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Echo Registry Review

Total questions: 160

Worksheet time: 1hrs 29mins

Name
Class
Date
1.

What does TEE stand for?

a)

Transthoracic Echo

b)

Transectopic Echo

c)

Transesophageal Echo

d)

I have no idea anymore

2.

All of the following are disease that present as dilated cardiomyopathy EXCEPT?

a)

alcohol abuse

b)

Acquired Immunodeficiency Syndrome (AIDS)

c)

postpartum cardiomyopathy

d)

glycogen storage disease

3.

which of the following is the most common cause of mitral stenosis?

a)

congenital

b)

rheumatic fever

c)

severe MAC

d)

left atrial tumor

4.

which of the following is NOT a symptom or clinical finding associated with infective endocarditis?

a)

fever

b)

positive blood culutres

c)

pulsus paradoxus

d)

malaise

5.

a pericardial effusion may form due to

a)

myocardial infarction

b)

trauma

c)

radiation exposure

d)

all of the above

6.

in dilated cardiomyopathies:

a)

all four chambers are dilated with systolic dysfunction

b)

all four chambers are dilated with normal systolic function

c)

all four chambers are within normal size limits with systolic dysfunction

d)

all four chambers are normal size limits with normal systolic function

7.

each answer is a characteristic of hypertrophic obstructive cardiomyopathy (HOCM) EXCEPT for:

a)

systolic anterior motion (SAM)

b)

mid-diastolic notching of the MV

c)

asymmetrical septal hypertrophy (ASH)

d)

mid systolic notching of the aortic valve

8.

what type of murmur is heard with aortic valve stenosis?

a)

mid-late systolic clic

b)

Austin Flint murmur

c)

decrescendo systolic murmur

d)

harsh, systolic ejection murmur

9.

in cardiac tamponade, the MV inflow ______ with inspiration and _____ with expiration

a)

increases, decreases

b)

decreases, increases

c)

decreases, unchanged

d)

unchanged, increases

10.

which tumor is most common benign tumor found in the adult heart?

a)

papillary fibroelastoma

b)

pericardial cyst

c)

myxoma

d)

rhabdomyoma

11.

which tumor is most common benign tumor found in pediatrics?

a)

papillary fibroelastoma

b)

pericardial cyst

c)

rhabdomyoma

d)

myxoma

12.

this image demonstrates which type of pathology?

a)

pericardial effusion

b)

dilated cardiomyopathy

c)

cardiac tamponade

d)

pseudoaneurysm

13.

which classification of aortic dissection involves just the descending thoracic or abdominal aorta?

a)

DeBakey Type I

b)

DeBakey Type II

c)

DeBakey Type III

d)

DeBakey Type IV

14.

which cardiac pathology may present with mid-systolic aortic valve closure?

a)

aortic regurg

b)

tricuspid regurg

c)

mitral regurg

d)

HOCM

15.

what coronary artery perfuses the wall segment indicated by the arrows?

a)

LAD

b)

LCX

c)

RCA

d)

PDAv

16.

what is the most common etiology of pulmonic stenosis?

a)

congenital

b)

degenerative

c)

carcinoid syndrome

d)

rheumatic fever

17.

a complication of this cardiomyopathy is:

a)

systemic emboli

b)

MR

c)

TR

d)

all of the above

18.

significant pulmonary regurg is a:

a)

LV volume overload

b)

RV volume overload

c)

LV pressure overload

d)

RV pressure overload

19.

MVP is considered present when any portion of the leaflet protrudes beyond the mitral annulus by

a)

<2 mm

b)

>4mm

c)

>2mm

d)

>2cm

20.

the connective tissue disease that manifests as "stretchy" skin, hypermobile joints, and easy bruising:

a)

Ehlers-Danlos syndrome

b)

Chagas disease

c)

Fabry's disease

d)

Cushing's disease

21.

this type of tumor results in the TV being thickened, retracted and immobile as shown below:

a)

carcinoid

b)

melanoma

c)

fibroelastoma

d)

myxoma

22.

which is NOT a possible cause of an aortic aneurysm?

a)

Marfan syndrome

b)

syphilis

c)

atherosclerosis

d)

AI

23.

to differentiate between restrictive cardiomyopathy and constrictive pericarditis, this parameter may be used:

a)

LV volume >22 mL/m^2

b)

respiratory variation of Mitral A velocity

c)

evaluation of LA and RA size

d)

IVC respiration variation

24.

untreated systemic HTN can cause

a)

CVA/TIA

b)

abdominal aortic aneurysm

c)

acute MI

d)

all of the above

25.

when color Doppler is applied to this image, what would be the most likely finding:

a)

MS

b)

AI

c)

MR

d)

TR

26.

the velocity measurement of 4.2 m/s and area of 0.7 cm^2 through the aortic valve would indicate:

a)

severe AI

b)

mild AS

c)

severe AS

d)

normal peak aortic valve velocity

27.

a characteristic in PSAX of RV pressure overload is

a)

flattening of IVS during systole

b)

flattening of the IVS throughout diastole and systole

c)

flattening of the IVS during diastole

d)

RV dilation

28.

the three layers of the pericardium include epicardium, myocardium and pericardium.

a)

true

b)

false

29.

a "spongy" appearance of the myocardium with prominent ventricular trabeculations describes:

a)

LV non compaction

b)

sarcoidosis

c)

infiltrative cardiomyopathy

d)

mural apical thrombus

30.

dilated cardiomyopathies create a pressure overload.

a)

true

b)

false

31.

the right sinus of valsalva is more prone to aneurysm than the left sinus of valsalva.

a)

true

b)

false

32.

echocardiography cannot rule out the presence of acute PE

a)

true

b)

false

33.

MR associated with SAM would have a posteriorly directed jet.

a)

true

b)

false

34.

decreased LV preload will augment dynamic outflow obstructions.

a)

true

b)

false

35.

amyloid and sarcoid are what type of cardiac abnormalities?

a)

dilated

b)

restrictive

c)

inflammatory

d)

hypertrophic

36.

a 2D echo finding associated with RV volume overload:

a)

flattening of the IVS in systole

b)

hyperkinetic IVS motion

c)

dyskinetic IVS motion

d)

flattening of the IVS in diastole

37.

Eisenmenger's syndrome may be associated with all of the following EXCEPT:

a)

bicuspid aortic valve

b)

PDA

c)

ASD

d)

VSD

38.

the Chiari network is found in the:

a)

RA

b)

RV

c)

LA

d)

LV

39.

surgical intervention of the aorta is considered when there is a rapid change in dilation of ____ mm per year

a)

1

b)

5

c)

3

d)

9

40.

increases in preload cause dialtion

a)

true

b)

false

41.

venous return decreases with inspiration

a)

true

b)

false

42.

which of the following is not included in the aortic root?

a)

sinotubular junction

b)

annulus

c)

sinus of valsalva

d)

infundibulum

43.

which pathology is a delayed form of pericarditis; occurring 1-12 weeks after MI?

a)

LV true aneurysm

b)

Takotsubo cardiomyopathy

c)

papillary muscle dysfunction

d)

Dressler's syndrome

44.

3 month post-op echo post MV replacement, you notice excessive rocking motion of the sewing ring. this is called what

a)

pannus

b)

dehiscence

c)

vegetation

d)

normal post op finding

45.

patient undergoes valve replacement for endocarditis. which of the following is an ABNORMAL post-op finding?

a)

a higher peak velocity than the pre op evaluation

b)

higher pressure gradient

c)

paravalvular leak

d)

increased pressure halftime

46.

what is the classic 2D finding associated with cardiac tamponade?

a)

diastolic collapse of the LV

b)

systolic collapse of the RV

c)

diastolic collapse of the RV

d)

systolic collapse of the LV

47.

during which part of the cardiac cycle can a bicuspid aortic valve be diagnosed?

a)

systole

b)

diastole

c)

IVRT

d)

IVCT

48.

which side of the MV will a vegetation likely appear on?

a)

atria

b)

ventricular

c)

on the septum

d)

on the chords

49.

what is a common cardiac auscultory finding for constrictive pericarditis?

a)

split S2

b)

S4

c)

pericardial knock

d)

systolic murmur

50.

which cardiac disease creates concentric hypertrophy?

a)

hypertensive heart disease

b)

hypertrophic cardiomyopathy

c)

chagas disease

d)

marfan syndrome

51.

what is NOT a complication of the pathology pictured?

a)

aortic dissection

b)

coronary ostial obstruction

c)

acute AI

d)

coronary sinus obstruction

52.

what is the best definition of PHTN?

a)

increased systolic and decreased diastolic blood pressure

b)

thickening and constriction of the small branches of pulmonary veins

c)

decreased systolic and increased diastolic blood pressure

d)

thickening and constriction of the small branches of the pulmonary arteries

53.

iron overload that can affect multiple organ systems:

a)

Pompes

b)

hemochromatosis

c)

Ebstein's

d)

hyperironlemia

54.

which of the following values indicate PHTN

a)

>25 mmHg at rest or >30 during exercise

b)

>30 mmHg at rest of >25 during exercise

c)

>45 mmHg at rest or >40 during exercise

d)

>55 mmHg at rest or >50 during exercise

55.

what is the difference between idiopathic and secondary PHTN

a)

idiopathic: known etiology

secondary: unknown etiology

b)

hell if i know

c)

idiopathic: unknown etiology

secondary: known etiology

d)

there is no difference

56.

which best defines the etiology of PHTN?

a)

increased workload of the left side of the heart

b)

increased workload on the LV

c)

increased workload of the right side of the heart

d)

increased workload on the valves of the heart

57.

increased pressure of pulmonary arteries leads to an enlarged RV

a)

true

b)

false

58.

which is the best definition of a murmur?

a)

sound go whoosh whoosh when i use my stethoscope

b)

lub, dub

c)

silent bloodflow across the ventricles and atria

d)

turbulent bloodflow across valves in the heart

59.

what does a crescendo-decrescendo murmur indicate?

a)

MR/TR

b)

AS/PS

c)

AI/PI

d)

MS/TS

60.

what does a holosystolic murmur indicate?

a)

AS/PS

b)

AI/PI

c)

MR/TR

d)

MS/TS

61.

what does an early diastolic/decrescendo murmur indicate?

a)

AS/PS

b)

AI/PI

c)

MR/TR

d)

MS/TS

62.

what does a mid-late diastolic murmur indicate?

a)

AS/PS

b)

AI/PI

c)

MR/TR

d)

MS/TS

63.

which is a key feature of PHTN?

a)

increased intensity of the second heart sound (P2)

b)

increased intensity of the first heart sound (P1)

c)

increased intensity of the third heart sound (P3)

d)

increased intensity of the fourth heart sound (P4)

64.

what would you see on an EKG in a patient with PHTN?

a)

AFIB

b)

RBBB

c)

LBBB

d)

sinus tachycardia

65.

what class of medications (and drugs) are considered first line of treatment for PHTN?

a)

diuretics - furosemide, hydrochlorothiazide

b)

beta blockers - metoprolol, carvedilol

c)

calcium channel blockers - amlodipine, Nifedipine

d)

anticoagulants - coumadin, Warfarin

66.

which of the following is a classic finding of MS?

a)

decreased LAP

b)

leaflet foming

c)

LV enlargement

d)

post stenotic dilation

67.

MR associated with MS is most likely due to

a)

aortic valve notching

b)

LAE

c)

LVE

d)

scarring of the septum

68.

signs and symptoms of MS include murmur, dyspnea, fatigue, dizziness, CP, syncope, and may worsen with exercise

a)

true

b)

false

69.

what contributes to the doming effect?

a)

commisural fushion

b)

increased pressure in the proximal chamber

c)

tethered leaflets

d)

all of the above

70.

choose the statement that supports the pressure halftime as it related to MS

a)

the flatter the waveform, the more severe the stenosis

b)

the lower the PHT the more critical the stenosis

c)

time required for the mean gradient across the valve to reduce to one half

d)

all of the above

71.

MVA =

a)

220/PHT

b)

PHT/220

c)

4V^2

d)

peak gradient/220

72.

if the MV PHT = 200 ms, the patient most likely has (hint: calculate the MVA to get the answer, you have 2 mins to answer)

a)

normal MV

b)

mild MS

c)

moderate MS

d)

severe MS

73.

choose a WELL KNOWN cause of MR

a)

annulus dilatation

b)

fatigue

c)

irregular rhythm

d)

all of the above

74.

chronic MR leads to decreased pulmonary artery pressure

a)

true

b)

false

75.

what does pulmonary venous systolic flow reversal indicate

a)

normal flow

b)

severe MR

c)

mild MR

d)

artifact

76.

what type of AS originates at the aortic valve cusps and moves out toward the commissures?

a)

congenital

b)

degenerative

c)

prosthetic

d)

rheumatic

77.

which of the following can over or underestimate AS

a)

improperly measured LVOT diameter

b)

tachycardia

c)

both A and B

d)

none of the above

78.

proximal to the aortic valve:

a)

supra aortic

b)

sub aortic

c)

inside the cusps

d)

in the descending AO

79.

the thickening of the valve because of accumulation of sugar chains

a)

fibroelastic deficiency

b)

ebstein's anomaly

c)

barlow's syndrome

d)

marfan's syndrome

80.

MVP must be greater than ___ beyond the annulus in systole

a)

3 mm

b)

4 mm

c)

2 mm

d)

1 mm

81.

combination of ASD and MS is what disease

a)

shone's

b)

ebstein's

c)

lutenbacher's

d)

eisenmenger's

82.

which is a secondary finding in MR

a)

MAC

b)

MVP

c)

PHTN

d)

endocarditis

83.

the mean pressure in the LA is

a)

0-2 mmHg

b)

2-6 mmHg

c)

2-12 mmHg

d)

120/80 mmHg

84.

chronic MR is a pressure overload

a)

true

b)

false

85.

acute MR can happen due to a MI

a)

true

b)

false

86.

with acute MR, you can have normal size chambers

a)

true

b)

false

87.

stroke volume is related to

a)

LVED volume

b)

LVES volume

c)

pressure

d)

PHTN

88.

what is the most common MS etiology

a)

lutenbacher's

b)

rheumatic fever

c)

shones

d)

MAC

89.

Frank Starling law is associated with afterload

a)

true

b)

false

90.

early closure of the PV is seen in

a)

AI

b)

AS

c)

PHTN

d)

carotid stenosis

91.

4TRv^2 is used to calculate RVSP

a)

true

b)

false

92.

reversal of cardiac shunts from left to right to right to left

a)

ebstein's anomaly

b)

eisenmenger's

c)

HTN

d)

barlows

93.

change in the structure of the RV due to abnormal pulmonary circulation in long standing PHTN

a)

ebstein's anomaly

b)

aortic aneurysm

c)

cor pulmonale

d)

AFIB

94.

what will you see in the short axis pap view with pressure overload:

a)

O shaped ventricle

b)

normal shaped ventricle

c)

D shaped LV

d)

no pap muscles

95.

PE is defined as:

a)

chronic AFIB

b)

DVT

c)

clot in the LV

d)

sudden/acute blockage of one or more of the pulmonary arteries

96.

a tumor or thrombus can cause or mimic MS

a)

true

b)

false

97.

PE can be fatal if left untreated

a)

true

b)

false

98.

MS always causes MR

a)

true

b)

false

99.

MS over time causes LAE

a)

true

b)

false

100.

you should check for LA thrombus in the presence of MS

a)

true

b)

false

101.

which is a primary finding of MS

a)

MR

b)

MVP

c)

LA tumor

d)

LA thrombus

102.

which is a secondary feature of MS

a)

LA tumor

b)

MAC

c)

PHTN

d)

decreased pressures

103.

which is a complication of MS

a)

LA tumor

b)

IE

c)

tricuspid atresia

d)

valve replacement

104.

severe MS valve area

a)

4-6 cm^2

b)

1.5 cm^2

c)

1-1.5 cm^2

d)

less than 1cm^2

105.

elevated pressures in the arterial vessels in the body is called

a)

hypothyroidism

b)

HTN

c)

hyperlipidemia

d)

hyperkalemia

106.

normal blood pressure

a)

100/20

b)

180/20

c)

120/80

d)

120/60

107.

systemic HTN is known as the "silent killer" when left untreated

a)

true

b)

false

108.

essential HTN is

a)

primary

b)

secondary

c)

not harmful to the body

d)

chemical

109.

all are risk factors for HTN EXCEPT:

a)

family history

b)

alcohol abuse

c)

stress

d)

drinking water

110.

which pathology can happen due to untreated, prolonged HTN

a)

venous insifficiency

b)

LVH

c)

dilated cardiomyopathy

d)

age

111.

diabetes is a comorbidity for HTN

a)

true

b)

false

112.

HTN can not cause a heart attack or stroke:

a)

true

b)

false

113.

HTN can cause aortic dissection or aneurysm

a)

true

b)

false

114.

all of the following are treatments for HTN EXCEPT:

a)

gain weight

b)

reduce stress

c)

diuretics

d)

change diet

115.

smoking will lower blood pressure

a)

true

b)

false

116.

which of the following is considered PHTN?

a)

1-2mmHg

b)

50-60mmHg

c)

3-5 mmHg

d)

5-10 mmHg

117.

congestion in the vascular bed of the lungs

a)

systemic HTN

b)

PHTN

c)

hyoptension

d)

hyperlipidemia

118.

glycogen storage disease within the myocardium

a)

hemochromatosis

b)

hyperkalemia

c)

pompe

d)

hypokalemia

119.

multisystem disorder characterized by extra cellular interstitial deposits of protein

a)

sarcoiosis

b)

pericardial effusion

c)

pompes

d)

amyloidosis

120.

inflammatory masses formed by granulomas that are deposited into multiple organs including the myocardium of the heart

a)

pompes

b)

amyloidosis

c)

sarcoidosis

d)

ebstein's

121.

endomyocardial fibrosis is also known as the "heart of africa"

a)

true

b)

false

122.

excessive alcohol use can result in dilated cardiomyopathy

a)

true

b)

false

123.

which of the following is also known as congestive cardiomyopathy

a)

HCM

b)

DCM

c)

RCM

d)

sarcoidosis

124.

the most common cardiomyopathy is known as RCM

a)

true

b)

false

125.

LV thrombus is a primary finding of DCM

a)

true

b)

false

126.

Takotsubo is also known as

a)

heart string syndrome

b)

LVH

c)

broken heart syndrome

d)

RCM

127.

Chagas disease is a genetic disease

a)

true

b)

false

128.

what is the inner layer of the arterial wall

a)

tunica externa

b)

tunica adventitia

c)

tunica intima

d)

tunica media

129.

congenital defect that impacts the connective tissue in the body

a)

fabry's

b)

ebstein's

c)

marfan's

d)

eisenmengers

130.

tear in the intimal lining of the aorta

a)

aortic aneurysm

b)

aortic stenosis

c)

aortic regurg

d)

aortic dissection

131.

the ascending aorta only dissection is classified as Type I

a)

true

b)

false

132.

aortic dissection can be fatal if not treated

a)

true

b)

false

133.

DCM requires transplant in end stages

a)

true

b)

false

134.

which echo method is most commonly used to estimate pressure gradients across valves?

a)

continuity equation

b)

pisa method

c)

bernoulli equation

d)

tissue doppler imaging

135.

what doppler technique is required for accurate gradient assessment in stenotic valves?

a)

color doppler

b)

PW

c)

CW

d)

M mode

136.

in severe AS, the mean transvalvular gradient is typically

a)

<10 mmHg

b)

10-19 mmHg

c)

20-39 mmHg

d)

>40 mmHg

137.

the peak velocity threshold for severe AS is

a)

>2.0 m/s

b)

>3.0 m/s

c)

≥ 4.0 m/s

d)

≥ 5.0 m/s

138.

pressure half time is most useful for quantifying the severity of

a)

AS

b)

MS

c)

TR

d)

MR

139.

a MVA <1.0 cm^2 with a mean gradient >10 mmHg suggests

a)

mild MS

b)

moderate MS

c)

severe MS

d)

critical MR

140.

in TR, the peak regurgitation velocity is used to estimate

a)

RV stroke volume

b)

PASP

c)

LV filling pressure

d)

aortic gradient

141.

the mean transmitral gradient in mild MS is usually

a)

< 5mmHg

b)

5-10 mmHg

c)

10-15 mmHg

d)

>15 mmHg

142.

the vena contracta width of >0.7 cm in MR responds to

a)

mild MR

b)

moderate MR

c)

severe MR

d)

indeterminate

143.

which parameter is least dependent on heart rate when assessing MS

a)

mean gradient

b)

pressure halftime

c)

MVA by planimetry

d)

LV inflow pattern

144.

PS is considered severe when the peak doppler velocity is

a)

>2.5 m/s

b)

>3.0 m/s

c)

>3.5 m/s

d)

>4.0 m/s

145.

in AI, pressure half time of <200 m/s indicates

a)

mild AI

b)

moderate AI

c)

severe AI

d)

indeterminate

146.

what is the hemodynamic consequence of overestimating doppler angle in stenosis assessment?

a)

overestimation of velocity and gradient

b)

underestimation of velocity and gradient

c)

no effect

d)

variable effect depending on valve

147.

which gradient is more clinically relevant in valve stenosis assessment?

a)

peak instantaneous gradient

b)

mean gradient

c)

pulse pressure

d)

pressure recovery

148.

a patient with MS has a pressure half time of 300 m/s. what is the estimated valve area? (hint: calculate the MVA, you have 2 minutes to answer)

a)

1.0 cm^2

b)

0.75 cm^2

c)

0.6 cm^2

d)

2.0 cm^2

149.

the gorlin equation is based on

a)

invasive catherization

b)

doppler continuity

c)

pisa method

d)

2D planimetry

150.

in MR, an effective regurgitant orifice area ≥ 0.40 cm^2 indicates

a)

mild

b)

moderate

c)

severe

d)

physiologic

151.

PI severity is best assessed by

a)

jet width

b)

pressure half time

c)

peak velocity alone

d)

jet duration into diastole

152.

what additional parameter must be added to TR gradient to estimate PASP

a)

mean RA pressure

b)

LVEDP

c)

LV systolic pressure

d)

systemic BP

153.

in low flow, low gradient AS, dobutamine stress echo helps determine true vs pseudo-severe stenosis

a)

true

b)

false

154.

MR jet area by color doppler is less reliable because it is highly dependent on

a)

LA compliance and gain settings

b)

LVOT velocity

c)

pulmonary vein flow

d)

heart rate

155.

severe TS usually presents with a mean gradient of

a)

<2 mmHg

b)

2-4 mmHg

c)

≥ 5 mmHg

d)

≥ 10 mmHg

156.

for severe MS, which combination is correct

a)

MVA 1.5, mean gradient <5

b)

MVA <1.0, mean gradient ≥ 10

c)

MVA 1.0, mean gradient <1

d)

MVA >2.0, mean gradient >10

157.

CW doppler across the aortic valve shows a (Vmax) of 4.2 m/s. what is the peak instantaneous pressure gradient? (you have 2 mins to answer so you can calculate)

a)

36 mmHg

b)

56 mmHg

c)

71 mmHg

d)

84 mmHg

158.

CW Doppler across the AV shows a mean transvalvular gradient of 45 mmHg (sinus rhythm, no tachycardia). severity? (you have 2 mins to answer for your valvulation

a)

mild

b)

moderate

c)

severe

d)

indeterminate

159.

CW Doppler across the pulmonic valve shows a peak velocity (Vmax) of 3.8 m/s. what is the severity of pulmonic stenosis? (you have 2 mins to answer and to calculate)

a)

mild

b)

moderate

c)

severe

d)

indeterminate

160.

An adult in sinus rhythm with normal SV has a mean aortic valve gradient of 32 mmHg on CW Doppler. Severity? (you have 2 mins to calculate and answer)

a)

mild

b)

moderate

c)

severe

d)

indeterminate