Final Review: Terry Reynold's 500 Questions

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 (V2 2- V12) (CSA LVOT x TVI LVOT) ÷ TVI MV 220 ÷ pressure half-time

(CSA LVOT x TVI LVOT) ÷ TVI MV

An effect of significant aortic valve stenosis on the left ventricle is: -Asymmetrical septal hypertrophy -Concentric left ventricular hypertrophy -Eccentric left ventricular hypertrophy -Protected in significant aortic valve stenosis

-Concentric left ventricular hypertrophy

The intracardiac pressure that will most likely be increased in patients with severe valvular aortic stenosis is: -Left ventricular pressure at end-diastole -Pulmonary artery pressure -Right atrial pressure -Right ventricular pressure at end-diastole

-Left ventricular pressure at end-diastole

Auscultatory findings in rheumatic mitral valve stenosis include: -Austin Flint murmur -Fixed splitting of S2 -Loud S1 -Mid-systolic click

-Loud S1

The murmur of aortic valve stenosis is best described as a: -Holo-diastolic decrescendo murmur heard best at the left sterna border -Holosystolic murmur heard at the apex radiating to the axilla -Mid-systolic murmur heard best at the right upper sterna border -Mid-systolic murmur heard best at the left upper sterna border

-Mid-systolic murmur heard best at the right upper sterna border

. Possible two-dimensional echocardiographic findings in significant aortic valve stenosis include all the following EXCEPT: -Aortic valve calcification -Left ventricular hypertrophy -Post-stenotic dilatation of the ascending aorta -Post-stenotic dilatation of the descending aorta

-Post-stenotic dilatation of the descending aorta

Left atrial thrombus is most often associated with: -Cor triatrium -Infective endocarditis -Mitral valve prolapsed -Rheumatic mitral valve stenosis

-Rheumatic mitral valve stenosis

The M-mode echocardiogram demonstrates multiple echoes within the aortic root. The aortic valve excursion as determined by two-dimensional echocardiography is 7 mm. On physical examination, a crescendo-decrescendo systolic ejection murmur and a diastolic decrescendo murmur were heard. The most likely diagnosis is aortic valve: -Insufficiency -Stenosis -Stenosis and aortic insufficiency -Stenosis and mitral valve stenosis

-Stenosis and aortic insufficiency

In the M-mode echocardiogram, features of mitral valve stenosis include all the following EXCEPT: -Anterior motion of the posterior mitral valve leaflets -Decreased aortic root dimension -Systolic anterior motion of the mitral valve leaflets -Left atrial dilatation

-Systolic anterior motion of the mitral valve leaflets

The vegetation diameter as determined by two-dimensional echocardiography that is most often associated with systemic emboli is: 3 mm 5 mm 7 mm 10 mm

10 mm

An end-diastolic velocity of 2 m/sec for pulmonary insufficiency was obtained with an estimated right atrial pressure of 7 mmHg. The pulmonary artery end-diastolic pressure (PAEDP) is: 2 mmHg 16 mmHg 23 mmHg 26 mmHg

23 mmHg

A deceleration time of 800 msec was obtained by pulsed-wave Doppler in a patient with rheumatic mitral valve stenosis. The pressure half-time is: 220 msec 232 msec 400 msec 800 msec

232 msec

Clinical evidence of porcine valve dysfunction is most likely to be seen when leaflets are thicker than: 1 mm 2 mm 3 mm 4 mm

3 mm

The normal pulmonary artery end-diastolic pressure (PAEDP) is: 0 to 5 mmHg 4 to 12 mmHg 9 to 18 mmHg 18 to 25 mmHg

4 to 12 mmHg

The cardiac Doppler formula that accurately determines the pressure gradient in the prosthetic aortic valve is: 4 x (V22) 4 x (V12 - V22) 4 x (V22 - V12) Area x V1

4 x (V22 - V12)

The abnormal mitral valve pressure half-time for patients with mitral valve stenosis is: 0 to 30 msec 30 to 60 msec 60 to 90 msec 90 to 400 msec

90 to 400 msec

Critical mitral valve stenosis is said to be presented if the mitral valve area is reduced to: -<1.0 cm2 -to 1.5 cm2 -1.5 to 2.5 cm2 -2.5 to 3.5 cm2

<1.0 cm2

Severe aortic insufficiency can be diagnosed by continuous-wave Doppler by all the following criteria EXCEPT: A maximum velocity of > 3 m/sec A pressure half-time of ≤ 300 msec Aortic insufficiency deceleration slope ≥ 3 m/sec Darkened spectrum of the regurgitant jet

A maximum velocity of > 3 m/sec

On M-mode, the abrupt downward motion of the pulmonary valve leaflet following atrial contraction is called the: A. "a" dip B. "b" dip C. "c" dip D. "d" dip

A. "a" dip

. The following data is obtained: left ventricular outflow tract diameter is 2.2 cm, left ventricular outflow tract maximum velocity is 1.1 m/sec, and peak aortic velocity is 6 m/sec. The aortic velocity ratio is: A. 0.18 B. 0.18cm C. 0.18cm^2 D. 0.69cm^2

A. 0.18

The normal left atrium to right atrium ratio is: A. 1:1 B. 1.3:1 C. 2:1 D. 3:1

A. 1:1

The preferred transducer frequency for imaging a barrel-chested patient is: A. 2.5 MHz B. 3.5 MHz C. 5.0 MHz D. 7.0 MHz

A. 2.5 MHz

The normal volume of clear serous fluid in the pericardial sac is: A. 20 to 50 cc B. 20 to 50 L C. 200 to 500 cc D. 200 to 500 L

A. 20 to 50 cc

The mitral valve area can be determined by Doppler with the following formula: A. 220 ÷ pressure half-time B. 220 ÷ deceleration time C. Deceleration time ÷pressure half-time D. Pressure half-time ÷ 220

A. 220 ÷ pressure half-time

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: A. 2×π×r² B. π× (D÷2)² C. 0.785 × D² D. π×D²÷4

A. 2×π×r²

The formula that is used to calculate the peak pressure gradient in coarctation of the aorta is: A. 4 (V2^2-V1^2) B. 4 (V2^2) C. 220 ÷ PHT CSA ×TVI

A. 4 (V2^2-V1^2)

The normal range for the interventricular septum and the posterior wall of the left ventricle at end-diastole by M-mode is: A. 6 to 11 mm B. 6 to 11 cm C. 0.6 to .011 mm 60 to 110 mm

A. 6 to 11 mm

The section of the aorta that is located between the diaphragm and the iliac arteries is called the: A. Abdominal aorta B. Aortic isthmus C. Descending thoracic aorta D. Transverse aorta

A. Abdominal aorta

M-mode findings associated with pulmonary hypertension include: A. Absent or shallow "a" dip of the pulmonic valve B. Deep "a" dip of the pulmonic valve C. Paradoxical "a" dip of the pulmonic valve D. Reverse "a" dip of the pulmonic valve

A. Absent or shallow "a" dip of the pulmonic valve

A possible etiology for pericardial effusion is: A. Acute MI B. Chronic AI C. Chronic MR D. Mitral valve stenosis

A. Acute MI

The coronary artery that predominantly supplies blood to the right ventricle is the: A. Acute marginal branch B. Anterior descending coronary artery C. Circumflex coronary artery D. Left main coronary artery

A. Acute marginal branch

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

A. Akinetic

. 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 Normal wall motion

A. Akinetic wall motion

. Possible causes of restrictive cardiomyopathy include all the following EXCEPT: A. Alcohol B. Amyloidosis C. Hemochromatosis D. Sarcoidosis

A. Alcohol

The most common etiology of secondary, non-ischemic dilated cardiomyopathy in the Western world is: A. Alcohol B. Infection (e.g., viral) C. Chemotherapy D. Pregnancy (postpartum)

A. Alcohol

. 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. Aneurysmectomy

All the following are true statements concerning primary cardiac tumors EXCEPT: A. Angiosarcoma is the most common pediatric primary cardiac tumor. B. Myxoma is the most common primary cardiac tumor. C. Primary intracardiac tumors are often benign (3:1) Primary pericardial tumors have a 50% chance of being malignant

A. Angiosarcoma is the most common pediatric primary cardiac tumor.

The most common primary malignant tumor of the heart is: A. Angiosarcoma. B. Fibroma. C. Lipoma. D. Rhabdomyoma.

A. Angiosarcoma.

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

A. Anterior

Left ventricular wall segments that are usually visualized in the apical four-chamber view include all the following EXCEPT: A. Anterior wall of the left ventricle B. Apex C. Interventricular septum D. Lateral wall of left ventricle

A. Anterior wall of the left ventricle

All of the following are considered atrioventricular valves EXCEPT: A. Aortic B. Mitral C. Bicuspid D. Tricuspid

A. Aortic

. 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. Aortic insufficiency

A communication between the ascending aorta and the main pulmonary artery is called: A. Aortopulmonary window B. Coarctation of the aorta C. Patent ductus arteriosus D. Supracristal septal defect

A. Aortopulmonary window

The best echocardiographic view for determining the presence of Ebstein's anomaly is the: A. Apical four-chamber view. B. Parasternal long-axis view. C. Parasternal short-axis view of the aortic valve. A. D, Subcostal four-chamber view.

A. Apical four-chamber view.

. Minor degrees of tricuspid regurgitation detected by Doppler in structurally normal hearts: A. Are a common finding B. Are a rare finding C. Depend on respiration D. Vary greatly from one echocardiography laboratory to another

A. Are a common finding

1. A color flow Doppler method for semi-quantitating mitral regurgitation is regurgitant jet: A. Area B. Height C. Length D. Turbulence

A. Area

The ellipsoid single-plane method for determining left ventricular volumes by two-dimensional echocardiography is also called: A. Area-length method B. Bullet method C. Length-diameter method Simpson's rule

A. Area-length method

. Characteristics findings in patients with idiopathic dilated cardiomyopathy include all the following EXCEPT: A. Asymmetric septal hypertrophy B. Dilated, poorly contracting left ventricle C. Low cardiac output D. High intracardiac pressures

A. Asymmetric septal hypertrophy

1. In patients with significant mitral regurgitation, the continuous-wave Doppler tracing of the regurgitant lesion may demonstrate a(n): A. Asymmetrical shape of the mitral regurgitation flow velocity spectral display B. Jet area of 20% C. Jet duration of less than 85 msec D. Symmetrical shape of the mitral regurgitation flow velocity spectral display

A. Asymmetrical shape of the mitral regurgitation flow velocity spectral display

Associated anomalies of sinus of Valsalva aneurysm include all the following EXCEPT: A. Atrial septal defect B. Bicuspid aortic valve C. Coarctation of the aorta D. Ventricular septal defect

A. Atrial septal defect

Prime characteristics of tetralogy of Fallot include all the following EXCEPT: A. Atrial septal defect B. Malalignment ventricular septal defect C. Pulmonic stenosis D. Right ventricular hypertrophy

A. Atrial septal defect

. An oxygen saturation sample taken at the superior vena cava is 74% and in the right atrium is 88%. A possible explanation is: A. Atrial septal defect. B. Coarctation of the aorta. C. Patent ductus arteriosus. D. Ventricular septal defect.

A. Atrial septal defect.

. Congenital heart diseases strongly associated with Ebstein's anomaly include: A. Atrial septal defect. B. Coarctation of the aorta. C. Discrete subaortic stenosis. D. Parachute mitral valve.

A. Atrial septal defect.

An unattached, freely moving clot within the left atrium is referred to as a: A. Ball thrombus B. Pedunculated thrombus C. Sessile thrombus Stationary thrombus

A. Ball thrombus

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. Bernoulli equation

. Possible repairs for D-transposition of the great arteries include all the following EXCEPT: A. Blalock-Taussig B. Jatene C. Mustard D. Senning

A. Blalock-Taussig

Possible echocardiographic findings in patients with Wolff-Parkinson-White type A syndrome include a(n): A. Brief anterior displacement of the left ventricular wall. B. Brief posterior displacement of the right ventricular wall. C. Increase in the interval between mitral valve closure and pulmonic valve opening. D. Sharp, brief, downward posterior dip of the interventricular septum.

A. Brief anterior displacement of the left ventricular wall.

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. Cleft mitral valve.

The typical murmur associated with patent ductus arteriosus is: A. Continuous murmur B. Decreased diastolic murmur C. Holosystolic murmur D. Late systolic murmur

A. Continuous murmur

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. Decrease in aortic root dimension

1. In patients with severe acute mitral regurgitation, the continuous-wave Doppler maximum velocity of the regurgitant jet is: A. Decreased B. Dependent largely upon left ventricular function C. Increased D. Unaffected

A. Decreased

The E-F slope of the M-mode of the anterior mitral valve leaflet in mitral valve stenosis is: A. Decreased B. Increased C. Notched D. Unaffected

A. Decreased

Important factors when considering surgical repair in Ebstein's anomaly include all the following EXCEPT: A. Degree of anterior tricuspid valve prolapse. B. Degree of "atrialization" of the right ventricle. C. Dysplasia of the valve leaflets. D. Extent of leaflet tethering.

A. Degree of anterior tricuspid valve prolapse.

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. Delayed closure of the tricuspid valve

The control that sets the upper limit to which ultrasound information will be processed and displayed is: A. Depth B. Far gain C. Overall gain D. Reject

A. Depth

The Doppler finding associated with persistent patent ductus arteriosus is: A. Diastolic flow reversal in the descending thoracic aorta B. Increased flow velocity at the aortic isthmus C. Increased pressure half-time of the mitral valve D. Systolic flow reversal in the pulmonary veins

A. Diastolic flow reversal in the descending thoracic aorta

. The echocardiographic features of amyloidosis include all the following EXCEPT: A. Dilatation of the ascending aorta B. Increased ventricular wall thickness C. Multivalvular regurgitation D. Pericardial effusion

A. Dilatation of the ascending aorta

The cardiomyopathy with which cardiac hemochromatosis is most often associated is: A. Dilated B. Hypertrophic C. Idiopathic D. Subaortic

A. Dilated

The cardiac involvement associated with acquired immunodeficiency syndrome (AIDS) is: A. Dilated Cardiomyopathy B. Hypertrophic cardiomyopathy C. Infiltrative cardiomyopathy D. Restrictive cardiomyopathy

A. Dilated Cardiomyopathy

Diastolic collapse of the right ventricle in cardiac tamponade occurs during: A. Early diastole B. Mid-diastole C. Late diastole D. Atrial systole

A. Early diastole

The principal echocardiographic feature of the left bundle branch block is: A. Early systolic dip. B. Hyperkinesis of the interventricular septum. C. Hyperkinesis of the posterior wall of the left ventricle. D. Posterior motion of the interventricular septum.

A. Early systolic dip.

A congenital malformation of the tricuspid valve in which one, two, or all three leaflets are displaced downward from the annulus is known as: A. Ebstein's anomaly B. Epstein-Barr anomaly. C. Tricuspid atresia. D. Tricuspid valve stenosis.

A. Ebstein's anomaly

The control used when information from a precise point in the cardiac cycle is required is the: A. Electrocardiogram trigger B. Overall gain C. Reject D. Time gain compensation

A. Electrocardiogram trigger

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. End-diastolic pressure

. 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

The Doppler control that eliminates low-level frequency shifts is: A. Filter B. Gain C. Output power D. Sample volume length

A. Filter

A large pericardial effusion precludes the diagnosis of all the following EXCEPT: A. Flail mitral valve B. Mitral valve prolapse C. Pulmonic valve prolapsed D. Systolic anterior motion (SAM) of the mitral valve

A. Flail mitral valve

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. Global left ventricular systolic function

A systolic high-velocity, late-peaking, dagger-shaped, continuous-wave Doppler signal is obtained. The most likely diagnosis is: A. Hypertrophic obstructive cardiomyopathy B. Mitral regurgitation C. Tricuspid regurgitation D. Valvular aortic stenosis

A. Hypertrophic obstructive cardiomyopathy

An intimal flap in the aorta is discovered in the parasternal long-axis view, suprasternal long-axis view, and abdominal aorta. The type of aortic dissection present is DeBakey type: A. I B. II C. III D. IV

A. I

The primary pulsed-wave mitral valve Doppler diastolic abnormality in a patient with systemic hypertension is stage: A. I B. II C. III D. IV

A. I

The pulsed-wave Doppler mitral flow pattern most often associated with hypertrophic obstructive cardiomyopathy is stage: A. I B. II C. III D. IV

A. I

The most common etiology of systemic hypertension is: A. Idiopathic processes B. Renal disease C. Pheochromocytoma D. Psychogenic origin

A. Idiopathic processes

A maneuver that will result in tachycardia and a transient decrease in blood pressure is: A. Inhalation of amyl nitrate B. Squatting C. Standing to supine D. Straight leg raising

A. Inhalation of amyl nitrate

In coarctation of the aorta, blood pressure in the legs: A. Is lower than in the right arm B. Is higher than in the right arm C. Is equal to blood pressure in the right arm D. Cannot be compared with blood pressure in the right arm

A. Is lower than in the right arm

Secondary findings in mitral valve stenosis may include: A. Left atrial dilatation and a normal or small left ventricular dimension B.Left atrial dilatation and pulmonary venous stenosis C. Left ventricular and left atrial dilatation D. Left ventricular hypertrophy and left atrial dilatation

A. Left atrial dilatation and a normal or small left ventricular dimension

The anterior mitral valve leaflet E-F slope is decreased in: A. Left atrial myxoma B. Left ventricular volume overload C. Mitral valve prolapse Mitral valve vegetation

A. Left atrial myxoma

Congestive heart failure in a patient with significant mitral regurgitation occurs because of increased pressure in the: A. Left atrium B. Right atrium C. Right ventricle D. Aorta

A. Left atrium

The pressure obtained by a pulmonary artery wedge reflects the pressure in the: A. Left atrium B. Pulmonary artery C. Right atrium D. Right ventricle

A. Left atrium

The cardiac chambers that are enlarged in patent ductus arteriosus are: A. Left atrium and left ventricle B. Left atrium and right ventricle C. Right atrium and left ventricle D. Right atrium and right ventricle

A. Left atrium and left ventricle

. 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. Left atrium and left ventricle.

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. Left atrium.

The pulsed-wave Doppler characteristics of an uncomplicated atrial septal defect are: A. Low -velocity left-to-right flow. B. High -velocity left-to- right flow. C. Low-velocity right-to-left flow. D. High-velocity right-to-left flow

A. Low -velocity left-to-right flow.

1. An accepted method for the semi-quantitation of mitral regurgitation with pulsed-wave Doppler is: A. Mapping technique B. Maximum velocity of the mitral regurgitation C. Peak A velocity D. Pressure half-time

A. Mapping technique

The inability of Doppler ultrasound waves to penetrate prosthetic valves is called flow: A. Masking B. Mapping C. Convergence D. Reverberation

A. Masking

The recommended method for determining left ventricular volumes by two-dimensional echocardiography is: A. Method of discs B. Single plane area-length C. Bullet method D. Prolate ellipse method

A. Method of discs

All the following may be used to calculate pulmonary artery pressure b cardiac Doppler EXCEPT: A. Mitral regurgitation B. Pulmonary insufficiency C. Right ventricular outflow tract acceleration D. Tricuspid regurgitation

A. Mitral regurgitation

A posterior echo-free space is detected during the systolic phase only by M-mode/two-dimensional echocardiography. This is considered a: A. Normal finding B. Small pericardial effusion C. Moderate pericardial effusion D. Large pericardial effusion

A. Normal finding

. 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. Overestimated

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. Paradoxical septal motion

Excellent two-dimensional views for imaging the tricuspid valve include all the following EXCEPT: A. Parasternal long-axis view B. Parasternal short-axis view of the aortic valve C. Apical four-chamber view D. Subcostal four-chamber view

A. Parasternal long-axis view

An underestimated Doppler peak pressure gradient in aortic coarctation may be caused by: A. Patent ductus arteriosus B. Significant aortic insufficiency C. Significant MR D. Ventricular septal defect

A. Patent ductus arteriosus

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. Pericardial effusion

The best guideline for differentiating pericardial effusion from pleural effusion by two-dimensional echocardiography is: A. Pericardial effusion is located anterior to the descending aorta; pleural effusion is present posterior to the descending aorta. B. Pericardial effusion is present posterior to the descending aorta; pleural effusion is located anterior to the descending aorta. C. Pericardial effusion is usually seen as an anterior clear space; pleural effusion is usually seen as a posterior clear space. D. Pericardial effusion is usually seen as a posterior clear space; pleural effusion is usually seen as an anterior clear space.

A. Pericardial effusion is located anterior to the descending aorta; pleural effusion is present posterior to the descending aorta.

The volume or pressure that exists in the ventricle at end-diastole is called: A. Preload B. Afterload C. No-load Sumload

A. Preload

Possible pharmacologic treatments for hypertrophic obstructive cardiomyopathy include: A. Propranolol B. Epinephrine C. Dobutamine D. Lasix

A. Propranolol

The Chiari network is found in the: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle

A. Right atrium

The Eustachian valve is found in the: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle

A. Right atrium

. In sinus of Valsalva aneurysm, the coronary cusp most often affected is: A. Right coronary cusp B. Non coronary cusp C. Left coronary cusp D. Each coronary cusp is equally affected

A. Right coronary cusp

The control labeled Doppler sample volume depth: A. Sets the range gate location for pulsed-wave Doppler B. Does not affect the pulse repetition frequency C. Does not affect the maximum velocity that can be displayed without signal aliasing D. Is useful in continuous-wave Doppler

A. Sets the range gate location for pulsed-wave Doppler

Premature closure of the mitral valve is associated with all the following EXCEPT: Acute severe mitral regurgitation Acute severe aortic insufficiency First-degree atrioventricular block Loss of sinus rhythm

Acute severe mitral regurgitation

Another term for a homograft prosthetic valve is: Allograft Autograft Biograft Heterograft

Allograft

On M-mode/two-dimensional echocardiography, dense echoes are noted posterior to normal mitral valve leaflets. The probable diagnosis is mitral valve: Annular calcification Fibrosis Papilloma Vegetation

Annular calcification

In mitral valve stenosis, the posterior mitral valve leaflet on M-mode moves: Anteriorly Laterally Medially Posteriorly

Anteriorly

Cardiac Doppler parameters used to assess the severity of valvular aortic stenosis include all the following EXCEPT: Aortic pressure half-time Aortic velocity ratio Mean pressure gradient Peak aortic valve velocity

Aortic pressure half-time

Conditions that may affect the left ventricle in the same way as aortic insufficiency include all the following EXCEPT: Atrial septal defect Mitral regurgitation Patent ductus arteriosus Ventricular septal defect

Atrial septal defect

. The usual site of attachment for vegetations on the mitral and tricuspid valves is the: Annulus Atrial side of the valve leaflets Papillary muscles Ventricular side of valve leaflets

Atrial side of the valve leaflets

Classic symptoms associated with severe valvular aortic stenosis include all the following EXCEPT: Angina pectoris Atypical chest pain Congestive heart failure Syncope

Atypical chest pain

The murmur associated with severe aortic insufficiency is: Austin Flint murmur Carvallo's murmur Graham Steell murmur Still's murmur

Austin Flint murmur

A pulmonic valve relocated to the aortic position is called a(n): Allograft Autograft Heterograft Homograft

Autograft

Echocardiographic signs associated with constrictive pericarditis include all the following EXCEPT: B notch Inferior vena cava plethora Railroad track sign Septal bounce

B notch

M-mode findings for the mitral valve in patients with rheumatic mitral valve stenosis include all the following EXCEPT: Anterior motion of the posterior mitral valve leaflet B notch of the anterior mitral valve leaflet Decreased E-F slope of the anterior mitral valve leaflet Thickened mitral valve leaflets

B notch of the anterior mitral valve leaflet

The left atrial cardiac catheterization pressure tracing in a patient with significant mitral regurgitation may demonstrate an increase in the: A. "a" wave B. "v" wave C. "x" wave D. "y" wave

B. "v" wave

The formula used to calculate cardiac output by Doppler is: A. EDV - ESV B. (CSA × TVI) × HR C. (CSA ÷ TVI) × HR D. (CSA ×TVI) × HR÷ BSA

B. (CSA × TVI) × HR

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

B. 220 ÷ pressure half-time

The maximum velocity of a persistent patent ductus arteriosus is 4 m/sec and the systolic blood pressure is 90/60. The systolic pulmonary artery pressure is: A. 4 mmHg B. 26 mmHg C. 26 mmHg plus right atrial pressure D. 64 mmHg

B. 26 mmHg

1. The proximal isovelocity surface area of a mitral regurgitant jet is 7.6 cm2. The aliasing flow velocity is 24 cm/sec. The time velocity integral (TVI) of the mitral regurgitation jet is 150 cm. The maximum velocity of the mitral regurgitation jet is 580 cm/sec. The mitral regurgitant stroke volume is: A. 24 cc B. 47 cc C. 150 cc D. 580 cc

B. 47 cc

Pulmonary insufficiency as detected by cardiac Doppler in structurally normal hearts is: A. A rare finding B. A common finding C. An abnormal finding D. Depend on expiration

B. A common finding

Early in the disease stage, the usual Doppler mitral inflow pattern in patients with dilated cardiomyopathy demonstrates: A. Abnormal compliance pattern B. Abnormal relaxation pattern C. Normal pattern D. Pseudonormal pattern

B. Abnormal relaxation pattern

The resistance to ejection of blood encountered by the contracting ventricle is called: A. Preload B. Afterload C. No-load D. Sumload

B. Afterload

The most specific echocardiographic findings for ischemic muscle is: A. Abnormal diastolic wall motion at the ischemic segment B. Alterations In systolic thickening C. Normal diastolic wall motion Normal systolic wall motion

B. Alterations In systolic thickening

The __________ mitral valve leaflet is continuous with the _________ aortic root, while the _____________ is continuous with the __________ aortic root. A. Anterior, anterior, posterior mitral valve leaflet, posterior B. Anterior, posterior, interventricular septum, anterior C. Posterior, anterior, interventricular septum, posterior D. Posterior, posterior, anterior mitral valve leaflet, anterior

B. Anterior, posterior, interventricular septum, anterior

. A patient with a long-standing history of hypertension is sent to the echocardiography laboratory 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: A. Acute severe aortic insufficiency due to infective endocarditis B. Aortic dissection C. Mitral valve prolapse D. Pericarditis

B. Aortic dissection

The most common etiology for ischemic heart disease is coronary artery: A. Aneurysm B. Atherosclerosis C. Embolus D. Spasm

B. Atherosclerosis

The Doppler formula used to calculate systolic pulmonary artery pressure in a patient with ventricular septal defect (VSD) is: A. BPs-BPd×4 B. BPs-4× (V max VSD^2) C. BPd-4× (V max VSD^2) D. 4 (V1^2)

B. BPs-4× (V max VSD^2)

Eisenmenger's syndrome may be associated with all the following EXCEPT: A. Atrial septal defect B. Bicuspid aortic valve C. Patent ductus arteriosus D. Ventricular septal defect

B. Bicuspid aortic valve

Findings associated with congenital aneurysm of the left atrium include: A. Electrical alternans B. Cardiac arrhythmia C. Bundle branch block D. Pathological Q wave

B. Cardiac arrhythmia

Turner's syndrome is strongly associated with: A. Atrial septal defect B. Coarctation of the aorta C. Tetralogy of Fallot D. Truncus arteriosus

B. Coarctation of the aorta

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

B. Continuity equation

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

B. Coronary artery aneurysm

The mitral valve M-mode points that denote the beginning and the end of diastole are: A. C to D B. D to C C. D to E D. E to F

B. D to C

. An increased mitral E-point to septal separation may indicate left ventricular: A. Decrease in compliance B. Decrease in ejection fraction C. Hyperdynamic wall motion D. Increase in end-diastolic pressure

B. Decrease in ejection fraction

1. In patients with significant mitral regurgitation, the isovolumic relaxation time may be: A. Increased B. Decreased C. Affected by respiration D. Unaffected

B. Decreased

The anatomic landmark that demarcates the end section of the descending thoracic aorta and the beginning of the abdominal aorta is the: A. Aortic isthmus B. Diaphragm C. Ligamentum arteriosum D. Renal arteries

B. Diaphragm

A strong indication for mitral valve stenosis on two-dimensional echocardiography is an anterior mitral valve leaflet that exhibits: A. Coarse, chaotic diastolic motion B. Diastolic doming C. Reverse doming D. Systolic bowing

B. Diastolic doming

Typical echocardiographic findings in a patient with isolated rheumatic mitral valve stenosis include all the following EXCEPT: A. D-shaped left ventricle B. Dilated left ventricle C. Left atrial enlargement D. Left atrial thrombus

B. Dilated left ventricle

A two-dimensional echocardiographic finding of an aortic intimal flap indicates aortic: A. Aneurysm B. Dissection C. Insufficiency D. Supravalvular stenosis

B. Dissection

The normal fetal vascular channel that connects the descending thoracic aorta and the main pulmonary artery is the: A. Ductus venosus B. Ductus arteriosus C. Ligamentum venosus D. Ligamentum arteriosum

B. Ductus arteriosus

The mean velocity of circumferential fiber shortening (Vcfm) may be calculated by: A. EDD - ESD ÷ EDD B. EDD - ESD ÷ LVET x EDD C. EDV - ESV D. EDV - ESV ÷ EDV

B. EDD - ESD ÷ LVET x EDD

The formula used for calculating stroke volume is: A. EDV + ESV B. EDV - ESV C. ESV - EDV D. (EDV - ESV) ÷ EDV

B. EDV - ESV

The physical finding of cyanosis is common in: A. Atrial septal defect B. Eisenmenger's syndrome C. Patent ductus arteriosus Ventricular septal defect

B. Eisenmenger's syndrome

The left atrial dimension is measured on M-mode during: A. Systole B. End-systole C. Diastole D. End-diastole

B. End-systole

The congenital heart defect most often associated with Down's syndrome (trisomy 21) is: A. Coarctation of the aorta B. Endocardial cushion defect C. Peripheral pulmonary stenosis D. Tetralogy of Fallot

B. Endocardial cushion defect

Coronary artery perfusion occurs from: A. Endocardium to epicardium B. Epicardium to endocardium C. Epicardium to myocardium D. Myocardium to endocardium

B. Epicardium to endocardium

The most common valvular tumor is the: A. Angiosarcoma B. Fibroelastoma C. Lipoma Myxoma

B. Fibroelastoma

: A two-dimensional echocardiographic finding associated with pulmonary hypertension is: A. Flattening of the interventricular septum in diastole B. Flattening of the interventricular septum in systole C. Dyskinetic interventricular septal motion D. Hyperkinetic interventricular septal motion

B. Flattening of the interventricular septum in systole

In general, and outside certain disease states, the greater the stretch of the muscle cell, the greater the force of contraction. This principle is called: A. Frank's law of the heart B. Frank-Starling law of the heart C. Force-velocity relationship Interval-length relationship

B. Frank-Starling law of the heart

Types of supravalvular aortic stenosis include: A. Discrete fibromuscular stenosis B. Hourglass deformity C. Hypertrophic obstructive cardiomyopathy D. Tunnel aortic valve stenosis

B. Hourglass deformity

A patient with chronic systemic hypertension presents to the echocardiography laboratory. The following pulsed-wave Doppler data is acquired from the tips of the mitral valve leaflets: E:A ratio 1.2:1, deceleration time 210 msec, isovolumic relaxation time 83 msec, and pulmonary vein reversal 46cm/sec. The Doppler data indicates diastolic filling stage: A. I B. II C. III D. IV

B. II

The effect inspiration has on venous return to the right atrium is: A. Decrease B. Increase C. Depends on the depth of inspiration D. No effect

B. Increase

1. Possible secondary echocardiographic/Doppler findings in patients with severe chronic mitral regurgitation include all the following EXCEPT: A. Increased mitral valve E velocity B. Increased peak aortic valve velocity C. Increased right ventricular dimension D. Shortened time too peak velocity of the right ventricular outflow tract

B. Increased peak aortic valve velocity

Secondary findings associated with systemic hypertension include al the following EXCEPT: A. Increased left ventricular mass B. Increased right ventricular mass C. Left atrial enlargement D. Left ventricular hypertrophy

B. Increased right ventricular mass

The pulmonic valve leaflet most commonly recorded by M-mode is the: A. Anterior B. Left C. Septal D. Right

B. Left

Conditions that may lead to clinical symptoms that mimic those associated with rheumatic mitral valve stenosis include: A. Aortic insufficiency B. Left atrial myxoma C. Pericardial effusion D. Ventricular septal defect

B. Left atrial myxoma

131. Patients with mitral valve stenosis, left atrial enlargement, and atrial fibrillation are at increased risk for the development of: A. Left atrial myxoma B. Left atrial thrombus C. Left ventricular dilatation D. Left ventricular thrombus

B. Left atrial thrombus

. Electrical pacing of the right ventricle mimics the electrocardiographic and echocardiographic findings of: A. Complete atrioventricular block. B. Left bundle branch block. C. Right bundle branch block. D. Wolff-Parkinson-White syndrome.

B. Left bundle branch block.

The coronary artery that has a branch called the circumflex artery is the: A. Left anterior descending coronary artery B. Left coronary artery C. Posterior descending coronary artery D. Right coronary artery

B. Left coronary artery

The most common location for beginning the adult echocardiographic examination is: A. Apical B. Left parasternal C. Right parasternal D. Subcostal

B. Left parasternal

A two dimensional echocardiographic finding that may indicate significant chronic mitral regurgitation is: A. Fine diastolic oscillations of the mitral valve B. Left ventricular enlargement C. Left ventricular hypertrophy D. Premature closure of the mitral valve

B. Left ventricular enlargement

Electrocardiographic evidence associated with systemic hypertension includes: A. Left atrial enlargement B. Left ventricular hypertrophy C. Right atrial enlargement D. Right ventricular hypertrophy

B. Left ventricular hypertrophy

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

B. Left ventricular inflow tract obstruction

Persistent patent ductus arteriosus results in: A. Right ventricular volume overload B. Left ventricular volume overload C. Right ventricular pressure overload D. Left ventricular pressure overload

B. Left ventricular volume overload

A dumbbell-shaped configuration of the interatrial septum is associated with: A. Amyloidosis B. Lipomatous hypertrophy C. Sarcoidosis D. Sarcoma

B. Lipomatous hypertrophy

The three basic planes of a complete two-dimensional echocardiographic examination are: A. Long-axis, diagonal-axis, four-chamber B. Long-axis, short-axis, four-chamber C. Long-axis, short-axis, subcostal D. Long-axis, short-axis, two-chamber

B. Long-axis, short-axis, four-chamber

. Dilated coronary sinus has been associated with all the following EXCEPT: A. Coronary atrioventricular fistula with drainage into the coronary sinus B. MR C. Persistent left superior vena cava D. Right atrial hypertension

B. MR

The most common regurgitation found in patients with dilated cardiomyopathy is: A. Aortic insufficiency B. MR C. Pulmonary insufficiency D. Tricuspid regurgitation

B. MR

A connective tissue disorder associated with aortic aneurysm is: A. Ehlers-Danlos syndrome B. Marfan's syndrome C. Pseudoxanthoma elasticum D. Turner's syndrome

B. Marfan's syndrome

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

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

. 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

B. Maximum peak instantaneous gradient

Right coronary aortic valve leaflet prolapsed will most likely be seen in a patient with: A. Coarctation of the aorta B. Membranous ventricular septal defect C. Ostium primum atrial septal defect D. Patent ductus arteriosus

B. Membranous ventricular septal defect

The most common type of ventricular septal defect is: A. Inlet (posterior). B. Membranous. C. Outlet (supracristal). Trabecular

B. Membranous.

. 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

A common finding associated with a regurgitant murmur in the elderly is: A. Aortic valve stenosis B. Mitral annular calcification C. Mitral valve stenosis D. Mitral valve vegetation

B. Mitral annular calcification

1. Systolic bowing of the interatrial septum toward the right atrium may be an indication of: A. Atrial septal defect B. Mitral regurgitation C. Tricuspid regurgitation Tricuspid stenosis

B. Mitral regurgitation

1. Cardiac Doppler evidence of severe mitral regurgitation includes all the following EXCEPT: A. Darkly stained continuous-wave Doppler tracing B. Mitral valve E velocity <1.5 m/sec C. Pulmonary vein systolic flow reversal D. Regurgitant jet area >8.0 cm2

B. Mitral valve E velocity <1.5 m/sec

In patients with mitral regurgitation, cardiac catheterization measurements include all the following EXCEPT: A. Left ventricular systolic/diastolic pressure B. Mitral valve area C. Pulmonary artery pressures D. Pulmonary capillary wedge pressure

B. Mitral valve area

1. The cardiac valves listed in decreasing order as they are affected by rheumatic heart disease are: A. Aortic, pulmonic, tricuspid, and mitral B. Mitral, aortic, tricuspid, and pulmonic C. Pulmonic, aortic, tricuspid, and mitral D. Tricuspid, mitral, pulmonic, and aortic

B. Mitral, aortic, tricuspid, and pulmonic

Echocardiographic findings in the post -myocardial infarction patient include: A. Mitral annular calcification B. Mural thrombus C. Valvular Stenosis D. Ventricular septal aneurysm

B. Mural thrombus

Amplification of received signals is controlled by: A. Output power B. Overall gain C. Pulse power D. Transmit power

B. Overall gain

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

B. Overestimates recent myocardial infarction and underestimates old myocardial infarction

The gold-standard two-dimensional echocardiographic view for diagnosing mitral valve prolapsed is the: A. Apical four-chamber view B. Parasternal long-axis view C. Parasternal short-axis view of the mitral valve Subcostal four-chamber

B. Parasternal long-axis view

The two-dimensional view that may be used to directly visualize a patent ductus arteriosus is the: A. Parasternal long-axis view of the left ventricle B. Parasternal short-axis view at the base C. Apical five-chamber view D. Subcostal four-chamber view

B. Parasternal short-axis view at the base

The two-dimensional echocardiographic view that best visualizes the proximal segments of the coronary arteries is the: A. Parasternal long-axis view of the left ventricle B. Parasternal short-axis view of the aortic valve C. Parasternal short-axis view of the left ventricle of papillary muscles D. Subcostal four-chamber view

B. Parasternal short-axis view of the aortic valve

When attempting to determine whether an inlet ventricular septal defect from the apical four-chamber view is present, the echocardiographer should tilt the probe: A. Anteriorly B. Posteriorly C. Medially D. Laterally

B. Posteriorly

Al 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

B. Pressure half-time

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

B. Prinzmetal's

The geometric shape of the right ventricle is: A. Prolate ellipse B. Pyramid C. Rectangle D. Circle

B. Pyramid

The E-F slope of the M-mode of the anterior mitral valve leaflet reflects the: A. Opening rate of the anterior mitral valve leaflet B. Rate of diastolic filling of the left ventricle C. Rate of left atrial emptying during diastasis D. Rate of systolic filling of the left ventricle

B. Rate of diastolic filling of the left ventricle

The moderator band is found in the: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle

B. Right ventricle

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. Right ventricular pressure overload

B. Right ventricular volume overload.

A quantitative measure of left ventricular systolic wall thickening is: A. DT - ST ÷ DT B. ST - DT ÷ DT x 100 C. DT + ST D. DT + ST ÷ DT

B. ST - DT ÷ DT x 100

Structures of the mitral valve apparatus include all of the following EXCEPT: A. Mitral annulus B. Sinuses of Valsalva C. Left ventricular walls D. Papillary muscles

B. Sinuses of Valsalva

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

B. Stage I diastolic filling pattern

A maneuver that will increase venous return is: A. Supine to standing B. Standing to walking C. Valsalva maneuver Quiet expiration

B. Standing to walking

1. An accepted method for determining the severity of mitral regurgitation by continuous-wave Doppler is spectral: A. Length B. Strength C. Velocity D. Width

B. Strength

Persistent patent ductus arteriosus during a pulsed-wave doppler examination may be confused with all the following EXCEPT: A. Pulmonic insufficiency B. Tricuspid insufficiency C. Aortopulmonary window D. Anomalous origin of the left coronary artery from the pulmonary artery

B. Tricuspid insufficiency

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

B. dP/dt

. The etiology of aortic valve stenosis includes all the following EXCEPT: Bacterial Congenital Degenerative Rheumatic

Bacterial

Secondary causes of mitral valve prolapsed include all the following EXCEPT: Atrial septal defect Bicuspid aortic valve Cardiac tamponade Primary pulmonary hypertension

Bicuspid aortic valve

A prosthetic heart valve is associated with a relatively high rate of outlet strut fracture is: Bjork-Shiley Carpentier-Edwards Ionescu Shiley Starr-Edwards

Bjork-Shiley

All the following are porcine tissue prosthetic valves EXCEPT: Bjork-Shiley Carpentier-Edwards Hancock Intact

Bjork-Shiley

. 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

C. (EDD-ESD) ÷ EDD× 100

The following data is obtained in a patient with aortic valve stenosis, left ventricular outflow tract diameter is 2.0 cm, and aortic time velocity integral is 40 cm. The aortic valve area is: A. 0.3 cm^2 B. 0.75 cm^2 C. 0.9 cm^2 D. 3.14 cm^2

C. 0.9 cm^2

The smallest vegetation that transthoracic two-dimensional echocardiography can detect is: A. 1 mm B. 2 mm C. 3 mm D. 4 mm

C. 3 mm

The normal mitral valve area is: A. 1 to 3 cm2 B. 3 to 5 cm2 C. 4 to 6 cm2 D. 7 to 9 cm2

C. 4 to 6 cm2

The left atrial dimension can be measured in the apical four-chamber view from the mitral ring to the posterosuperior roof at end-systole. In normal subjects, the upper limit of normal is: A. 2.6± 0.6 cm B. 3.6± 0.6 cm C. 4.2± 0.6 cm D. 5.2± 0.6 cm

C. 4.2± 0.6 cm

The pressure drop between two chambers may be calculated by the formula: A. CSA ×TVI B. 220÷ pressure half-time C. 4×V2^2 D. Transmitted frequency -received frequency

C. 4×V2^2

1. The radius of a mitral regurgitation flow convergence hemisphere is 1.1 cm. The proximal isovelocity surface area (PISA) is: A. 1.21 cm2 B. 3.8 cm2 C. 7.6 cm2 D. 15.2 cm2

C. 7.6 cm2

Wall segments that are visualized in the parasternal short-axis view of the left ventricle at the level of the papillary muscles include all the following EXCEPT: A. Anterior septum B. Anterior wall C. Antero-inferior wall D. Antero-lateral wall

C. Antero-inferior wall

The regurgitant fraction (RF%) for aortic insufficiency may be calculated by the following pulsed-wave Doppler formula: A. Aortic RF%= mitral SV-aortic SV÷mitral SV B. Aortic RF%=aortic SV-tricuspid SV÷aortic SV C. Aortic RF%=aortic SV-mitral SV÷aortic SV D. RF% is solely a cardiac catheterization technique that cannot be duplicated in the echocardiography lab

C. Aortic RF%=aortic SV-mitral SV÷aortic SV

Valvular lesions with which coarctation of the aorta is strongly associated include: A. Aortic valve prolapsed B. Aortic valve regurgitation C. Bicuspid aortic valve D. Pulmonic valve stenosis

C. Bicuspid aortic valve

. Narrowing of the aorta at the aortic isthmus is: A. Aortic arch aneurysm B. Aortic dissection C. Coarctation of the aorta D. Persistent patent ductus arteriosus

C. Coarctation of the aorta

The method that would best allow visualization of shunt flow across an atrial septal defect is: A. M-mode echocardiography B. Two-dimensional echocardiography C. Contrast echocardiography D. Stress echocardiography

C. Contrast echocardiography

The difference between the transmitted and the reflected frequency is known as the: A. Bernoulli equation B. Doppler principle C. Doppler shift D. Gorlin equation

C. Doppler shift

1. Possible presenting symptoms of significant chronic mitral regurgitation include: A. Angina pectoris B. Ascites C. Fatigue D. Syncope

C. Fatigue

1. M-mode findings associated with significant chronic mitral regurgitation include all the following EXCEPT: A. Left atrial enlargement B. Left ventricular enlargement C. Fine diastolic flutter of the mitral valve D. Flying W of the pulmonic valve

C. Fine diastolic flutter of the mitral valve

The hump or break occasionally seen on the M-mode of the mitral valve between the E and F points is designated: A. B notch B. f wave C. Fo D. h wave

C. Fo

The boundaries of the functional left ventricular outflow tract are best described as extending from the: A. Anterior aortic valve annulus to the posterior aortic valve annulus B. Anteromedial position of the tricuspid valve annulus to the pulmonic valve annulus C. Free edge of the anterior mitral valve leaflet to the aortic valve annulus D. Tips of the left ventricular papillary muscles to the edge of the anterior mitral valve leaflet

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

Wall segments and structures that may be visualized in the apical two-chamber view include all of the following EXCEPT: A. Anterior wall of the left ventricle B. Coronary sinus C. Free wall of the right ventricle D. Inferior wall of the left ventricle

C. Free wall of the right ventricle

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

C. Ground-glass appearance

1. The effects of chronic mitral regurgitation on interventricular septal motion include: A. Akinesis B. Dyskinesis C. Hyperkinesis D. Paradoxical motion

C. Hyperkinesis

The normal response of non-infarcted myocardium in a patient with acute myocardial infarction is: A. Akinesis B. Dyskinesis C. Hyperkinesis D. Hypokinesis

C. Hyperkinesis

A more appropriate name for idiopathic hypertrophic subaortic stenosis (IHSS) is: A. Aortic tunnel disease (ATD) B. Discrete subaortic valve stenosis (DSS) C. Hypertrophic Cardiomyopathy (HCM) Subaortic hourglass deformity (SHD

C. Hypertrophic Cardiomyopathy (HCM)

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

C. Implies elevated pulmonary pressure

. A common mitral valve finding of dilated cardiomyopathy in two-dimensional echocardiography is: A. Decreased E septal separation B. Reverse diastolic doming C. Incomplete closure of the mitral valve D. Premature closure of the mitral valve

C. Incomplete closure of the mitral valve

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 Unaffected

C. Increased

Characteristics signs of decreased stroke volume on M-mode include all the following EXCEPT: A. Decreased D-E excursion of the mitral valve B. Gradual closure of the aortic valve during systole C. Increased "a" dip of the pulmonic valve Increased mitral valve E-point septal separation

C. Increased "a" dip of the pulmonic valve

. Possible echocardiographic findings for patients with right bundle branch block include: A. Decreased interval between tricuspid valve closure and pulmonic valve opening. B. Early, systolic bouncing of the interventricular septum. C. Increased interval between mitral and tricuspid valve closure. D. Systolic paradoxical septal motion.

C. Increased interval between mitral and tricuspid valve closure.

Possible complications of chronic mitral regurgitation include all the following EXCEPT: A. Atrial fibrillation B. Congestive heart failure C. Increased risk of sudden death D. Pulmonary hypertension

C. Increased risk of sudden death

The type of infarction that most often involves the right ventricle is: A. Anterior B. Antero-postero C. Inferior D. Lateral

C. Inferior

A maneuver that results in an acute increase in blood pressure is: A. Inhalation of amyl nitrate B. Supine to standing C. Isometric handgrip D. Inspiration

C. Isometric handgrip

The point at which the descending aorta and the aortic arch join is called the aortic: A. Bifurcation B. Bulb C. Isthmus D. Sinus

C. Isthmus

. Common two-dimensional echocardiographic findings in hypertrophic obstructive cardiomyopathy include all the following EXCEPT: A. Endocardial flattening of the interventricular septum B. Left atrial enlargement C. Left ventricular enlargement D. Thickening of the anterior mitral valve leaflet

C. Left ventricular enlargement

A common electrocardiographic finding in patients with hypertrophic obstructive cardiomyopathy is: A. Depressed ST segments B. Elevated ST segments C. Left ventricular hypertrophy D. Right ventricular hypertrophy

C. Left ventricular hypertrophy

Expected echocardiographic findings in patients with Ebstein's anomaly include all the following EXCEPT: A. Abnormal apical insertion of the tricuspid valve B. Atrial septal defect C. Left ventricular volume overload D. Right ventricular volume overload

C. Left ventricular volume overload

1. A cardiac catherization technique used to determine the severity of mitral regurgitation is: A. Cardiac fluoroscopy B. Coronary arteriography C. Left ventriculography D. Supravalvular angiography

C. Left ventriculography

Stress echocardiography methods may be used to detect stunned or hibernating myocardium include: A. Cold pressure B. Handgrip C. Low-dose dobutamine D. Treadmill

C. Low-dose dobutamine

1. The peak mitral regurgitant velocity reflects the: A. Direction of the regurgitant jet B. Etiology of the mitral regurgitation C. Maximum pressure difference between the left atrium and the left ventricle D. Severity of the mitral regurgitation

C. Maximum pressure difference between the left atrium and the left ventricle

The thickest layer of an arterial wall is the tunica: A. Adventitia B. Intima C. Media D. Vasorum

C. Media

When attempting to determine the presence of a peri-membranous ventricular septal defect in the parasternal long-axis view, the echocardiographer should tilt the probe: A. Anteriorly B. Posteriorly C. Medially D. Laterally

C. Medially

A hallmark M-mode aortic valve finding in patients with hyper trophic obstructive cardiomyopathy is aortic valve: A. Diastolic flutter B. Fenestration C. Mid-systolic notching D. Vegetation

C. Mid-systolic notching

M-mode findings associated with hypertrophic cardiomyopathy include all the following EXCEPT: A. Asymmetric septal hypertrophy B. Mid-systolic notching of the aortic valve C. Mid-systolic notching of the pulmonary valve D. Systolic anterior motion of the mitral valve

C. Mid-systolic notching of the pulmonary valve

Common cardiac Doppler findings in Ebstein's anomaly include all the following EXCEPT: A. Atrial septal defect with right -to-left shunting. B. Functional right ventricular outflow tract obstruction. C. Mitral regurgitation. D. Tricuspid regurgitation.

C. Mitral regurgitation.

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

C. Mitral valve prolapsed

Two-dimensional echocardiographic examination reveals thin mobile mitral valve leaflet tips and a Doppler E velocity of 1.8 m/sec with a pressure half-time of 180 msec. The most likely diagnosis is: A. Abnormal relaxation of the left ventricle B. Aortic insufficiency C. Moderate to severe mitral annular calcification D. Rheumatic mitral stenosis

C. Moderate to severe mitral annular calcification

The most common primary benign cardiac neoplasm is: A. Fibroma B. Lipoma C. Myxoma D. Papilloma

C. Myxoma

All of the following are names for pulmonic valve leaflets EXCEPT: A. Anterior B. Left C. Non-coronary D. Posterior

C. Non-coronary

Functional classifications of cardiomyopathy include all the following EXCEPT: A. Dilated (congestive) B. Hypertrophic C. Non-dilated D. Restrictive

C. Non-dilated

A potential space behind the left atrium where pericardial effusion could accumulate is the: A. Sinus of Valsalva B. Pleural potential space C. Oblique sinus D.Coronary sinus

C. Oblique sinus

The most common type of atrial septal defect is: A. Coronary sinus. B. Ostium primum C. Ostium secundum D. Sinus venosus.

C. Ostium secundum

1. The Doppler finding of mitral valve regurgitation in coronary artery disease is most likely due to: A. Flail mitral valve B. Mitral valve prolapsed C. Papillary muscle dysfunction D. Subaortic stenosis

C. Papillary muscle dysfunction

An unexpected postoperative finding with atrial septal defect repair is: A. Atrial septal aneurysm B. Mitral valve prolapsed C. Paradoxical interventricular septal motion D. Right ventricular volume overload pattern

C. Paradoxical interventricular septal motion

The best two-dimensional view for determining mitral valve area is the: A. Apical four-chamber view B. Parasternal long-axis view C. Parasternal short-axis view D. Subcostal four-chamber view

C. Parasternal short-axis view

The two-dimensional echocardiographic views used to determine whether truncus arteriosus is present are the parasternal long-axis view and the: A. Apical five-chamber view B. Parasternal right ventricular inflow tract view C. Parasternal short-axis view of the aortic valve D. Parasternal short-axis view of the left ventricle

C. Parasternal short-axis view of the aortic valve

Another name that identifies Uhl's anomaly is: A. Barlow's syndrome B. Ebstein's anomaly C. Parchment heart D. Right ventricular aplasia

C. Parchment heart

. The type of ventricular septal defect most often associated with ventricular septal aneurysm is: A. Inlet B. Outlet. C. Peri-membranous. D. Trabecular.

C. Peri-membranous.

Types of atrial septal defect include all the following EXCEPT: A. Ostium primum. B. Ostium secundum. C. Peri-membranous. D. Sinus venosus.

C. Peri-membranous.

. Common echocardiographic/Doppler findings in systemic lupus erythematosus include: A. Aortic dissection B. Granular appearance of the myocardium C. Pericarditis D. Valvular aortic stenosis

C. Pericarditis

The time (in milliseconds) for the pressure difference across a valve to fall to one-half of the initial peak pressure difference is known as the: A. Acceleration half-time B. Deceleration half-time C. Pressure half-time D. Velocity half-time

C. Pressure half-time

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

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

Signs and symptoms of mitral valve stenosis secondary to rheumatic heart disease include: A. Angina pectoris B. Cyanosis C. Pulmonary Hypertension D. Vertigo

C. Pulmonary Hypertension

1. Possible complications of acute, severe mitral regurgitation include: A. Syncope B. Hemoptysis C. Pulmonary edema D. Systemic embolization

C. Pulmonary edema

Complications of a right atrial clot include: A. Interatrial septal aneurysm B. Patent foramen ovale C. Pulmonary embolism Systemic embolism

C. Pulmonary embolism

. Possible echocardiographic findings for pulmonary hypertension include all the following EXCEPT: A. Right atrial enlargement B. Right ventricular enlargement C. Pulmonary vein enlargement D. Tricuspid regurgitation

C. Pulmonary vein enlargement

Two-dimensional echocardiographic findings for rheumatic mitral stenosis include all the following EXCEPT: A. Hockey -stick appearance of the anterior mitral valve leaflet B. Increased left atrial dimension C. Reverse doming of the anterior mitral valve leaflet D. Thickened mitral valve leaflets and subvalvular apparatus

C. Reverse doming of the anterior mitral valve leaflet

The most common primary benign cardiac tumor found in children is: A. Myxoma B. Papilloma C. Rhabdomyoma D. Rhabdomyosarcoma

C. Rhabdomyoma

1. The most common etiology of mitral valve stenosis is: A. Congenital B. Left atrial myxoma C. Rheumatic fever D. Severe mitral annular calcification

C. Rheumatic fever

A 23-year-old woman complaining of dyspnea presents to the cardiologist. Upon examination, a diastolic rumble and opening snap are heard. The patient remembers having rheumatic fever at the age of 10. Her electrocardiogram demonstrated left atrial enlargement and right ventricular hypertrophy. The diagnosis is: A. Aortic valve stenosis B. Mitral regurgitation C. Rheumatic mitral valve stenosis D. Valvular pulmonic valve stenosis

C. Rheumatic mitral valve stenosis

1. Possible electrocardiographic findings for patients with significant mitral regurgitation include all the following EXCEPT: A. Left atrial enlargement B. Left ventricular hypertrophy C. Right atrial enlargement D. Right ventricular hypertrophy

C. Right atrial enlargement

The correct order for the branches of the aortic arch is: A. Left subclavian, right subclavian, left common carotid B. Right brachiocephalic, left brachiocephalic, left common carotid C. Right brachiocephalic, left common carotid, left subclavian D. Sinus of Valsalva, right innominate, left innominate

C. Right brachiocephalic, left common carotid, left subclavian

The most common location for a pericardial cyst is the: A. Hilium B. Left costophrenic angle C. Right costophrenic angle D. Superior mediastinum

C. Right costophrenic angle

The two-dimensional echocardiographic finding in acute pulmonary embolism is: A. Left ventricular dilatation B. Left ventricular hypertrophy C. Right ventricular dilatation D. Right ventricular hypertrophy

C. Right ventricular dilatation

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

C. Right ventricular hypertrophy

The Doppler finding used to calculate mean pulmonary artery pressure is: A. Mitral regurgitation B. Pulmonary insufficiency C. Right ventricular outflow tract acceleration time D. Tricuspid regurgitation

C. Right ventricular outflow tract acceleration time

Important factors in evaluating post-surgical repair of tetralogy of Fallot include all the following EXCEPT: A. Evaluate right and left ventricular function B. Rule out residual pulmonic valve stenosis C. Rule out residual shunting at the margins of the atrial septal defect repair D. Rule out residual shunting at the margins of the ventricular septal defect repair

C. Rule out residual shunting at the margins of the atrial septal defect repair

1. The effect significant mitral regurgitation has on the pulsed-wave Doppler tracing of the pulmonary veins may be described as: A. S wave increases, D wave decreases B. S wave increases, D wave increases C. S wave decreases, D wave increases D. Unaffected

C. S wave decreases, D wave increases

1. A heart sound associated with significant chronic pure mitral regurgitation is: A. Loud S1 B. Fixed split S2 C. S3 D. S4

C. S3

Diastolic mitral regurgitation is associated with: A. Flail mitral valve B. Mitral valve prolapse C. Severe aortic insufficiency D. Severe tricuspid regurgitation

C. Severe aortic insufficiency

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

C. Smaller

. The characteristics shape of the left ventricular in patients with dilated cardiomyopathy is: A. Elongated B. Rectangular C. Spherical D. Triangular

C. Spherical

A maneuver that will increase venous return is: A. Expiration B. Squatting to standing C. Straight leg raising D. Supine to standing

C. Straight leg raising

. A common late complication associated with dilated cardiomyopathy is: A. Infective endocarditis B. MR C. Systemic emboli D. Ventricular gallops

C. Systemic emboli

A bright horizontal echo that gives the edge of an atrial or ventricular septal defect a broadened appearance is referred to as the: A. A sign B. Fo sign C. T sign D. W sign

C. T sign

All the following statements concerning metastases of cardiac tumors are true EXCEPT: A. Metastases are 10 to 40 times more likely than primary lesions B. The most common metastatic tumor is a direct extension of lung and breast cancer C. The most common metastatic tumor is myxoma D. Renal cell carcinoma may present as a right atrial mass by direct extension up the inferior vena cava .

C. The most common metastatic tumor is myxoma

A method used to compensate for the attenuation of signals as a function of time/depth along the ultrasound beam is: A. Overall gain B. Pulse power C. Time gain compensation D. Transmit power

C. Time gain compensation

The imaginary boundaries that define the mid-left ventricle are the: A. Mitral annulus to the tip of the papillary muscles B. Base of the papillary muscles to the cardiac apex C. Tip of the papillary muscles to the base of the papillary muscles Aortic annulus to the edge of the mitral valve

C. Tip of the papillary muscles to the base of the papillary muscles

The echocardiographic examination that would be the first choice to delineate a suspected left atrial clot is: A. Stress echocardiogram B. Intracardiac echocardiogram C. Transesophageal echocardiogram D. Transthoracic echocardiogram

C. Transesophageal echocardiogram

A maneuver that increases the obstruction in patients with hypertrophic obstructive cardiomyopathy is: A. Leg raising B. Standing to supine C. Valsalva D. Inspiration

C. Valsalva

. 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

C. Velocity at the site of stenosis

The cardiac chambers in which rhabdomyomas are most often visualized are the: A. Atria. B. Great vessels. C. Ventricles. D. Atria, great vessels, and ventricles equally.

C. Ventricles.

The formula used to determine mitral valve area in the cardiac catheterization laboratory is: CO ÷ BSA CO ÷ MPG CO ÷ DFP ÷ 38 x √MPG CO ÷SEP ÷44.3 x √MPG

CO ÷ DFP ÷ 38 x √MPG

Possible causes of ruptured chordae tendineae of the mitral valve include all the following EXCEPT: Carcinoid heart disease Infective endocarditis Mitral valve prolapsed Trauma

Carcinoid heart disease

Tricuspid valve leaflets that are in a fixed semi-open position with diffuse thickening are found in: Carcinoid heart disease Cardiac amyloidosis Cardiac hemochromatosis Cardiac sarcoidosis

Carcinoid heart disease

A regurgitant jet area <1.0 cm2 is noted in a prosthetic aortic valve. This can be explained by: Ball variance Closing volume Disc embolization Disc occlusion

Closing volume

On M-mode echocardiography, the effect of infundibular pulmonic stenosis on the pulmonic valve is: Absent "a" dip Coarse systolic flutter Deep "a" dip Shallow "a" dip

Coarse systolic flutter

The severity of aortic insufficiency may best be determined with color flow Doppler by the following method: Measuring the aortic insufficiency jet aliasing area in the parasternal long-axis view Comparing the aortic insufficiency jet height with the left ventricular outflow tract height Measuring the aortic insufficiency jet maximal height Noting the temporal pattern of color variance

Comparing the aortic insufficiency jet height with the left ventricular outflow tract height

The most common etiology of pulmonic valve stenosis is: Carcinoid Congenital Infective endocarditis Rheumatic

Congenital

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

Congenital

The square root is commonly found in: Aortic valve stenosis Constrictive pericarditis Pericardial effusion Pulmonary hypertension

Constrictive pericarditis

The following data is obtained: left ventricular outflow tract diameter is 2.2 cm, left ventricular outflow tract maximum instantaneous aortic velocity is 6m/sec. The aortic valve area is: A. 0.4 cm^2 B. 0.75cm^2 C. 0.68 cm D. 0.69 cm^2

D. 0.69 cm^2

In patient with aortic valve stenosis, the continuous-wave Doppler recordings demonstrate a maximum systolic velocity across the aortic valve of 5 m/sec. The maximum peak instantaneous pressure gradient is: A. 5 mmHg B. 25 mmHg C. 50 mmHg D. 100 mmHg

D. 100 mmHg

A maximum velocity of 2 m/sec is obtained in a patient with rheumatic mitral valve stenosis: A. 2 mmHg B. 4 mmHg C. 8 mmHg D. 16 mmHg

D. 16 mmHg

The upper limit of normal for the aortic root diameter in adults as measured by M-mode echocardiography ranges from: A. 1.3 to 2.4 cm B. 2.2 to 2.5 cm C. 25 to 32 mm D. 33 to 37 mm

D. 33 to 37 mm

The top normal left ventricular internal dimension at end diastole in an adult by M-mode is: A. 16 mm B. 26 mm C. 36 mm D. 56 mm

D. 56 mm

The following two-dimensional and cardiac Doppler information is gathered: the mitral annulus diameter is 4.5 cm, the aortic annulus is 2.0 cm, the mitral time velocity integral is 20 c, and the aortic time velocity integral is 17 cm. The mitral regurgitant fraction is: A. 26.5% B. 31.8% C. 53% D. 83%

D. 83%

The aortic valve area considered critical aortic valve stenosis is: A. < 3 cm2 B. < 2 cm2 C. < 1 cm2 D. < 0.75 cm2

D. < 0.75 cm2

The formula used to estimate left ventricular end-diastolic pressure (LVEDP) from the continuous-wave Doppler recording of aortic insufficiency is LVEDP is equal to: A. BPs - Vmax AI B. BPd - Vmax AI C. BPd - 4× EDV AI D. BPd - 4× EDV AI^2

D. BPd - 4× EDV AI^2

A complete atrioventricular canal defect is ostium primum atrial septal defect with: A. Coarctation B. Cleft mitral valve, coarctation of the aorta C. Canal-type ventricular septal defect, patent ductus arteriosus D. Canal-type ventricular septal defect, common atrioventricular valve

D. Canal-type ventricular septal defect, common atrioventricular valve

The four defects that make up tetralogy of Fallot are pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and: A. Atrial septal defect B. Cleft mitral valve C. Coarctation of the aorta D. Deviation of the aorta

D. Deviation of the aorta

All the following events are considered to occur in late diastole EXCEPT: A. A-dip of the pulmonic valve leaflet on M-mode B. A-point of the anterior mitral valve leaflet on M-mode C. A-point of the mitral valve Doppler waveform D. E-point of the anterior mitral valve leaflet on M-mode

D. E-point of the anterior mitral valve leaflet on M-mode

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

D. EDV-ESV ÷ EVD x 100

The percentage of blood pumped out of the heart per beat is called: A. Stroke volume B. Cardiac output C. Cardiac index D. Ejection fraction

D. Ejection fraction

A fusiform aneurysm is an aneurysm that involves the: A. One point of the aorta at which there is an expansion of a pouch with a relatively small neck B. Descending aorta only C. Entire aorta from the aortic root to the ligamentum arteriosum D. Entire circumference of the aorta

D. Entire circumference of the aorta

. A speckled or ground-glass appearance of the ventricular septum seen two-dimensional echocardiography is found in: A. Constrictive Pericarditis B. Coronary artery disease C. Dilated cardiomyopathy D. Hypertrophic cardiomyopathy

D. Hypertrophic cardiomyopathy

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

D. Hypokinetic

The most common cause of primary dilated cardiomyopathy is: A. Adriamycin toxicity B. CAD C. Hemochromatosis D. Idiopathic

D. Idiopathic

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

D. Increase

Echocardiographic findings in dilated cardiomyopathy include all the following EXCEPT: A. Apical mural thrombus B. Dilated ventricular cavities C. Enlarged atrial cavities D. Increased mitral valve leaflet excursion

D. Increased mitral valve leaflet excursion

Failed fusion of the superior and inferior endocardial cushions is associated with all of the following EXCEPT: A. Partial atrioventricular canal defect B. Complete atrioventricular canal defect C. Isolated inlet ventricular septal defect D. Isolated supracristal ventricular septal defect

D. Isolated supracristal ventricular septal defect

1. Flail mitral valve can be differentiated from severe mitral valve prolapsed on two-dimensional echocardiography because flail mitral valve leaflet demonstrates: A. A thicker mitral valve B. Chronic mitral regurgitation C. Leaflet tips that point toward the left ventricle D. Leaflet tips that point toward the left atrium

D. Leaflet tips that point toward the left atrium

Normal pressure values in millimeters of mercury for the listed cardiac chambers or great vessels include all the following EXCEPT: A. Right atrial pressure: 0 to 5 mean B. Right ventricle: 25 systolic, 0 to 5 diastolic C. Pulmonary artery: 25 systolic, 10 to 15 diastolic D. Left ventricle: 120 systolic, 80 diastolic

D. Left ventricle: 120 systolic, 80 diastolic

The parasternal long-axis view allows identification of all the following wall segments EXCEPT: A. Basal and mid-interventricular septum B. Basal and mid-posterior wall of the left ventricle C. Infero-lateral wall of the left ventricle D. Left ventricular apex.

D. Left ventricular apex.

Fibrin within a pericardial effusion most likely indicates: A. Cardiac tamponade B. Constrictive pericarditis C. Infective endocarditis D. Long-standing pericardial effusion

D. Long-standing pericardial effusion

. A possible etiology for aortic aneurysm is: A. Aortic insufficiency B. Coronary artery disease C. Dilated cardiomyopathy D. Marfan's syndrome

D. Marfan's syndrome

1. Chronic mitral regurgitation results in all the following EXCEPT: A. Left atrial enlargement B. Left ventricular enlargement C. Left ventricular volume overload pattern D. Mitral annular calcification

D. Mitral annular calcification

. The cardiovascular abnormalities seen in patients with Marfan's syndrome include all the following EXCEPT: A. Aortic dissection B. Dilatation of the aortic root C. Mitral valve prolapsed D. Myocardial ischemia

D. Myocardial ischemia

A right ventricle volume overload pattern is associated with all the following echocardiographic findings EXCEPT: A. Abnormal interventricular septal motion B. Dilatation of the right ventricle C. Pancaking of the interventricular septum during ventricular diastole D. Pancaking of the interventricular septum during ventricular systole

D. Pancaking of the interventricular septum during ventricular systole

A primary benign cardiac tumor that is found most often on the endocardial surface of the atrioventricular valves or valvular endocardium is: A. Fibroma B. Lipoma C. Myxoma D. Papilloma

D. Papilloma

The most of the interventricular septum in pulmonary hypertension is: A. Akinetic B. Hyperkinetic C. Hypokinetic D. Paradoxical

D. Paradoxical

. In patients with pericardial effusion, an echo-free space will be seen between the epicardium and the: A. Endocardium B. Fibrous pericardium C. Myocardium D. Parietal Serous Pericardium

D. Parietal Serous Pericardium

A thrombus shape that is associated with embolization is: A. Spherical B. Flat C. Eccentric D. Pedunculated

D. Pedunculated

The most accurate method for determining the severity of mitral valve stenosis is: A. Determining the maximum velocity across the mitral valve by pulsed-wave Doppler B. Measuring the E-F slope of the anterior mitral valve leaflet by M-mode C. Measuring the thickness of the mitral valve leaflets D. Performing planimetry of the mitral valve orifice by two-dimensional echocardiography

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

The most effective treatment for cardiac tamponade is: A. Aspirin B. Bed rest C. Pericardiectomy D. Pericardiocentesis

D. Pericardiocentesis

Air in the pericardial sac is known as: A. Cardiac tamponade B. Effusive-constrictive pericardium C. Hemopericardium D. Pneumopericardium

D. Pneumopericardium

. Possible echocardiographic findings in sarcoid heart disease include: A. Asymmetric septal hypertrophy B. Concentric left ventricular hypertrophy C. Dilatation of the ascending aorta D. Posterobasal aneurism

D. Posterobasal aneurism

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: A. Equiphasic B. Phasic C. Predominantly diastolic D. Predominantly systolic

D. Predominantly systolic

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

D. Propranolol

A saline contrast injection to rule out atrial septal defect is performed. Contrast appears in the left atrium 4 to 8 cycles after the appearance of contrast in the right atrium. The best explanation is: A. Left-to-right atrial septal defect shunt B. Right-to-left atrial septal defect shunt C. Left ventricle-to-right atrium shunt D. Pulmonary arteriovenous fistula

D. Pulmonary arteriovenous fistula

Possible etiologies for mitral regurgitation include all the following EXCEPT: A. Mitral annulus calcification B. Mitral valve endocarditis C. Papillary muscle dysfunction D. Pulmonary hypertension

D. Pulmonary hypertension

. Pulsed-wave and color flow Doppler are useful in hypertrophic obstructive cardiomyopathy in all the following ways EXCEPT: A. Aid in guiding the continuous- wave Doppler beam B. Determine the presence and severity and severity of mitral regurgitation C. Help distinguish left ventricular outflow tract flow from mitral regurgitation D. Quantitate the severity of the left ventricular outflow tract obstruction

D. Quantitate the severity of the left ventricular outflow tract obstruction

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. Re-perfused viable myocardium that is not functioning

D. Re-perfused viable myocardium that is not functioning

The Doppler hemodynamic parameters that should be evaluated for 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

D. Regurgitant fraction

The control that selects the minimum signal amplitude to be displayed is: A. Depth B. Far gain C. Output power D. Reject

D. Reject

The useful artifact associated with lodging of a bullet within the heart is: A. Enhancement B. Mirroring C. Shadowing D. Reverberation

D. Reverberation

Pericardial tumors include all the following EXCEPT: A. Angiosarcoma. B. Lipoma. C. Mesothelioma. D. Rhabdomyosarcoma.

D. Rhabdomyosarcoma.

The valvular disease with which atrial fibrillation is most commonly associated is: A. Acute aortic insufficiency B. Aortic valve stenosis C. Mitral valve prolapse D. Rheumatic mitral valve stenosis

D. Rheumatic mitral valve stenosis

Defects that are associated with tetralogy of Fallot in about 25% of cases include: A. Bicuspid aortic valve B. Overriding pulmonary artery C. Parachute tricuspid valve D. Right aortic arch

D. Right aortic arch

The three branches that normally originate from the aortic arch include all the following EXCEPT: A. Brachiocephalic artery B. Left common carotid artery C. Left subclavian artery D. Right subclavian artery

D. Right subclavian artery

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

. A left atrial dimension of 68 mm is obtained by M-mode echocardiography. This measurement is best described as: A. Normal B. Mildly dilated C. Moderately dilated D. Severely dilated

D. Severely dilated

Possible echocardiographic findings in patients with Wolff-Parkinson-White type B syndrome include a(n): A. Brief anterior displacement of the left ventricular wall. B. Brief posterior displacement of the right ventricular wall. C. increase in the interval between mitral valve closure and pulmonic valve opening. D. Sharp, brief, systolic downward posterior dip of the interventricular septum.

D. Sharp, brief, systolic downward posterior dip of the interventricular septum.

Congenital heart diseases that are ductal-dependent include all the following EXCEPT: A. Aortic atresia B. Interrupted aortic arch C. Pulmonary atresia D. Sinus venosus atrial septal defect

D. Sinus venosus atrial septal defect

A pressure overload of the right ventricle may produce all the following echocardiographic findings EXCEPT: A. D-shaped left ventricle B. Right ventricular dilatation C. Right ventricular hypertrophy D. Small, protected right ventricle

D. Small, protected right ventricle

Maneuvers that will increase the duration and severity of mitral valve prolapsed include all of the following EXCEPT: A. Inhalation of amyl nitrate B. Valsalva maneuver C. Supine to standing D. Squatting

D. Squatting

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

D. Stage III diastolic filling pattern

The view of choice when examining a patient with secundum atrial septal defect is: A. Apical four chamber B. Parasternal long axis C. Parasternal short axis view of the aortic valve D. Subcostal four chamber

D. Subcostal four chamber

The two-dimensional echocardiographic view that permits examination of the aortic arch is: A. Parasternal long axis B. Apical two chamber C. Subcostal four chamber D. Suprasternal long axis

D. Suprasternal long axis

The two-dimensional echocardiographic view that is the best approach for ruling out coarctation of the aorta is: A. Parasternal long-axis view B. Parasternal short-axis view of the aortic valve C. Subcostal five-chamber view D. Suprasternal long-axis view of the aortic arch

D. Suprasternal long-axis view of the aortic arch

The mitral valve finding most strongly associated with hypertrophic obstructive cardiomyopathy is mitral valve: A. Aneurism B. Fenestration C. Flail leaflet D. Systolic anterior motion

D. Systolic anterior motion

Auscultatory findings for mitral valve stenosis include all the following EXCEPT: A.Diastolic rumble at the apex B.Loud first heart sound C.Opening snap D. Systolic ejection murmur heard at the base

D. Systolic ejection murmur heard at the base

. Right ventricular systolic pressure may be calculated when the following condition is present: A. Aortic insufficiency B. MR C. Pulmonary insufficiency D. TR

D. TR

The method used most often for calculating ejection fraction by M-mode echocardiography is: A. Ellipsoid biplane method B. Simpson's method of discs C. Single-plane area-length method D. Teicholtz regression

D. Teicholtz regression

The landmarks used to identify the anatomic and functional right ventricular outflow tract are the: A. Anterior mitral valve leaflet to the left edge of the interventricular septum B. Aortic valve annulus to the tricuspid valve annulus C. Tricuspid valve annulus to the aortic valve annulus D. Tricuspid valve annulus to the pulmonary valve annulus

D. Tricuspid valve annulus to the pulmonary valve annulus

The anomaly characterized by a single great vessel arising from the base of the hear t is called: A. L-transposition of the great arteries B. Pulmonary atresia C. Tetralogy of Fallot D. Truncus arteriosus

D. Truncus arteriosus

The expected conventional 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

A maneuver that results in a decrease in venous return is: A. Inspiration B. Squatting C. Straight leg raising D. Valsalva

D. Valsalva

The recommended maneuver to use when performing a transesophageal contrast examination in a patient with a possible patent foramen ovale is: A. Inhalation of amyl nitrate B. Squatting C. Supine to standing D. Valsalva maneuver

D. Valsalva maneuver

Likely complications of cardiac metastatic tumors include all the following EXCEPT: A. Congestive heart failure due to myocardial infiltration. B. Embolization of parts or pieces of the tumor. C. Pericardial effusion/tamponade. D. Valvular fenestration.

D. Valvular fenestration.

All the following are considered pulmonary vessels EXCEPT: A. Main pulmonary artery B. Pulmonary capillaries C. Pulmonary veins D. Vena cava

D. Vena cava

Hibernating myocardium is: A. Myocardium that is hyperkinetic post-myocardial infarction B. Re-perfused 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

D. Viable myocardium that is nonfunctioning because of chronic ischemia

Tardokinesis is a delay in: A. Left ventricular filling B. Right ventricular filling C. Valve opening D. Wall motion

D. Wall motion

Echocardiography differentiates a pseudo aneurysm from a true ventricular aneurysm by the: A. Diastolic motion of the aneurysm B. Length of the aneurysm C. Width of the border of the aneurysm D. Width of the neck of the aneurysm

D. Width of the neck of the aneurysm

With M-mode echocardiography, asymmetric septal hypertrophy is present when the interventricular septum to posterior wall ratio is: A. greater than or equal to 0:1 B. greater than or equal to 1:1 C. greater than or equal to 1.2:1 D. greater than or equal to 1.3:1

D. greater than or equal to 1.3:1

In standard imaging (M-mode and two-dimensional echocardiography), the control that determines the amount of electrical energy transmitted to the transducer from the pulser is: A. Overall gain B. Radiofrequency gain C. Time gain compensation D.Transmit power

D.Transmit power

The characteristic M-mode pulmonic valve leaflet pattern in pulmonic valve stenosis is: Absent "a" dip Deep "a" dip Reversed "a" dip Shallow "a" dip

Deep "a" dip

Abnormal rocking motion of a prosthetic valve by two-dimensional echocardiography indicates prosthetic valve: Dehiscence Stenosis Thrombus Vegetation

Dehiscence

The characteristic feature of the murmur of aortic insufficiency is a: Diastolic decrescendo blowing murmur heard best along the left sterna border Diastolic crescendo-decrescendo murmur heard best along the left upper sterna border Diastolic rumble following an opening snap Harsh systolic ejection murmur heard best at the right upper sterna border

Diastolic decrescendo blowing murmur heard best along the left sterna border

The characteristic M-mode findings for aortic valve stenosis include all the following EXCEPT: A lack of systolic flutter of the aortic valve leaflets Diastolic flutter of the aortic valve leaflets Reduced leaflet separation in systole Thickening of the aortic valve leaflets

Diastolic flutter of the aortic valve leaflets

Cardiac catheterization findings in constrictive pericarditis include: Absent "a" wave Dip-and-plateau waveform Increased "v" wave Increased peak-to-peak pressure gradient

Dip-and-plateau waveform

Complications associated with infective endocarditis that may be indications for surgery include all the following EXCEPT: Congestive heart failure Dyspnea Myocardial or annular abscess Recurrent systemic emboli

Dyspnea

The essential two-dimensional echocardiographic finding of valve ring abscess secondary to infective endocarditis may be best described as: Echolucent Hyperechoic Pedunculated Sessile

Echolucent

In acute pericarditis, a possible electrocardiographic finding in most if not all leads is: Depressed ST segments Elevated ST segments Increased QRS voltage Pathologic Q waves

Elevated ST segments

The M-mode measurements that have been proposed as an indicator for aortic valve replacement in patients with chronic severe aortic insufficiency are left ventricular: End-diastolic dimension ≥ 55 mm and fractional shortening of ≤25% End-diastolic dimension ≤ 55 mm and fractional shortening of ≥ 25% End-diastolic dimension ≥70 mm and left atrial dimension ≥ 55 mm End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%

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

Septal motion in significant aortic insufficiency often demonstrates: Anterior motion during systole Exaggerated early diastolic dip Normal motion Thinning with dyskinesis during systole

Exaggerated early diastolic dip

The most common symptom of infective endocarditis is: Chest pain Dyspnea Fever Orthopnea

Fever

The hallmark M-mode finding for aortic insufficiency is: Coarse diastolic flutter of the anterior mitral valve leaflet Fine diastolic flutter of the anterior mitral valve leaflet Chaotic diastolic flutter of the mitral valve Systolic flutter of the aortic valve

Fine diastolic flutter of the anterior mitral valve leaflet

High-frequency diastolic flutter of the aortic valve with echoes extending into the left ventricular outflow tract during diastole on M-mode echocardiographic represents: Ascending aortic aneurysm Flail aortic valve leaflet Valvular aortic sclerosis Valvular aortic stenosis

Flail aortic valve leaflet

An M-mode of the aortic root demonstrates fine vibrations in the left atrium. The most likely cause is: Flail mitral valve Left atrial myxoma Left atrial thrombus Mitral valve prolapsed

Flail mitral valve

On M-mode echocardiographic finding of the tricuspid valve, systolic coarse chaotic oscillation of the tricuspid valve leaflets may indicate: A normal echocardiographic finding Atrial fibrillation/atrial flutter Flail tricuspid valve leaflet Pulmonic valve insufficiency

Flail tricuspid valve leaflet

The simplest semiquantitative technique for determining the severity of aortic insufficiency using pulsed-wave Doppler is: Comparing the detected jet height to the left ventricular outflow tract height Detecting a laminar diastolic flow pattern, which indicates severe aortic insufficiency Examining the spectral strength of the regurgitant jet Flow mapping of the left ventricle

Flow mapping of the left ventricle

A possible auscultatory finding in a patient with pericarditis is: Fixed splitting of S2 Mid-systolic click Friction rub Pericardial knock

Friction rub

The formula used to determine aortic valve area in the cardiac catheterization laboratory is the: Bernoulli equation Continuity equation Doppler equation Gorlin equation

Gorlin equation

When pulmonary artery systolic pressure exceeds 70 mmHg, dilation of the pulmonic annulus results in a regurgitation jet of high velocity which is responsible for the murmur called: Austin Flint Rivero-Carvallo Graham Steell Lillehei-Kaster

Graham Steell

A color flow Doppler technique that permits detection of 3+ to 4+ aortic insufficiency is: Early diastolic flow reversal in the abdominal aorta Early diastolic flow reversal in the descending thoracic aorta Holodiastolic flow reversal in the descending thoracic aorta Holosystolic flow reversal in the abdominal aorta

Holodiastolic flow reversal in the descending thoracic aorta

The mitral valve inflow pattern often associated with severe acute aortic insufficiency is stage: I II III IV

III

The most common etiology of constrictive pericarditis is: Cardiac surgery Idiopathic Rheumatic fever Tuberculosis

Idiopathic

The most common etiology for chronic aortic insufficiency is: Idiopathic dilatation of the aortic root and aortic annulus Infective endocarditis Marfan's syndrome Trauma

Idiopathic dilatation of the aortic root and aortic annulus

The Doppler signal of aortic insufficiency may be differentiated from the Doppler signal of mitral stenosis by the following guideline: If the diastolic flow pattern commences before mitral valve opening, then the signal is due to aortic insufficiency If the diastolic flow pattern commences after mitral valve opening, then the signal is due to aortic insufficiency The Doppler flow velocity pattern of mitral valve stenosis is laminar, while the Doppler flow velocity pattern of aortic insufficiency is turbulent Since both mitral valve stenosis and aortic insufficiency are diastolic, it is not possible to differentiate the Doppler flow velocity patterns.

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

The onset of flow to peak aortic velocity Doppler tracing in severe valvular aortic stenosis is: Increased Decreased Decreased with expiration Increased with inspiration

Increased

The classic cardiac Doppler features of mitral valve stenosis include all the following EXCEPT: Increased E velocity Increased mitral valve area Increased pressure half-time Turbulent flow

Increased mitral valve area

Doppler evidence of constrictive pericarditis includes: Increased peak velocity across the mitral valve with inspiration Increased peak velocity across the aortic valve with inspiration Increased peak velocity across the mitral valve with expiration Increased peak velocity across the tricuspid valve with expiration

Increased peak velocity across the mitral valve with expiration

In pure rheumatic mitral valve stenosis, the left atrium is _______ and the left ventricle is _______. Decreased, decreased Increased, decreased Increased, increased Unchanged, increased

Increased, decreased

Low-frequency diastolic fluttering of the aortic valve closure line on the M-mode of the aortic valve is: A normal finding Indicative of cusp rupture or flail aortic valve Pathognomonic for bicuspid aortic valve Pathognomonic for significant aortic valve stenosis

Indicative of cusp rupture or flail aortic valve

. A patient with a history of mitral valve prolapsed presents to the echocardiography laboratory with the complaints of fever, night sweats, and weight loss. The most likely explanation is: Congestive heart failure Coronary artery disease Infective endocarditis Kawasaki disease

Infective endocarditis

Aortic ring abscess is usually caused by: Infective endocarditis Rheumatic fever Valvular prolapsed Valvular regurgitation

Infective endocarditis

The most common etiology of acute aortic insufficiency is: Aortic balloon valvuloplasty Hypertension Infective endocarditis Rheumatic fever

Infective endocarditis

Pulsed-wave Doppler evidence of cardiac tamponade includes: Systolic flow reversal in the pulmonary veins Systolic flow reversal in the hepatic veins Inspiratory increase in peak velocity across the mitral valve with an inspiratory decrease in peak velocity across the tricuspid valve Inspiratory decrease in velocity across the mitral valve with an inspiratory increase in velocity across the tricuspid valve

Inspiratory decrease in velocity across the mitral valve with an inspiratory increase in velocity across the tricuspid valve

Coarse fluttering of a tissue prosthetic valve leaflet on M-mode is associated with: Insufficiency Normal function Stenosis Vegetation

Insufficiency

Prosthetic valve prolapsed as seen by two-dimensional echocardiography is associated with prosthetic valve: Insufficiency Normal function Stenosis Vegetation

Insufficiency

An example of bovine pericardium tissue valve is: Bjork-Shiley Intact Ionescu-Shiley Starr-Edwards

Ionescu-Shiley

The M-mode finding for ruptured chordae tendineae of the tricuspid valve is: Coarse diastolic flutter of the anterior tricuspid valve leaflet Fine diastolic flutter of the anterior tricuspid valve leaflet Irregular low-frequency diastolic fluttering of the anterior tricuspid valve leaflet Right atrial enlargement

Irregular low-frequency diastolic fluttering of the anterior tricuspid valve leaflet

Secondary echocardiographic/Doppler findings in patients with rheumatic mitral stenosis include all the following EXCEPT: Abnormal interventricular septal wall motion Increased right heart dimensions Increased tricuspid regurgitant jet velocity Left ventricular dilatation

Left ventricular dilatation

A two-dimensional echocardiographic finding in a patient with pure aortic insufficiency is: Left atrial enlargement Left ventricular enlargement Right atrial enlargement Right ventricular hypertrophy

Left ventricular enlargement

The principle electrocardiographic finding in severe valvular aortic stenosis is: Atrial fibrillation Left atrial enlargement Left ventricular hypertrophy Right ventricular hypertrophy

Left ventricular hypertrophy

The severity of aortic valve stenosis may be underestimated if only the maximum velocity measurement is used in the following condition: Anemia Doppler intercept angle of 0° Low cardiac output Significant aortic insufficiency

Low cardiac output

Of the three pressure gradients that can be measured in the cardiac catheterization laboratory, the largest is: Maximum peak instantaneous gradient Mean transvalvular systolic gradient Peak-to-peak gradient Peak-to-mean gradient

Maximum peak instantaneous gradient

With thrombotic obstruction of a prosthetic valve in the aortic position, continuous-wave Doppler findings include: Effective orifice area is normal Velocity ratio is increased Maximum velocity is increased Pressure half-time is increased

Maximum velocity is increased

Methods for determining the severity of tricuspid regurgitation with pulsed-wave Doppler include all the following EXCEPT: Increased E wave velocity for the tricuspid valve Mapping technique Maximum velocity of the tricuspid regurgitant jet Systolic flow reversal in the hepatic vein

Maximum velocity of the tricuspid regurgitant jet

Of the transvalvular pressure gradients that can be measured in the echocardiography laboratory, the most useful in examining aortic valve stenosis is probably: Mean diastolic gradient Mean systolic gradient Peak instantaneous pressure gradient Peak-to-peak gradient

Mean systolic gradient

The associated auscultatory findings for mitral valve prolapsed include: Ejection click Friction rub Mid-systolic click Pericardial knock

Mid-systolic click

A Doppler mean pressure gradient of 18 mmHg is calculated in a patient with valvular aortic stenosis. The severity of the stenosis is: Mild Moderate Moderately severe Severe

Mild

Mitral valve leaflet chordal rupture usually results in: Aortic insufficiency Mitral regurgitation Pulmonary insufficiency Tricuspid regurgitation

Mitral regurgitation

Mitral stenosis is considered to be severe by all the following criteria EXCEPT: Mean pressure gradient ≥ 12 mmHg Mitral valve area <1.0 cm2 Mitral valve Doppler A velocity > 1.3 m/sec Pressure half-time > 220 msec

Mitral valve Doppler A velocity > 1.3 m/sec

When performing an echocardiogram on a patient with a thoracic skeletal abnormality (e.g., pectus excavatum), the echocardiographer must be careful to rule out: Atrial septal defect Bicuspid valve prolapsed Coarctation of the aorta Mitral valve prolapsed

Mitral valve prolapsed

Pathologies that may result in a left ventricular pressure overload include all the following EXCEPT: Discrete subaortic stenosis Mitral valve stenosis Systemic hypertension Valvular aortic stenosis

Mitral valve stenosis

Proximal flow convergence of an aortic insufficiency jet as seen on color flow Doppler may represent: Physiologic insufficiency Mild (1+) aortic insufficiency Moderate (2+) aortic insufficiency Moderately severe (3+ 4+) aortic insufficiency

Moderately severe (3+ 4+) aortic insufficiency

M-mode reveals diastolic flutter of the anterior mitral valve and a left ventricular end-systolic dimension of 58 mm. Two-dimensional echocardiography demonstrates an aortic root that is 4.5 cm in diameter with aortic valve sclerosis. The aortic insufficiency jet is mapped to the level of the papillary muscles by pulsed-wave Doppler. The pressure half-time of the continuous-wave Doppler tracing of the aortic insufficiency jet is 280 m/sec. The jet height to left ventricular outflow tract height ratio is 53%. The severity of the aortic insufficiency in this case is: Physiologic insufficiency Mild (1+) Moderate (2+) Moderately severe (3+)

Moderately severe (3+)

Bioprosthetic leaflet degeneration and calcification occurs: Only in adults More frequently in children Equally in children and adults Primarily in women 40 years of age or older

More frequently in children

The mitral valve is considered to be prematurely closed due to severe acute insufficiency when the C point of mitral valve closure occurs: On or before inception of the Q wave Less than 0.05 seconds after the Q wave 0.05 to 0.07 seconds after the Q wave of the electrocardiogram On or before inception of the T wave

On or before inception of the Q wave

The M-mode finding that indicates severe acute aortic insufficiency is premature aortic valve: Closure Diastolic flutter Mid-systolic closure Opening

Opening

The cardinal symptoms of valvular aortic stenosis include all the following EXCEPT: Angina pectoris Congestive heart failure Palpitations Syncope

Palpitations

The murmur of tricuspid regurgitation is best described as a: Holodiastolic murmur heard best at the lower left sternal border Pansystolic murmur heard best at the lower left sterna border Pansystolic murmur heard best at the cardiac apex with radiation to the axilla Systolic ejection murmur heard best at the upper right sterna border

Pansystolic murmur heard best at the lower left sterna border

In significant chronic aortic insufficiency, M-mode/two-dimensional evidence includes all the following EXCEPT: Hyperkinesis of the interventricular septum Hyperkinesis of the posterior wall of the left ventricle Left ventricular dilatation Paradoxical interventricular septal motion

Paradoxical interventricular septal motion

M-mode and two-dimensional echocardiographic findings for chronic tricuspid regurgitation include: Left ventricular volume overload Paradoxical septal motion Protected right ventricle Right ventricular hypertrophy

Paradoxical septal motion

The two-dimensional view that best visualizes systolic doming of the aortic valve leaflets is the: Apical five-chamber view Parasternal long-axis view Parasternal short-axis view of the aortic valve Subcostal short-axis view of the aortic valve

Parasternal long-axis view

Doppler evaluation of a prosthetic mitral valve should include all the following EXCEPT: Effective orifice area (continuity equation) Peak A velocity Peak and mean pressure gradients Pressure half-time

Peak A velocity

The classic auscultatory finding in constrictive pericarditis is: Friction rub Mid-systolic click Opening snap Pericardial Knock

Pericardial Knock

Low voltage of the QRS complex throughout the electrocardiogram is often found in: Constrictive pericarditis Mitral stenosis Pericardial effusion Pleural effusion

Pericardial effusion

The swinging heart syndrome is associated with: Cardiac trauma Constrictive pericarditis Mitral valve prolapsed Pericardial effusion

Pericardial effusion

Echocardiographic evidence of severe, acute aortic insufficiency includes all the following EXCEPT: Premature closure of the mitral valve Premature opening of the aortic valve Premature opening of the mitral valve Reverse doming of the anterior mitral valve leaflet

Premature opening of the mitral valve

The term myxomatous degeneration is associated with mitral valve: Flail leaflet Prolapse Stenosis Vegetation

Prolapse

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

Prolapsed

. A shortened interval between the aortic second sound (A2) and mitral valve opening recorded for a mitral valve prosthesis may indicate all the following EXCEPT: Perivalvular leak Poor left ventricular function Prolonged PR interval on the electrocardiogram Prosthetic mitral valve dysfunction

Prolonged PR interval on the electrocardiogram

. Infective endocarditis is a greater risk in patients with: Atrial fibrillation Coronary artery disease Left ventricular aneurysm Prosthetic heart valve

Prosthetic heart valve

The most common cause of pathologic pulmonary insufficiency is: Carcinoid heart disease Infective endocarditis Pulmonary hypertension Rheumatic heart disease

Pulmonary hypertension

Fine diastolic flutter of the tricuspid valve is a characteristic finding for: Infundibular stenosis Primary pulmonary hypertension Pulmonary insufficiency Pulmonary valve stenosis

Pulmonary insufficiency

In significant chronic tricuspid valve regurgitation, all the following are dilated EXCEPT: Hepatic veins Inferior vena cava Pulmonary veins Right atrium

Pulmonary veins

A possible M-mode finding for constrictive pericarditis is premature opening of the: Aortic valve Mitral valve Pulmonic valve Tricuspid valve

Pulmonic valve

Possible two-dimensional echocardiographic findings for valvular pulmonic stenosis include all the following EXCEPT: Pulmonic valve prolapsed Right ventricular hypertrophy Systolic doming of the pulmonic valve leaflets Valvular thickening

Pulmonic valve prolapsed

A pulse that is associated with significant aortic insufficiency is: Pulsus alternans Pulsus bisferiens Pulsus paradoxus Pulsus parvus et tardus

Pulsus bisferiens

Signs and symptoms of significant tricuspid regurgitation include all the following EXCEPT: Hepatomegaly Jugular venous distention Pulsus paradoxus Right ventricular failure

Pulsus paradoxus

The pulse associated with cardiac tamponade is: Pulsus alternans Pulsus bisferiens Pulsus paradoxus Pulsus parvus

Pulsus paradoxus

The pulse that is characteristic of significant valvular aortic stenosis is: Pulsus alternans Pulsus bisferiens Pulsus paradoxus Pulsus parvus et tardus

Pulsus parvus et tardus

A key word that is often used to describe the characteristics of the valve leaflets in mitral valve prolapsed is: Dense Doming Redundant Sclerotic

Redundant

The most common etiology of tricuspid valve stenosis is: Carcinoid heart disease Infective endocarditis Rheumatic fever Right atrial myxoma

Rheumatic fever

The absence of inferior vena cava collapse upon inspiration indicates elevated pressure in the: Aorta Left atrium Left ventricle Right atrium

Right atrium

The single most reliable echocardiographic predictor of cardiac tamponade that can be identified by M-mode or two-dimensional imaging is diastolic collapse of the: Left atrium Left ventricle Right atrium Right ventricle

Right ventricle

Secondary echocardiographic findings associated with severe valvular aortic stenosis include all the following EXCEPT: Decreased left ventricular systolic function (late in course) Left ventricular hypertrophy Post-stenotic dilatation of the ascending aorta Right ventricular hypertrophy

Right ventricular hypertrophy

Causes of organic tricuspid regurgitation include all the following EXCEPT: Rheumatic heart disease Right ventricular infarct Tricuspid valve prolapsed Flail tricuspid valve

Right ventricular infarct

Pulmonary insufficiency is associated with: Left ventricular volume overload Right atrial hypertrophy Right ventricular hypertrophy Right ventricular volume overload

Right ventricular volume overload

Valvular annuloplasty is best accomplished by the following device: Balloon Ring Stent Coil

Ring

Heart sounds associated with significant valvular aortic stenosis include: Loud S1 Fixed split S2 S3 S4

S4

When M-mode evaluation of a systolic ejection murmur reveals thickened aortic valve leaflets and an aortic cusp excursion of 2.0 cm, the most likely diagnosis is aortic valve: Insufficiency Sclerosis Stenosis Vegetation

Sclerosis

A Doppler mean pressure gradient across a stenotic mitral valve of 12 mm HG is obtained. The severity of the mitral stenosis is: Mild Moderate Moderately severe Severe

Severe

Reverse diastolic doming of the anterior mitral valve leaflet is associated with: Flail mitral valve Papillary muscle dysfunction Rheumatic mitral valve stenosis Severe aortic insufficiency

Severe aortic insufficiency

The M-mode appearance of mitral valve and aortic valve vegetations is described as: Doming Prolapsing Shaggy Relapsing

Shaggy

The echocardiographer may differentiate between the similar systolic flow pattern seen in coexisting severe aortic valve stenosis and mitral regurgitation by all the following methods EXCEPT: The aortic ejection time is shorter than the mitral regurgitation time 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 Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis

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

Causes of tricuspid regurgitation include all the following EXCEPT: Carcinoid heart disease Ebstein's anomaly Pulmonary hypertension Sinus of Valsalva aneurysm

Sinus of Valsalva aneurysm

An M-mode echocardiographic sign for constrictive pericarditis is: B notch Chaotic notch Fibrillatory notch Spanish notch

Spanish notch

An M-mode echocardiographic sign of constrictive pericarditis is: B notch sign Mid-late systolic dip sign Smoke-signal sign Square root sign

Square root sign

An example of a bi-leaflet tilting disc prosthetic heart valve is: Medtronic-Hall Omniscience St. Jude's Starr-Edwards

St. Jude's

A technique used in the cardiac catheterization laboratory that determines the severity of aortic insufficiency is: Austin Flint technique Judkin's technique Left ventriculography Supravalvular aortography

Supravalvular aortography

The typical two-dimensional echocardiographic findings in rheumatic tricuspid stenosis include all the following EXCEPT: Diastolic doming of the anterior tricuspid valve leaflet Leaflet thickening Restricted motion of the tricuspid leaflets Systolic bowing of the posterior tricuspid valve leaflet

Systolic bowing of the posterior tricuspid valve leaflet

The M-mode findings for tricuspid valve stenosis include all the following EXCEPT: Anterior motion of the posterior tricuspid valve leaflet Decreased E-F slope of the anterior tricuspid valve leaflet Increased leaflet thickness Systolic doming of the anterior tricuspid valve leaflet

Systolic doming of the anterior tricuspid valve leaflet

Echocardiographic characteristics of mitral valve prolapsed include all the following EXCEPT: Increased mitral valve annulus Systolic bowing of the mitral valve toward the left atrium Systolic doming of the leaflets Thickened, redundant leaflets

Systolic doming of the leaflets

Cardiac Doppler findings associated with significant chronic tricuspid regurgitation include all the following EXCEPT: Concave late systolic configuration of the regurgitant signal Increased E velocity of the tricuspid valve Systolic flow reversal in the hepatic vein Systolic flow reversal in the pulmonary vein

Systolic flow reversal in the pulmonary vein

An intracardiac pressure may be determined from the continuous-wave tricuspid regurgitation signal is: Mean pulmonary artery pressure Pulmonary artery end-diastolic pressure Systolic pulmonary artery pressure Total pulmonary vascular resistance

Systolic pulmonary artery pressure

Systolic reflux of saline contrast noted by two-dimensional echocardiography in the inferior vena cava denotes the presence of: Cardiac tamponade Constrictive pericarditis Pulmonary insufficiency Tricuspid regurgitation

Tricuspid regurgitation

Possible echocardiographic/Doppler findings in a patient with carcinoid heart disease include all the following EXCEPT: Pulmonic valve insufficiency Pulmonic valve stenosis Tricuspid valve prolapse Tricuspid valve regurgitation

Tricuspid valve prolapse

Complications associated with prosthetic heart valve dysfunction include all the following EXCEPT: Dehiscence Leaflet degeneration Thrombosis Tumor

Tumor

A pulsed-wave Doppler blood flow velocity profile of aortic insufficiency obtained from the apical five-chamber view will demonstrate a diastolic: Laminar high-velocity flow signal Laminar low-velocity flow signal Turbulent high-velocity flow signal Turbulent low-velocity flow signal

Turbulent high-velocity flow signal

The most common type of right ventricular outflow tract obstruction is: Sub-infundibular Subvalvular Supravalvular Valvular

Valvular

The right ventricular outflow tract obstruction associated with post-stenotic dilatation of the main pulmonary artery is: Valvular Subvalvular Supravalvular Sub-infundibular

Valvular

The complications of infective endocarditis include all the following EXCEPT: Congestive heart failure Embolization Valve ring abscess Valvular prolapsed

Valvular prolapsed

Post-stenotic dilatation of the main pulmonary artery is a two-dimensional echocardiographic finding for: Pulmonary insufficiency Pulmonary tumor Tricuspid regurgitation Valvular pulmonic stenosis

Valvular pulmonic stenosis

Pulmonary artery banding may result in all the following EXCEPT: Pseudoaneurysm formation Right ventricular hypertrophy Supravalvular pulmonary stenosis Valvular pulmonic stenosis

Valvular pulmonic stenosis

The classic manifestation of infective endocarditis is cardiac valve: Doming Sclerosis Tumor Vegetation

Vegetation

The best Doppler method for evaluating an aortic valve replacement is probably: Deceleration slope Maximum peak instantaneous gradient Pressure half-time Velocity ratio

Velocity ratio

. In the parasternal long-axis view, severe aortic valve stenosis is defined as an aortic valve leaflet separation that measures: ≥ 14 mm ≤ 12 mm ≤ 10 mm ≤ 8 mm

≤ 8 mm

A redundant mitral valve leaflet is considered present when the leaflet thickness on M-mode/two-dimensional echocardiography is: ≥ 2 mm ≥ 3 mm ≥ 4 mm ≥ 5 mm

≥ 5 mm