Davies 2.0

The American Society of Echo adopted the "leading edge" method of measurement because:
A. people were turning up the gain too much
B. The nature of the interaction between ultrasound and anatomical interfaces makes this advisable
C. the advent of grayscale M mode made this possible
D. It produces the most consistent and reproducible measurements

D

The term basilar area of the ventricle refers to the:
A. Ventricular myocardium at the apex
B. mid segments of the ventricle
C. Ventricular myocardium at the AV valves
D. none of the above

C

The infundibulum is related to the area of the right ventricle called the:
A. inflow tract
B. outflow tract
C. apical area
D. subvalvular area

B

The three primary branches of the aortic arch include all of the following except the:
A. innominate arteryB. Right subclavian arteryC. Left common carotid arteryD. Left subclavian artery

B

The term tunica adventitia refers to:
A. the inner lining of the arterial wall
B. the outer lining of the arterial wall
C. transverse arterial muscle fibers
D. the intimal wall
E. the middle layer of the arterial wall

B

The term tunica intima refers to which of the following:
A. the inner lining of the arterial wall
B. the outer lining of the arterial wall
C. transverse arterial muscle fibers
D. longitudinal muscle fibers
E. the middle layer of the arterial wall

A

Dextracardia indicates:
A. enlargement of all cardiac chambers
B. an abnormal conduction system
C. heart located in the right side of the chest
D. dual chambers of the right ventricle

C

You are asked to pay particular attention to the semilunar valves. These valves are the:
A. mitral and aortic valvesB. mitral and tricuspid valvesC. pulmonic and tricuspid valvesD. aortic and pulmonic valves

D

The great vessels of the heart are:
A. inferior vena cava and superior vena cava
B. inferior vena cava and subclavian artery
C. aorta and subclavian artery
D. aorta and pulmonary artery

D

In M-mode, the structure used to pinpoint end systole for measurement is:
A. the R wave of the ECG
B. maximum anterior motion of the left ventricular posterior wall
C. Maximum posterior motion of the interventricular septum
D. the Q wave of the ECG

B

The motion of the septum should be evaluated by M mode at the:
A. Basal levelB. Mitral levelC. Midventricular levelD. apical level

C

The coronary sinus returns blood to the left atrium. True or false?

False

The ostium of the coronary arteries may sometimes be visualized in a short-axis two-dimensional echo view at the level of the aortic valve. True or false?

True

Since phrases of the cardiac cycle are discussed in terms of systole and diastole of the ventricle, what phase would be occurring during atrial filling?
A. diastoleB. systoleC. insovolumic phase

B

In the ECG cycle, late ventricular filling occurs after the:
A. P waveB. Q waveC. R waveD. T wave

A

If a patient presents with an early diastolic murmur you would concentrate interest on the: (true or False)
Aortic valve?Mitral valve?Tricuspid valve?Pulmonic valve?

True, false, false, true

Which valve would you suspect to be abnormal if auscultation revealed an Austin-Flint murmur?
A. aortic valveB. mitral valveC. Tricuspid valveD. pulmonic valve

A

Most authors consider the major components of the first heart sound to be:
A. closure of the semilunar valvesB. closure of the atrioventricular valvesC. opening of the semilunar valvesD. opening of the atrioventricular valves

b

The heart sound most often associated with mitral valve prolapse is:
A. Gallop rhythmB. Ejection soundsC. Opening snapD. Systolic click

D

The heart sound associated with mitral and/or tricuspid stenosis is:
A. Ejection soundB. Gallop rhythmC. A friction rubD. Opening snap

D

Early diastolic murmurs are due to aortic or pulmonic insufficiency:True or false?

True

Myxomas are the most common type of cardiac tumor. They compromise half of all reported cases. which of the following statements are true?
These tumors can be located either inside or outside the heart.
Approximately 40% of patients with left atrial myxomas have systemic emboli to the brain or extremities.
Myxomas occur only in the left atrium.
Females are affected slightly more often than males.

false, true, false, true

Symptoms associated with pericarditis include: (true or false)
A severe, sharp pain located precordially that may radiate into the shoulders and neck
ankle swelling
changing positions and taking deep breaths increases the pain
the pain is dull and radiates into the jaw

true, false, true, false

Symptoms noted with mitral valve prolapse syndrome include: (true or false)
palpitations and sharp pain unrelated to exercise.
lower back pain and headache
fatigue and dyspnea
palpitations and dizzy spells

True, false, true, true

A pseudonym for mitral valve prolapse syndrome is:
A. ebstein's anomalyB. Barlow's syndromeC. Crohn's diseaseD. Prinzmetal angina

B

the term dyspnea refers to the condition of:
A. Difficulty in digesting foodB. difficulty in breathingC. rapid breathingD. deep breathing

B

If a patient awakens in the night with shortness of breath, 1-2 hours after falling asleep, what disease might be suspected?
A. angina pectorisB. mitral valve prolapseC. constrictive pericarditisD. congestive heart failure

D

Anemia or cyanosis may be a manifestation of serious underlying heart disease. true or false?

True

Palpitation of arterial pulses is a method used to help determine the presence or absence of diagnostic physical signs for certain cardiac diseases. Which of the following statements is/are correct? (True or false)
Heart failure, obstruction of flow by valvular stenosis, and constrictive pericarditis can cause a diminished stroke volume.
Normal peripheral pulses arrive later than the carotid pulse.
pulsus alternans implies impaired ventricular function and is often resent in massive pericardial effusion, particularly pericardial tamponade.
Aortic regurgitation and carotid atherosclerosis cause a large stroke volume, wide pulse pressure, and lowered peripheral resistance with resultant bounding hyperkinetic pulses.

True, true, true, true

Dextracardia can be detected by chest x-ray, percussion, ECG examination, auscultation, and asking the patient.True or false?

True

Which of the following signs are indicative but not diagnostic of heart disease? (True or false)
Sharp chest pains.
cyanosis.
Clubbing.
Obesity.

True, true, true, true

Which one of the following is most likely to cause a decrease in cardiac output?
A. a decrease in peripheral resistance
B. hyperemia
C. decrease in LV stroke volume
D. increase in heart rate
E. hypertension

C

If all other factors remain constant, you would expect a reduction in vessel diameter to:
A. increase velocityB. decrease the likelihood of turbulenceC. decrease viscosityD. decrease kinetic energyE. increase flow

A

A decrease in LV contractility secondary to acute MI will:
A. increase cardiac output (Q) by increasing resistance (R)
B. decrease cardiac output (Q) by decreasing pressure (delta P)
C. increase velocity of flow in the aorta
D. decrease deltaP with no effect on cardiac output (Q)

B

Which on of the following is most likely to cause turbulent flow of blood in the aorta?
A. an increase in cardiac output from 5 L/min to 20 L/min
B. an increase in hematocrit
C. a decrease in cardiac output to one-half of normal
D. an increase in arterial pressure of 5 mmHg
E. a hypertensive episode

A

Which of the following are characteristics of turbulent flow? (true or false)
It can be predicted by Reynold's number.
It is responsible for murmurs, bruits and thrills.
It increases pressure downstream.
It occurs where there are abrupt variations in vessel diamter.
It is affected by velocity.

True, true, false, true, true

During an experiment, a lab animal suddenly develops 2:1 heart block, effectively reducing heart rate by one-half. Which ONE of the following responses would account for pressure being maintained at the same level as before the heart block?
A. peripheral resistance decreased by one-half.
B. massive vasodilation of the arterial sphincters.
C. peripheral resistance doubled
D. arteriovenous shunting
E. peripheral resistance unchanged

C

A subject has a cardiac output of 5 L/min at a heart rate of 75 beats/min. If stroke volume remains constant, what will be the effect of an increase in heart rate to 150 beats per minute?
A. cardiac output would increase to 22.5 L/min
B. cardiac output would increase to 25 L/min
C. Cardiac output would increase to 10 L/min
D. nothing; cardiac output is independent of heart rate
E. cardiac output would triple

C

Which ONE of the following statements is True regarding the term blood pressure?
A. it is reported in cm H₂O unless otherwise specified
B. it represents the force exerted by the blood against any unit area of the vessel wall
C. it is constant throughout the cardiac cycle
D. it represents and can be used interchangeable with flow
E. it is the same as hydrostatic pressure

B

The minimal pressure in the arterial system during a cardiac cycle is termed:
A. systolic pressureB. pulse pressureC. diastolic pressureD. mean pressureE. mean pulse pressure

C

In measuring human blood pressure, the first sound was heard at 130 mmHg, the second at 105, the third at 100, and the last at 95. What is the estimated mean blood pressure?
A. 118 mmHgB. 115 mmHgC. 122 mmHgD. 107 mmHgE. 104 mmHg

D

Which ONE of the following is a correct statement describing transmission of the arterial pressure wave?
A. it originates at the level of the arterioles.
B. it slows with increasing age
C. it slows with increasing calcification of the vessels
D. it is caused in part by the inertia of blood in the aorta

D

In laminar flow, the velocity of the blood is:
A. directly proportional to the cross-sectional area of the vessel
B. it slows with increasing age
C. it slows with increasing calcification of the vessels
D. it is caused in part by the inertia of blood in the aorta

D

The principal site of peripheral resistance in the vascular bed is determined to be in the arterioles because:
A. The blood pressure does not change across these vessels
B. the blood flow is slowest in the arterioles
C. the pressure drop across these vessels is greatest
D. these vessels have thick muscular coats
E. the blood pressure is highest here

C

The arterial pressure wave moves toward the periphery, all of the following occur except:
A. the pulse amplitude is increased by the presence of reflected waves
B. speed of propagation diminished
C. pulsatile changes in arterioles and capillaries are "dampened" owing to vascular distensibility and resistance
D. speed of propagation increases

B

The incisura on the aortic pressure wave:
A. indicates the closure of the AV valves
B. occurs when the aortic valve opens
C. is inscribed just after the aortic valve closes
D. occurs during rapid ventricular filling
E. result from aortic valve malfunction

C

Starling's law of the heart can best be expressed by which one of the following?
A. as heart rate increases, ventricular contractility also increases.
B. increasing the arterial pressure decreases the stroke volume
C. within limits, an increase in venous return results in an increase in stroke volume
D. the product of heart rate and stroke volume equals the cardiac output

C

Which ONE of the following best describes the role of the heart as a pump?
A. regulating cardiac output
B. forcing blood from the venous to the arterial circulation, restoring energy necessary for the blood flow
C. suctioning blood from the venous circulation
D. removing carbon dioxide from venous blood and supplying oxygen

B

Which ultrasound system control automatically calibrates for measurements?
A. overall gainB. RejectC. Near gainD. Depth

D

Increasing system gain can reduce technical artifacts.True or false?

False

The purpose of the time-gain compensation (TGC) circuit is: (True or false)
To suppress near field echoes.
To enhance far-field echoes.
To selectively eliminate weak echoes.
To compensate for loss of ultrasound energy (attenuation) as the beam enters the body.

True, True, false, true

Which of the following are true/false regarding the side lobes seen in 2D images?
They are generated from the edges of individual transducer elements.
They are a greater problem with mechanical systems.
They are a greater problem with phased array systems.
They display fuzzy areas on the image.

True, false, true, false

In a parasternal long-axis transducer position, imaging is being done from the wrong intercostal space when: (true or false)
The interventricular septum and the anterior aortic root wall meet at a right angle.
The interventricular septum and the anterior aortic root wall are contiguous.
The interventricular septum and the anterior aortic root wall do not meet.
The interventricular septum and the posterior aortic root wall meet.

true, false, true, true

With which of the following conditions would a contrast agent not likely be used to enhance the echo diagnosis?
A. atrial septal defectB. idiopathic hypertrophic subaortic stenosisC. ventricular septal defectD. patent ductus arteriosus

B

Left-to-right shunts are more difficult than right-to-left shunts to detect with peripheral-vein contrast injections because:
Contrast is totally filtered out at the pulmonary capillary level.
Negative contrast is not as easy to identify as positive contrast.
Microbubbles will not travel left to right because of pressure differences.
The microbubbles traveling from the right side into the left are rare and difficult to see.

False, true, false, true

In which condition could amyl nitrate be useful?
A. mitral stenosisB. atrial septal defectC. aortic stenosisD. Idiopathic hypertrophic subaortic stenosis

D

The apical four-chamber view is frequently the first approach for a Doppler study because:
A. it is the easiest location from which to obtain image and doppler information
B. the transducer is closest to the valves in this position
C. the Doppler beam is parallel to the flow through multiple valves
D. more abnormalities can be identified from this location

Parasternal long-axis views are good for Doppler applications because of the relationship of angle to flow.True or false?

False

Left atrial dilation is associated with:
A. significant mitral regurgitationB. increased pulmonary pressuresC. patent ductus arteriosusD. all of the above

D

The E-F slope of the mitral valve corresponds to which event in the cardiac cycle?
A. The "conduit phase"B. rapid diastolic fillingC. Early systoleD. Late systole

B

Normal opening of the mitral valve is caused by the pressure being higher in the left ventricle than in the left atrium.True or False?

false

The M-mode criterion that defines mitral stenosis the least is:
A. anterior movement of the posterior leafletB. A reduced E-F slopeC. An increased A-C intervalD. A dense, thickened appearance of the valves

C

The mitral two-dimensional echo view that best allows calculation of the mitral orifice is the:
A. parasternal long-axis viewB. apical two-chamber viewC. parasternal short-axis viewD. subcostal four-chamber view

C

The mitral two-dimensional echo view that is most used in continuous-wave Doppler imaging of mitral stenosis is the:
A. parasternal long-axis viewB. apical four-chamber viewC. parasternal short-axis viewD. subcostal four-chamber view

B

The criterion that is the most helpful in defining mitral stenosis is:
A. left ventricular enlargementB. Left ventricular hypertrophyC. Left atrial enlargementD. Aortic root dilation

C

Following a mitral commissurotomy, the valve orifice can be accurately evaluated with the:
A. M-mode, by defining the leaflet separation
B. Two-dimensional echocardiography, by imaging the actual orifice.
C. Doppler, by the velocity of the flow and Bernoulli's equation
D. Doppler, by estimating valve area using the pressure half-time formula

D

Which of the following mitral conditions could cause mitral regurgitation?
A. mitral stenosisB. mitral prolapseC. mitral vegetationD. all the above

D

Peak mitral regurgitant velocity tells the examiner:
A. the severity of mitral regurgitation
B. maximum instantaneous pressure difference between the LV and LA
C. the cause of the mitral regurgitation
D. the direction of the regurgitant jet

B

A two-dimensional echo criterion that can be very helpful in determining mitral regurgitation is:
A. high frequency oscillations of the mitral valve
B. premature closure of the aortic valve
C. left ventricular enlargement
D. left ventricular hypertrophy

B

The two-dimensional echo view best for Doppler analysis of mitral regurgitation is:
A. the parasternal long axis-view
B. the parasternal short-axis view
C. the apical four chamber view
D. none of the above

C

Left atrial enlargement could be a criterion for determining mitral regurgitation. True or false?

True

Mitral regurgitation is always associated with mitral valve prolapse. true or false?

False

Which of the mitral conditions listed below could be associated with mitral regurgitation?
A. Rupture of the chordaeB. Flail leafletC. Annular calcificationD. all of the aboveE. none of the above

D

The term myxomatous degeneration used to describe a mitral valve prolapse denotes:
A. thickening of the mitral valve leaflets
B. a myxoma in the vicinity of the mitral valve
C. redundancy of the mitral valve leaflets
D. a vegetation on the mitral valve leaflets

A

Which set of echocardiographic features best predicts the presence of mitral stenosis in combined mitral stenosis and mitral insufficiency?
A. separation of the mitral valve leaflets on the two-dimensional parasternal short-axis view
B. Doming on the two-dimensional parasternal long-axis view
C. Reduced E-F slope on the M-mode
D. thickened leaflets, seen on the apical four-chamber view

B

The normal brief posterior displacement of the interventricular septum with the onset of diastole (diastolic dip) may be exaggerated in:
A. mitral insufficiencyB. mitral stenosisC. aortic insufficiencyD. aortic stenosis

B

In the M-mode recording of mitral stenosis, the posterior leaflet of the mitral valve moves anteriorly with the anterior leaflet:
A. alwaysB. in 80-90% of casesC. in 30-40 % of casesD. never

B

Aortic valve closure is related to an increased pressure in the aorta relative to the left ventricle. True or False?

true

The amplitude of aortic root motion has been used to assess:
A. the vigor of left ventricular contraction
B. the degree of aortic stenosis
C. the degree of aortic insufficiency
D. the size of the left atrium

A

Findings consistent with aortic stenosis seen on the M-mode echocardiogram include:
A. normal thickness of the left ventricular wall
B. thickened aortic leaflet
C. a dilated left atrium
D. hyperdynamic left ventricular contractility

B

The M-mode findings of a young patient with congenital aortic stenosis frequently demonstrate:
A. systolic doming of the cusps
B. normal leaflet separation
C. thickened, restricted cusps
D. diastolic separation of the cusps

B

The M-mode criterion that is not useful for defining aortic stenosis is:
A. dense, thick aortic valve echoesB. a reduced "box" openingC. diastolic aortic valve oscillationD. left ventricular hypertrophy

C

The best two-dimensional view used for imagining and calculating the aortic valve orifice is the:
A. parasternal long-axis viewB. parasternal short-axis viewC. apical four-chamber viewD. apical two-chamber view

B

The best approach for continuouswave Doppler analysis of aortic stenosis is the:
A. aortic insufficiencyB. mitral stenosisC. mitral regurgitationD. Tricuspid regurgitation

A

The criterion that is not helpful for defining aortic stenosis is:
A. Left ventricular hypertrophyB. aortic postvalvular dilationC. left ventricular enlargementD. diastolic oscillations of the aortic cusps

D

Bicuspid aortic stenosis is a congenital abnormality:(True or False)

True

Valve mobility may be the most helpful factor in defining the differences between aortic stenosis and sclerosis. (true or false)

True

Aortic regurgitation can best be defined by the M-mode criterion of:
A. high frequency oscillations of the aortic valves
B. left ventricular hypertrophy
C. aortic root dilation
D. high frequency oscillations of the mitral valve

D

One of the first indications of aortic regurgitation noted by two-dimensional echo is:
A. left atrial enlargementB. thickened aortic valveC. left ventricular hypertrophyD. left ventricular enlargement

D

Aortic regurgitation is best evaluated by Doppler in the:
A. parasternal long-axis viewB. parasternal short-axis viewC. apical four-chamber viewD. subcostal four-chamber view

D

Paradoxical septal motion is most commonly associated with aortic regurgitation. (true or false)

False

Aortic regurgitation may be associated with bacterial endocarditis of the aortic valve:(True or false)

True

Early closure of the mitral valve in patients with acute aortic insufficiency is due to:
A. reduced cardiac outputB. the regurgitant jet restricting mitral valve motionC. elevated left ventricular diastolic pressureD. reduced left ventricular compliance

C

Reverse doming of the anterior mitral valve leaflet can be observed in:
A. idiopathic hypertrophic subaortic stenosis
B. aortic stenosis
C. aortic regurgitation
D. mitral regurgitation

C

tricuspid valve hemodynamics occur approximately 50 milliseconds prior to mitral valve hemodynamics. (true or false)

True

The best 2D echo view for Doppler analysis of the tricuspid valve is the:
A. PLAXB. PSAXC. AP4D. suprasternal long-axis view

C

Which condition is most indicative of tricuspid stenosis?
A. RV enlargementB. RV hypertrophyC. RA enlargementD. pulmonary insufficiency

C

Which tricuspid M-mode criterion clearly indicates tricuspid regurgitation?
A. reduced E-F slopeB. Mid to late prolapseC. notchingD. none of the above

D

Which of the following 2D echo criteria may be most useful in defining tricuspid regurgitation?
A. reduced tricuspid E-F slopeB. RV enlargementC. RV hypertrophyD. RA enlargement

D

The 2D echo view that is best for Doppler analysis of tricuspid regurgitation is the:
A. PLAXB. PSAXC. AP4D. Suprasternal long-axis view

C