximum peak instantaneous gradient
C. Peak-to-mean gradient
D. peak-to-peak gradient

A

B. Maximum peak instantaneous gradient

41
Q

!!!

  1. In tricuspid valve stenosis, the Doppler formula used for determining tricuspid valve area (TVA) is:

A. Pressure half-time ÷220
B. 220 (190) ÷ pressure half-time
C. 220 ÷ deceleration time
D. 0.5 ×deceleration time

A

B. 190 ÷ pressure half-time

*Note: TV has a large normal orifice area: 7 - 9 cm2

TS occurs when TVA <1.5cm2 or mean transvalvular gradient: > 2mmHg

42
Q

!!!

The descent of the mitral annulus in the apical four-chamber view may be used to evaluate:

A. Global left ventricular systolic function
B. Segmental left ventricular function
C. Severity of mitral regurgitation
D. Severity of aortic valve stenosis

A

A. Global left ventricular systolic function

The base of the heart move downward, while the apex remains relatively fixed. The normal descent of the mitral annulus is >10mm (MAPSE)

43
Q

The 2D echo finding in acute pulmonary embolism is:

  1. LV dilatation
  2. LV hypertrophy
  3. RV dilatation
  4. RV hypertrophy
A

RV dilatation

44
Q

A common two-dimensional echocardiographic finding in patients with chronic renal failure is:

A. Pericardial effusion
B. Pulmonary hypertension
C. Valvular regurgitation
D. Valvular stenosis

A

A. Pericardial effusion - due to volume overload

*Note: additional common etiology of PE include neoplasm, trauma, collagen vascular disease (LSE), viral and bacterial infection

45
Q
  1. When compared with angiographic volumes, echocardiographic ventricular volumes are:
    A. A.Equal
    B. Larger
    C. Smaller
    D. Variable, depending on the method used to determine echocardiographic volume
A

C. Smaller

46
Q

!!!

  1. The rate at which the left ventricular pressure rises in systole is referred to as:

A. dv/dt
B. dP/dt
C. dt/dP
D. dd/tP

A

B. dP/dt

*Note: LV/RV Contractility (dp/dt) - represents the ratio of pressure change in the ventricular cavity during the isovolemic contraction period.

LV dP/dt is estimated by using time interval between 1 and 3 m/sec on MR velocity spectrum.

(Normal LV dp/dt is > 1200 mmHg/s).

RV dP/dt is estimated by using time interval between 1 and 2 m/sec on TR velocity spectrum.

47
Q

The formula used to determine percent fractional shortening is:

  1. (EDD -ESD) x 100
  2. (EDV - ESV) x 100
  3. (EDD - ESD) / EDD x 100
  4. (EDV - ESV) / EDD x 100
A
  1. (EDD - ESD) / EDD x 100

*Note: a method used for determining global LV function is percent fractional shortening. The normal range for this M-mode measurement is 28-41%

Echo Registry Review (25 decks)

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