Echo Midterm
Name 2 views you could use to detect Pulmonic regurgitation with color doppler 1. 2.
LAX/ SAX RVOT SAX Base SUB SAX
Grade 4+ MR, is indicative of a. severe MR b. Mild MR c. Moderate MR d. Trace of MR
a. severe MR
During an echo, if you detect a thickened aortic valve with a peak velocity of >2.6m/sec, the patient has ______. If you detect a thickened aortic valve without decreased excursion and a peak velocity <2.5m/sec, the patient has aortic _____. a. stenosis, sclerosis b. sclerosis, stenosis
a. stenosis, sclerosis
On M- mode Mitral valve prolapse creates a a. systolic dip b. diastolic dip
a. systolic dip
According to the continuity equation, the aortic valve area (AVA)= (.785) (LVOT diameter)2 (V1/V2) a. true b. false
a. true
Aortic regurgitation is possible with Aortic stenosis a. true b. false
a. true
Diastolic doming of the anterior mitral valve leaflet creates a "hockey stick" appearance with mitral stenosis a. true b. false
a. true
In cases of mid aortic insufficiency, the steeper the AI waveform slope the more severe a. true b. false
a. true
Mitral regurgitation is probable with mitral stenosis a. true b. false
a. true
Mitral stenosis can eventually cause pulmonary hypertension a. true b. false
a. true
Mitral stenosis creates a turbulent diastolic flow a. true b. false
a. true
Pulmonic insufficiency creates a low- pitched diastolic murmur that may increase with inspiration. When pulmonary hypertension is present, a high pitched blowing diastolic murmur may be heard (Graham- Steele murmur) a. true b. false
a. true
Tricuspid regurgitation is possible with tricuspid stenosis a. true b. false
a. true
Tricuspid stenosis can be congenital a. true b. false
a. true
Tricuspid stenosis murmur can vary with respiration a. true b. false
a. true
Up to 87% of patients have trace to mild Pulmonic regurgitation a. true b. false
a. true
When measuring the mitral valve deceleration slope, you would measure from the peak E waveform down to the E-F slope, back to baseline. a. true b. false
a. true
You measure aortic regurgitation using the pressure half time method a. true b. false
a. true
What is the valve area calculation for Tricuspid valve area? a. pressure half time/ 220 b. 190/ pressure half time c. peak gradient/190
b. 190/ pressure half time
Which of the following represents the formula for calculating the mitral valve area? a. pressure half time/ 220 b. 220/ pressure half time c. peak gradient/ 220 d. 4(V)2 where V= peak velocity
b. 220/ pressure half time
Severe tricuspid stenosis valve area is a. > 1.0cm2 b. < 1.0cm2 c. 7 to 9cm2
b. < 1.0cm2
Normal peak velocity for the mitral valve flow is a. >1.3 m/sec b. <1.3 m/sec c. 4m/sec d. 6m/sec
b. <1.3 m/sec
The AVA is calculated by using the following equation: a. AVA= (.785) (LVOTd) (V1) / (V2) b. AVA= (.786) (LVOT diameter squared) (V1) / (V2)
b. AVA= (.786) (LVOT diameter squared) (V1) / (V2) . Should be .785......
What equation is used to determine the pressure gradient between two chambers? a. peak velocity equation b. Bernoulli equation c. maximum velocity equation
b. Bernoulli equation
Downward displacement of the tricuspid valve leaflets into the right ventricle is known as a. carcinoid heart disease b. Ebstiens Anomaly c. cardiac hemochromatosis d. cardiac sarcoidosis
b. Ebstiens Anomaly
The flow convergence method can be used to estimate the MR volume. This method is also called a. PSAE b. PISA c. bernoulli d. mean PG
b. PISA
2D planimetry of the Aortic valve is performed in the a. SAX MV View b. SAX AORTA View c. RVIT
b. SAX AORTA View
Pulmonic insufficiency as seen on Doppler echo from the parasternal window. appears -- the baseline during -- a. above/ systole b. above/ diastole c. below/ systole d. below/ diastole
b. above/ diastole
Utilizing CW doppler, Tricuspid stenosis will have a ____ E-F slope a. increased b. decreased c. remains the same
b. decreased
In the SAX view of the mitral valve, tracing the opening of the mitral valve with mitral stenosis it will present a(an) a. increased MVA b. decreased MVA
b. decreased MVA
Mitral valve stenosis impedes _____ blood flow traveling from the _____ into the _____ a. systolic, left atrium, left ventricle b. diastolic, left atrium, left ventricle c. diastolic, right atrium, right ventricle d. systolic, left ventricle, aorta
b. diastolic, left atrium, left ventricle
When measuring the aortic root, everything on the aortic side of the annulus is measured during a. end systole b. end diastole
b. end diastole
A complication of mitral stenosis is increased cardiac output a. true b. false
b. false
A mean PG >3 mmHG is indicative of severe tricuspid stenosis a. true b. false
b. false
Aortic stenosis creates a turbulent diastolic color flow that travels from the aorta into the left ventricle a. true b. false
b. false
Calcific/ Rheumatic Aortic stenosis presents on an M- mode with decreased aortic cusp separation (ACS) = 2.6 -3.5 a. true b. false
b. false
Mitral regurgitation creates diastolic turbulent color flow a. true b. false
b. false
On a 2D echo, tricuspid stenosis has an increased tricuspid valve orifice a. true b. false
b. false
To acquire doppler of the Pulmonary vein you would use CW a. true b. false
b. false
Tricuspid stenosis impedes systolic blood flow due to narrowing or thickening of the Tricuspid valve. a. true b. false
b. false
Mitral regurgitation creates a _____ murmur a. holodiastolic blowing b. holosystolic blowing c. holosystolic click d. holosdiastolic click
b. holosystolic blowing
The characteristic M- mode findings for calcific aortic valve stenosis include all of the following EXCEPT: a. thickening of the aortic cusps b. increased aortic cusp separation c. decreased aortic cusp separation
b. increased aortic cusp separation
When measuring the aortic root, everything on the aortic side of the annulus is measured a. inner to inner b. leading edge to leading edge
b. leading edge to leading edge
Aortic stenosis is _____ of the aortic valve that impedes _____ blood flow a. narrowing, diastolic b. narrowing, systolic c. dilation, diastolic d. dilation, systolic
b. narrowing, systolic
The gold- standard two- dimensional echocardiographic view for diagnosing mitral valve prolapse is the: a. apical 4C b. parasternal long axis c. parasternal short axis of mitral valve d. apical 5C
b. parasternal long axis
To provoke MVP the tech can have the patient _____ a. breathe in b. perform the valsalva maneuver
b. perform the valsalva maneuver
P1 and P2 represents the ____ in the chambers ____ and ____ a. velocity, superior and inferior b. pressure, proximal and distal
b. pressure, proximal and distal
The E- wave peak velocity of the mitral valve ____ a. increases with age b. represents the early diastolic LA- LV pressure gradient
b. represents the early diastolic LA- LV pressure gradient
What type of aortic stenosis originates at the aortic valve cusps? a. degenerative b. rheumatic c. congenital d. prosthesis
b. rheumatic
If you detect an increased depth of the "a" wave > = 8 mm while acquiring the M- mode of the left pulmonic cusp, what is most likely the diagnosis? a. severe pulmonic regurgitation b. severe pulmonic stenosis c. severe pulmonary hypertension d. none of the above
b. severe pulmonic stenosis
What condition is most likely present if the peak pressure gradient across the pulmonic valve is >64 mmHg? a. normal pulmonic valve b. mild pulmonic stenosis c. moderate pulmonic stenosis d. severe pulmonic stenosis
d. severe pulmonic stenosis
Regurgitant flow through the aortic valve occur during a. diastole b. systole
diastole
When stenosis is present, the sonographer must obtain information pertaining to the valve which includes: a. peak velocity b. mean pressure gradient c. max pressure gradient d. valve area e. all of the above
e. all of the above
Pulmonic stenosis impedes diastolic blood flow from the RV into the main pulmonary artery. a. true b. false
false - PS impedes SYSTOLIC
The typical two-dimensional echocardiographic findings in rheumatic tricuspid stenosis include all the following EXCEPT: A. Diastolic doming of the anterior tricuspid valve leaflet B. Leaflet thickening C. Restricted motion of the tricuspid leaflets D. Systolic bowing of the posterior tricuspid valve leaflet
D. Systolic bowing of the posterior tricuspid valve leaflet
A peak pressure gradient of flow through a valve is obtained by using the equation: a. 4V squared b. squared 4 c. PHT/220 d. V4 squared
a. 4V squared
The murmur associated with severe aortic insufficiency is: a. Austin Flint murmur b. Carvallo's murmur c. Graham Steel murmur d. Still's murmur
a. Austin Flint murmur
Which doppler signal is used to calculate the tricuspid stenosis mean pressure gradient? a. CW b. PW c. all of the above
a. CW
Which spectral doppler is used to asses valvular regurgitation? a. CW b. PW
a. CW
When measuring blood flow through the mitral valve, we measure (circle all that apply) a. E/A velocity b. Deceleration slope c. D-E excursion d. EPSS
a. E/A velocity b. Deceleration slope
An MR jet that extends just beyond the mitral valve leaflets is a. Grade I b. Grade II c. Grade III d. Grade IV
a. Grade I
When is a raphe typically seen? a. bicuspid aortic valve b. cleft aortic valve c. degenerative aortic stenosis d. rheumatic aortic stenosis
a. bicuspid aortic valve
Tricuspid valve leaflets that are fixed, thick and rigid is seen with: a. carcinoid heart disease b. cardiac amyloidosis c. cardiac hemochromatosis d. cardiac sarcoidosis
a. carcinoid heart disease
The E-F slope of the M-mode of the anterior mitral valve leaflet in mitral stenosis is: a. decreased b. increased c. notched d. unaffected
a. decreased
The mitral valve is open during a. diastole b. systole
a. diastole
Mitral stenosis is associated with what type of murmur? a. diastolic rumble b. systolic rumble
a. diastolic rumble
The aortic annulus and LVOT is measured a. inner to inner b. leading edge to leading edge
a. inner to inner
The aortic annulus and LVOT is measured during a. mid systole b. end diastole
a. mid systole
MVP murmur presents as a a. mid systolic click b. blowing noise c. opening snap d. all of the above
a. mid systolic click
In most cases if the AMVL prolapses there is a _____ directed jet a. posterior b. anterior
a. posterior
How do you measure pulmonic insufficiency? a. pressure half time slope b. peak PV velocity
a. pressure half time slope
Diastolic flutter of the tricuspid valve may be detected in the presence of -- a. pulmonic insufficiency b. pulmonic stenosis c. tricuspid regurgitation d. tricuspid stenosis
a. pulmonic insufficiency
The etiology of aortic valve stenosis includes all of the following EXCEPT: a. pulmonic stenosis b. congential c. calcific d. rheumatic
a. pulmonic stenosis
Regurgitant flow through the mitral valve occurs during a. diastole b. systole
b. systole
The aortic valve is open during a. diastole b. systole
b. systole
A normal diastolic IVC measurement is a. 1.1 - 1.4 cm b. 1.2 - 3.2 cm c. 1.2 - 2.1 cm
c. 1.2 - 2.1 cm
Severe aortic stenosis peak velocity is a. >2.0 m/s b. >3.0 m/s c. >4.0 m/s d. >5.0 m/s
c. >4.0 m/s
Name two views where we could evaluate the tricuspid valve a. RVIT, RVOT b. PSLAX, SAX AO c. SAX AO, RVIT d. APICAL 4CH, APICAL 3CH
c. SAX AO, RVIT
Which of the following is the most common cause of pulmonic stenosis? a. rheumatic heart disease b. carcinoid heart disease c. congenital heart disease d. pulmonary artery aneurysm
c. congenital heart disease
_____ is the most common heart problem association with MVP a. mitral stenosis b. mitral valve pressure c. mitral regurgitation c. mitral valve obstruction
c. mitral regurgitation
Mitral stenosis is: a. back flow of blood into the aorta b. back flow of blood into the RA c. narrowing, thickening of the hearts mitral valve d. back flow of blood into the LA E. none of the above
c. narrowing, thickening of the hearts mitral valve
The best two- dimensional view for determining mitral valve area is: a. Apical 4C b. parasternal long axis c. parasternal short axis d. apical 2C
c. parasternal short axis
The peak A wave of the mitral valve _____ a. decreases with age b. represents the early diastolic LV- LA pressure gradient c. represents the late diastolic LA- LV pressure gradient
c. represents the late diastolic LA- LV pressure gradient
The most common cause of tricuspid valve stenosis is a. carcinoid heart disease b. infective endocarditis c. rheumatic fever d. right atrial myxoma
c. rheumatic fever
The image represents a football shaped opening known as a. semilunar bicuspid mitral valve b. atrioventricular bicuspid pulmonary valve c. semilunar bicuspid aortic valve d. none of the above
c. semilunar bicuspid aortic valve
The normal aortic cusp separation is: a. 0.6- 1.1cm b. < 2 cm squared c. < 1 cm squared d. 1.5- 2.6cm
d. 1.5- 2.6cm
The normal tricuspid valve area is: a. 1 to 3 cm2 b. 3 to 5 cm2 c. 4 to 6 cm2 d. 7 to 9 cm2
d. 7 to 9 cm2
With severe mitral stenosis, the MVA is _____ cm squared a. < 2.0 b. > 2.0 c. > 1.0 d. < 1.0
d. < 1.0
Causing of MVP include: a. Marfans syndrome b. hereditary factors c. mitral stenosis d. A & B e. all of the above
d. A & B
What view could you use to evaluate aortic stenosis? a. RVIT, RVOT b. RVOT, SAX AO c. SAX AO, RVIT d. APICAL 5CH, APICAL 3CH
d. APICAL 5CH, APICAL 3CH
When measuring flow through the MV, we measure normal flow, using _____, at the MV ______. a. CW, annulus b. PW annulus c. CW, leaflet tips d. PW, leaflet tips
d. PW, leaflet tips
A patient with aortic stenosis typically undergoes serial echoes in order to track changes of the -- a. peak, mean and max PG b. systolic and diastolic function c. chamber and wall size d. all of the above
d. all of the above
Complications with mitral regurgitation results in a. left atrial enlargement b. pulmonary hypertension c. possible left atrial thrombus d. all of the above
d. all of the above
Pulmonic stenosis is not that common in the adult. Which of the following 2D echo findings would indicate pulmonic stenosis? a. thickening of the pulmonic leaflets with systolic doming b. Right ventricular hypertrophy c. flattening of the interventricular septum d. all of the above
d. all of the above
Several windows should be utilized when acquiring the aortic valve doppler waveform, to include the a. apical window b. suprasternal window c. right parasternal window d. all of the above
d. all of the above
The following spectral doppler tracing represents what semilunar valve measurement? a. peak PG b. max PG c. mean PG d. all of the above
d. all of the above
When severe tricuspid regurgitation is suspected, enlargement may be noted in the: a. IVC b. RA c. hepatic veins d. all of the above
d. all of the above
A diastolic flutter of the anterior mitral valve leaflet can be caused from a. mitral regurgitation b. mitral stenosis c. aortic stenosis d. aortic regurgitation
d. aortic regurgitation
Mitral regurgitation is a. back flow of blood into the aorta b. back flow of blood into the LV c. narrowing of the hearts mitral valve d. back flow of blood into the LA
d. back flow of blood into the LA
On a 2D echo, AS may present; a. thickened cusps b. left ventricular hypertrophy c. dilated pulmonary artery d. both a & b
d. both a & b
When MR is present you should look at your 2D image and evaluate the: a. mitral valve apparatus b. left atrium c. aortic stenosis d. both a & b e. all of the above
d. both a & b
Tricuspid stenosis murmur is described as a a. diastolic blowing b. holosystolic blowing c. holosystolic click d. diastolic rumble
d. diastolic rumble
The patient has severe aortic insufficiency, what will be heard during the auscultation? a. high pitched, blowing, diastolic decrescendo murmur at the left sternal border b. low pitched, mid systolic, "rumble" at the apex c. high pitched, blowing, diastolic crescendo murmur at the apex d. low pitched, mid diastolic, "rumble" at the apex (Austin Flint Murmur)
d. low pitched, mid diastolic, "rumble" at the apex (Austin Flint Murmur)