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WorksheetsBalian Bunyi MCQ Practice 1
Total questions: 40
Worksheet time: 20mins
Which of the following probes is MOST appropriate for a focused cardiac ultrasound (FoCUS) exam on an adult?
Linear array (high frequency, 7-15 MHz)
Curvilinear array (low frequency, 2-5 MHz)
Phased array (low frequency, 1-5 MHz)
Endocavitary probe
Which probe movement involves tilting the probe along its long axis?
A)Rotation
B)Sliding
Fanning
Rocking
Time Gain Compensation (TGC) is used to:
Compensate for increased attenuation of sound waves at greater depths.
Increase the frame rate for better temporal resolution.
Switch between imaging modes.
Change the probe frequency based on depth.
Which artifact creates a duplicate or ghost image of a structure on the opposite side of a strong reflector (like the pleura)?
Side lobe artifact
Mirror image artifact
Comet tail artifact
Ring-down artifact
M-mode (Motion Mode) is most useful for:
Generating a detailed anatomical cross-section.
Evaluating the movement of structures over time with high temporal resolution.
Assessing blood flow velocity and direction.
Measuring the volume of an organ.
A key limitation of Color Flow Doppler is:
It provides poor temporal resolution for rapid events.
It inaccurately measures high-velocity flows.
It is angle-dependent
It is susceptible to aliasing when velocities exceed the Nyquist limit.
Pulsed Wave (PW) Doppler is characterized by:
The ability to sample flow at a specific, user-defined location (sample volume).
Continuously sending and receiving sound waves.
Being the best modality for measuring very high velocities (e.g., in stenosis).
Providing a color overlay on the 2D image.
When imaging the internal jugular vein for central line placement, compressing the vein with the probe is a key maneuver. This primarily demonstrates:
Assessing venous valve function.
Demonstrating the artery's pulsatility.
Ruling out thrombus.
Evaluating blood flow turbulence.
The "Focal Zone" marker on the side of the screen should be positioned:
At the deepest point of interest.
At the level you want optimal lateral resolution.
At the skin surface.
It has no significant practical impact on image quality.
Tissue Harmonic Imaging (THI) improves image quality by:
Using lower frequency transmitted waves.
Processing higher frequency echoes generated within the tissue.
Increasing the output power (Mechanical Index).
Eliminating the need for gain adjustment.
When using PW Doppler, obtaining an accurate velocity measurement requires:
Placing the sample volume at a 90-degree angle to the vessel.
Placing the Doppler beam as parallel as possible to the direction of blood flow.
Using the highest possible frequency setting.
Maximizing the color gain.
Increasing the sector width in a cardiac exam will primarily:
Improve temporal frame rate.
Worsen temporal resolution.
Increase penetration depth.
Reduce lateral resolution.
During an E-FAST exam on a blunt trauma patient, you identify a large, anechoic stripe in Morison's Pouch. The MOST appropriate action is:
Obtain a formal radiology ultrasound for confirmation.
Administer a 1L crystalloid fluid bolus.
Prepare the patient for emergent laparotomy.
Perform a diagnostic peritoneal lavage (DPL).
The "Spine Sign" on thoracic ultrasound refers to:
Visualization of the thoracic spine above the diaphragm.
Visualization of the thoracic spine through the liver.
Visualization of the spine above the diaphragm in a parasternal view.
A sonographic artifact caused by scoliosis.
A trauma patient is hypotensive. Your E-FAST shows a positive "curtain sign" bilaterally and a sliding pleura on the right. On the left, you see complete absence of lung sliding and no B-lines. The MOST likely diagnosis is:
Bilateral hemothorax.
Right-sided pneumothorax, left-sided pulmonary contusion.
Left-sided pneumothorax.
Bilateral pulmonary edema.
What is the primary ultrasound finding that confirms the diagnosis of a hemothorax (as opposed to a simple pleural effusion) in an acute trauma setting?
The presence of swirling echogenic material within the anechoic fluid.
The presence of septations within the fluid collection.
A complex, localized fluid collection.
There is NO reliable sonographic finding to differentiate acute hemothorax from simple effusion.
During the pericardial views of an E-FAST on a stab wound victim to the chest, you identify a small, anechoic stripe in the subxiphoid view that appears only during systole. This is MOST suggestive of:
A normal pericardial recess with no pericardial or pleural effusion.
A pericardial effusion with early tamponade physiology.
A pleural effusion mistaken for pericardial fluid.
Epicardial fat pad.
The "Lung Point Sign" is:
A static hyperechoic point at the lung base indicating contusion.
The transition point between normal lung sliding and the absence of sliding.
A point where multiple B-lines originated in interstitial syndrome.
The point where the diaphragm meets the chest wall.
A "positive" FAST exam for abdominal free fluid in a stable pediatric trauma patient:
Is a strong indication for immediate laparotomy.
Should be followed by a CT scan for further characterization.
Is less reliable than in adults and should be ignored.
Is diagnostic of solid organ injury.
What is the most significant limitation of the E-FAST exam in trauma?
It cannot reliably detect pneumothorax.
It has poor sensitivity for detecting retroperitoneal hematomas.
It is too time-consuming to be useful in the initial trauma survey.
It requires a radiologist to perform if it is a pediatric patient.
In a dyspneic patient, you perform lung ultrasound and see bilateral, diffusely spaced, multiple B-lines (3 or more between ribs) in multiple lung zones. This finding is MOST consistent with:
Chronic obstructive pulmonary disease (COPD).
Normal lung aeration.
Interstitial syndrome.
Large pleural effusion
A patient with suspected pneumonia presents with fever and cough. Lung ultrasound reveals a subpleural consolidation with a hyperechoic, irregularly-shaped deep border and associated dynamic air bronchograms. This pattern is called:
Atelectasis
Hepatization
Alveolar-interstitial syndrome
Tissue-like sign with shred sign
A patient with end-stage renal disease on dialysis presents with worsening dyspnea. Lung ultrasound shows bilateral, diffuse B-lines. After aggressive dialysis, a repeat scan shows the B-lines have resolved. This BEST demonstrates:
The utility of LUS in diagnosing pneumonia.
The dynamic nature in tracking volume status and pulmonary edema.
The poor specificity of B-lines.
The presence of irreversible lung fibrosis.
What is the clinical significance of a "static" air bronchogram within a lung consolidation, as opposed to a "dynamic" one?
It suggests a more favorable prognosis.
It is pathognomonic for pulmonary infarction.
It may indicate a post-obstructive pneumonia or atelectasis.
It rules out an infectious aetiology.
In a mechanically ventilated patient, you assess for "fluid responsiveness" using IVC Distensibility Index (IVC-DI). Which finding would MOST suggest the patient will increase their stroke volume with a fluid bolus?
IVC diameter is fixed and does not change with the respiratory cycle.
IVC-DI is >18%.
IVC is dilated (>2.5 cm) and does not change.
IVC-DI is <12%.
What is the purpose of the "Sniff Test" during IVC assessment?
To assess diaphragmatic function.
To provoke maximum IVC collapse in a spontaneously breathing patient.
To increase intrathoracic pressure and assess for reflux in hepatic veins.
To improve subcostal image quality.
A major limitation of using IVC collapsibility to guide fluid therapy in spontaneously breathing patients is:
It cannot be measured accurately.
It has poor predictive value for fluid responsiveness in strongfuly breathing patients.
It is not applicable in distributive shock.
It directly measures left ventricular preload.
When assessing the IVC, why is it standard to measure the diameter within 2-3 cm caudal to the IVC-RA junction?
To avoid hepatic vein artifact.
This is the point of maximum diameter, ensuring consistency.
To avoid measurement inaccuracies from the "floppy" intrahepatic portion.
This is where the phrenic nerve crosses.
When measuring the abdominal aorta with ultrasound to screen for an aneurysm, the correct technique is to measure the:
Inner-wall to inner-wall diameter in the longitudinal plane.
Outer-wall to outer-wall diameter in the transverse plane.
Inner-wall to inner-wall diameter at the point of maximum pulsation.
Outer-wall to outer-wall diameter in the longitudinal plane.
The "cobra head" sign in abdominal ultrasound refers to:
The bifurcation of the common iliac arteries.
The origin of the superior mesenteric artery (SMA) from the aorta.
A normal variant of the proximal superior mesenteric artery.
The appearance of a dilated proximal common iliac artery.
The first major anterior branch of the abdominal aorta below the diaphragm is the:
Superior Mesenteric Artery (SMA)
Inferior Mesenteric Artery (IMA)
Celiac Trunk
Right Renal Artery
The "seagull sign" in abdominal ultrasound is used to identify:
The renal arteries.
The bifurcation of the aorta.
The branches of the celiac trunk (common hepatic and splenic arteries).
The superior mesenteric artery and vein.
In a cardiac ultrasound, a dilated aortic root (>4.0 cm in an average adult) is MOST associated with which of the following conditions?
Chronic obstructive pulmonary disease (COPD).
Systemic hypertension and connective tissue disorders.
Constrictive pericarditis.
Isolated right heart failure.
A patient in distributive shock from sepsis has a bedside cardiac ultrasound showing a hyperdynamic, underfilled left ventricle and a very small, collapsing IVC. However, you note the abdominal aorta appears dilated at 4.2 cm in the transverse plane. What is the MOST appropriate interpretation?
The patient has a ruptured AAA causing shock.
The AAA is an incidental, chronic finding; shock is due to sepsis.
The aortic measurement is falsely high due to hypovolemia.
The patient has an aortic dissection.
Which of the following findings on a cardiac ultrasound would be MOST specific for a Stanford Type A aortic dissection?
Aortic root dilation >4.5 cm.
An intimal flap in the ascending aorta that moves with the cardiac cycle.
Aortic valve regurgitation.
A pericardial effusion.
The primary diagnostic criterion for an acute deep venous thrombosis (DVT) on compression ultrasound is:
Visualization of echogenic material within the vein lumen.
Absence of Doppler flow signal in the vein.
Non-compressibility of the vein with probe pressure.
Dilation of the vein compared to the adjacent artery.
During a pre-intubation airway ultrasound, you are identifying the cricothyroid membrane. The sonographic landmark to locate it is:
The thyroid cartilage, which appears as a hyperechoic, curvilinear structure with posterior shadowing.
The tracheal rings, which appear as hypoechoic, U-shaped structures with comet-tail artifact.
The hyoid bone, which is hyperechoic with dense shadowing.
The thyroid gland, which is homogeneously hypoechoic.
To confirm endotracheal tube (ETT) placement using ultrasound, you place the linear probe transversely just above the suprasternal notch. After intubation, you observe a single, strong "flutter" artifact with each ventilation. This indicates:
Esophageal intubation.
Endotracheal intubation.
Mainstem bronchial intubation.
The tube is in the pharynx.
The Optic Nerve Sheath Diameter (ONSD) is used as a non-invasive surrogate for:
Intraocular pressure.
Intracranial pressure (ICP).
Cerebral perfusion pressure.
Retinal artery pressure.
When performing ONSD measurement, the correct location and technique is to:
Measure the diameter 10 mm behind the globe in the axial plane, inner-to-inner sheath.
Measure the diameter 3 mm behind the globe in the axial plane, outer-to-outer sheath.
Measure the diameter at the retina in the sagittal plane.
Measure the diameter of the optic nerve within the globe.
