Echo Misc.

Which M-mode finding is considered to be a specific indicator of a fenestrated aortic valve?

a. diastolic flutter of the mitral valve

b. premature opening of the aortic valve

c. diastolic flutter of the aortic valve

d. early systolic closure of the aortic valve

c. diastolic flutter of the aortic valve

When a patient has a clinical diagnosis of pericarditis:

a. a pericardial effusion is always present on echo

b. a pericardial effusion may not be present on echo

c. pericardial thickening is always present on echo

d. pericardial thickening must not be present on echo

b. a pericardial effusion may not be present on echo

In normal patients, most ventricular filling occurs:

a. with atrial contraction

b. in the first third of diastole

c. in the middle third of diastole

d. during the PR interval of the ECG

b. in the first third of diastole

The patient you are examining has clear cut auscultatory and angiographic evidence for mitral prolapse, yet the resting echocardiogram is normal.  You should then:

a. raise the patient's legs

b. perform a cold pressor test

c. echo the patient in the standing position

d. have the patient hold his breath in deep inspiration

c. echo the patient in the standing position

Tricuspid valve closure normally occurs:

a. before mitral closure

b. simultaneous with mitral closure

c. less than 0.06 seconds after mitral closure

d. more than 0.06 seconds after mitral closure

c. less than 0.06 seconds after mitral closure

The 2-D echocardiogram of a teenage boy shows that the mid-portion of the atrial septum cannot be seen.  Which type of congenital heart disease might this patient have?

a. supra-mitral ring

b. cor triatriatum

c. ostium primum ASD

d. ostium secundum ASD

d. ostium secundum ASD

Premature opening of the pulmonary valve may be seen in:

a. cardiac tamponade

b. pulmonary insufficiency

c. constrictive pericarditis

d. acute severe pulmonary hypertension

c. constrictive pericarditis

For patients with aortic stenosis and atrial fibrillation, peak systolic aortic velocity will be:

a. unaffected by R-R interval

b. lower following long R-R intervals

c. higher following long R-R intervals

d. higher following short R-R intervals

c. higher following long R-R intervals

Aliasing on color flow Doppler is shown by a:

a. mosaic of colors

b. display of green

c. reversal in color

d. reversal in intensity

c. reversal in color

Premature mitral valve closure on M-mode is a sign of high left ventricular diastolic pressure in:

a. aortic stenosis

b. aortic insufficiency

c. mitral insufficiency

d. 1st degree heart block

b. aortic insufficiency

Endothelialized                   can have the same tissue characteristics as myocardium by 2-D echo:

a. thrombi

b. vegetation’s

c. anomalous chordae

d. ring calcification

a. thrombi

On M-mode, a flail mitral valve may have a similar appearance to:

a. a cleft mitral valve

b. a stenotic mitral valve

c. an infected mitral valve

d. a parachute mitral valve

c. an infected mitral valve

In patients with large pericardial effusions the motion of the pericardium may be:

a. damped

b. increased

c. unchanged

d. paradoxical

a. damped

On a two-dimensional echocardiogram, a cleft mitral valve may be confused with an anatomic:

a. bicuspid valve

b. tricuspid valve

c. floppy mitral valve

d. parachute mitral valve

b. tricuspid valve

In patients with ventricular septal defects and left to right shunting the _______ maybe dilated.

a. left atrium

b. right atrium

c. left ventricle

d. pulmonary veins

a. left atrium

Patients with long standing aortic stenosis will usually have:
a. LVH

b. LV dilation

c. diastolic aortic flutter

d.mitral ring calcification

a. LVH

One advantage to using the parasternal long axis view to diagnose mitral valve prolapse is:

a. there is less motion of the mitral annulus

b. false prolapse caused  by the annulus shape is avoided

c. the ultrasonic beam is perpendicular to the leaflets in systole

d. the relative position of the mitral and tricuspid valves is better visualized

b. false prolapse caused  by the annulus shape is avoided

Patients with aortic insufficiency may have serial echoes to check for:

a. amount of mitral valve flutter

b. left ventricular wall thickness

c. diastolic aortic cusp separation

d. left ventricular dimension changes

d. left ventricular dimension changes

An M-mode of a mitral heterograft valve resembles an M-mode of which valve?

a. mitral

b. aortic

c. pulmonic

d. tricuspid

b. aortic

Which technique would best allow you to assess the severity of aortic regurgitation?

a. pulsed wave Doppler

b. continuous wave Doppler

c. M-mode echocardiography

d. two-dimensional echocardiography

a. pulsed wave Doppler

On the EKG, ventricular repolarization is represented by the:

a. P wave

b. T wave

c. R wave

d. QRS complex

b. T wave

A common cause for right ventricular volume overload is:

a. patent ductus

b. pulmonic stenosis

c. tetralogy of Fallot

d. tricuspid regurgitation

d. tricuspid regurgitation

The most common cause of mitral regurgitation in elderly patients is:

a. atrial fibrillation

b. rheumatic heart disease

c. calcified mitral annulus

d. papillary muscle dysfunction

c. calcified mitral annulus

A patient is sent to the echo lab with the diagnosis of constrictive pericarditis. You perform a contrast study to look for:

a. atrial level shunt

b. persistent left superior vena cava

c. systolic appearance of contrast in the IVC

d. presystolic appearance of contrast in the IVC

d. presystolic appearance of contrast in the IVC

A patient with a systolic murmur and a fixed split S₂ may have which of the following:

a. tricuspid stenosis

b. subaortic stenosis

c. atrial septal defect

d. transposition of the great arteries

c. atrial septal defect

The A-dip in the M-mode pulmonary valve is caused by contraction of the:

a. left atrium

b. right atrium

c. left ventricle

d. right ventricle

b. right atrium

Which of the following is associated with severe, acute mitral regurgitation?

a. mitral stenosis

b. pulmonary edema

c. left atrial enlargement

d. left ventricular hypertrophy

b. pulmonary edema

What percent of left ventricular filling is normally contributed by atrial systole?

a. 10

b. 30

c. 50

d. 70

b. 30

Which valve lesion is most commonly associated with left bundle branch block?

a. Ebstein's anomaly

b. mitral valve prolapse

c. calcified aortic stenosis

d. calcified mitral stenosis

c. calcified aortic stenosis

Premature closure of the aortic valve on M-mode is most consistent with:

a. mitral stenosis

b. aortic stenosis

c. aortic regurgitation

d. mitral regurgitation

d. mitral regurgitation

An intra-aortic balloon pump assists the left ventricle by increasing:

a. pre-load

b. after-load

c. coronary blood flow

d. systolic blood pressure

c. coronary blood flow

Over stimulation of the parasympathetic nervous system will:

a. increase the heart rate

b. decrease the heart rate

c. increase the contractility

d. decrease the contractility

b. decrease the heart rate

At cardiac catheterization a patient has equal end-diastolic pressures between both atria and both ventricles suggesting:

a. patent ductus arteriosus

b. constrictive pericarditis

c. chronic mitral regurgitation

d. cardiac tamponade

b. constrictive pericarditis

The beginning of systole is accompanied by which heart sound:

a. S1

b. S2

c. S3

d. S4

a. S1

High frequency systolic vibrations of the aortic valve on M-mode are most consistent with:

a. mitral insufficiency

b. low cardiac output

c. aortic valve stenosis

d. normal findings

d. normal findings

An M-mode sweep from LV to aorta is used in patients suspected with pericardial effusion to:

a. rule out tamponade

b. rule out Dressler's syndrome

c. differentiate pericardial from pleural effusion

d. differentiate restrictive from constrictive pericarditis

c. differentiate pericardial from pleural effusion

In patients with larger pericardial effusions, which of the following can be a false positive diagnosis on M-mode?

a. aortic dissection

b. mitral valve prolapse

c. papillary muscle dysfunction

d. Ebstein's anomaly

b. mitral valve prolapse

When measuring mitral orifice size in a patient with mitral stenosis, care must be taken to:

a. use high gain for maximum visualization of the leaflets

b. measure the opening as close to the left atrium as possible

c. measure the opening at the leaflet tips

d. measure the opening at end diastolic

c. measure the opening at the leaflet tips

The use of the continuity equation in patient with aortic stenosis is based on the premise that:

a. the worse the stenosis, the higher the V¹

b. the worse the stenosis, the lower the V¹

c. he higher the cardiac output the lower the V²

d. flow below the valve is equal to flow above the valve

d. flow below the valve is equal to flow above the valve

A B-notch on the mitral valve M-mode is associated with:

a. atrial fibrillation

b. increased pulmonary pressures

c. first degree AV block

d. increased LV end diastolic pressure

d. increased LV end diastolic pressure

After a patient has had a mitral commissurotomy, which of the following will be seen on echo?

a. the mitral motion will be normal

b. the mitral ring will appear as bright echo reflectors

c. the valve will still appear rheumatic

d. the E-to-F slope will decrease

c. the valve will still appear rheumatic

In a patient with IHSS:

a. the aortic valve will show mid-diastolic closure

b. the LV posterior wall to septal ratio is usually greater than 1.3

c. mitral regurgitation is often present

d. the systolic anterior motion of the MV will decrease with Valsalva maneuver

c. mitral regurgitation is often present

Which of the following does NOT usually happen with left heart failure?

a. elevation of LV end-diastolic pressure

b. elevation of pulmonary venous pressures

c. fall in cardiac output

d. fall in aortic pressure

d. fall in aortic pressure

Which of the following is NOT a common symptom of congestive heart failure?

a. dyspnea on exertion

b. pedal edema

c. orthopnea

d. syncope

d. syncope

When ultrasound waves travel through a medium which contains many small scatterers (e.g., red blood cells), the amount of sound that is scattered would:

a. increase sharply with increasing frequency

b.increase sharply with increasing wavelength

c. be independent of frequency

d. decrease with increasing beam area

e. decrease sharply with increasing frequency

a. increase sharply with increasing frequency

With phased array transducers, the transmitted sound beam is swept by:

a. mechanically oscillating the transducer elements

b. mechanically rotating the transducer elements

c. varying the timing of pulses to the transducer elements

d. varying the voltage of pulses to the transducer elements

e. varying the resonant frequency of the transducer elements

c. varying the timing of pulses to the transducer elements

The Doppler shift frequency from moving reflectors is the:

a. received ultrasonic frequency

b. transmitted ultrasonic frequency

c. ratio of transmitted and received ultrasonic frequencies

d. difference between the transmitted and received ultrasonic frequencies

e. sum of the transmitted and received ultrasound frequencies

d. difference between the transmitted and received ultrasonic frequencies

If the distance to a reflector doubles, the time between pulse transmission and echo detection at the transducer:

a. decreases by one-quarter

b. decreases by one-half

c. remains the same

d. doubles

e. quadruples

d. doubles

The two-dimensional image of a phased array echograph is produced by:

a. rotating a single crystal transducer through a 360° arc

b. oscillating a single low frequency transducer through a 30° to 90° arc

c. sequentially activating a series of adjacent crystals to angulate the ultrasound beam

d. a microcomputer that keeps the M-mode signal in phase with the cardiac cycle

e. simultaneous activation of a linear array of piezoelectric crystals

c. sequentially activating a series of adjacent crystals to angulate the ultrasound beam

Which of the following conditions is NOT associated with overriding of the aorta?

a. pulmonary atresia with a ventricular septal defect (pseudotruncus)

b. tetralogy of Fallot

c. pulmonary atresia with intact ventricular septum

d. truncus arteriosus

e. double outlet right ventricle

c. pulmonary atresia with intact ventricular septum