Mock echo registry

What structures aid in stabilizing each AV valve from protruding into the atria?

a. Chordae tendinae
b. Myocardial tendons
c. Fibrous strands
d. Papillary muscles

A

What portion of the ECG is best for diagnosis of myocardial ischemia or injury?

a. QRS complex
b. ST segment
c. QT interval
d. PR interval

B

On the mitral valve inflow Doppler tracing of a patient with constrictive pericarditis, the E velocity will be:

a. Increased \>25% upon inspiration and decreased with expiration
b. Decreased

D

An ausculatory finding in constrictive pericarditis may be:
a. Pericardial knock
b. Honking sound
c. Pericardial rub
d. Carvallo's sign

A

Right ventricular early diastolic collapse seen on M-mode echocardiography suggests:
a. Cardiac tamponade
b. Constrictive pericarditis
c. Pleural effusion
d. Pericarditis

A

The most common cardiac valve tumor is a:
a. Myxoma
b. Lipoma
c. Rhabdomyoma
d. Fibroelastoma

D

A high density, well defined spectral doppler tracing of mitral regurgitation may indicate
a. LAE
b. Late closure of MV
c. Mild regurgitation
d. Severe regurgitation

D

The image best describes this type of VSD:
a. Outlet
b. Perimembranous or inlet
c. Atrioventricular
d. Muscular

B

Patients with constrictive pericarditis typically go into heart failure due to:
a. Increased pulmonary pressures
b. Diastolic dysfunction
c. Systolic dysfunction
d. Increased pericardial pressures

B

What is the finding with Chagas disease, which helps to identify it as the cause of dilated cardiomyopathy?
a. Left ventricular apical aneurysm
b. Mitral regurgitation
c. Dilated left ventricle
d. Dilated right ventricle

A

17. Maneuvers that may decrease left ventricular volume and provoke mitral prolapse include:
a. Supine to standing position
b. Valsalva maneuver
c. Amyl nitrate
d. all the above

D

Aortic stenosis has narrow pulse pressure.
a. True
b. False

True

DeBakey Type I aortic dissection involves the:
a. descending only
b. ascending aorta
c. ascending and descending
d. Sinus of Valsalva

C

Endocardial cushion defects have a high incidence with:
a. Down's syndrome
b. Fitz-hugh Curtis syndrome
c. Marfan 's syndrome
d. Acromegaly

A

This abnormality is a common prosthetic valve dysfunction in patients diagnosed with infective endocarditis:
a. Stenosis
b. Ring abscess
c. Pericardial effusion

B

Chest pain that is relieved with sitting up or leaning forward best describes:

a. pleural effusion
b. dilated cardiomyopathy
c.mitral valve prolapse
d. pericarditis

D

A pericardial effusion is rarely seen behind this chamber:
a. LA
b. LV
c. RV
d. RA

A

In a dilated cardiomyopathy left ventricular function:

a. becomes hyperkinetic
b. decreases
c. increases
d. becomes hypertrophied

B

In differentiating MR and LVOT Doppler tracing the following should be considered:

a. MR duration is shorter than LVOT outflow
b. LVOT usually peaks in early systole
c. MR duration is longer than LVOT outflow
d. With amyl nitrate administration only the LVOT will increase

C

Myocardium that is ischemic but not yet infarcted with decreased contractility is referred to as:
a. necrotic
b. shocked
c. hibernating
d. stunned

C

A ventricular septal defect is noted on the apical four chamber view near the apex. This type of defect is referred to as a:
a. membranous
b. outlet
c. inlet
d. muscular

d

A tricuspid valve area of 1.5 cm^2 is suggestive of:
a. Severe tricuspid stenosis
b. Moderate TS
c. Moderate to severe TS
d. Mild TS

A

Which of the following is an ultrasound characteristic of acute myocardial infarction:
a. lack of systolic thickening of the affected area
b. thin walls associated with affected area
c. normal thickness of the walls associated with affected area
d. bright echogenicity of the affected area

A

The most common benign primary cardiac tumor is the:
a. myxoma
b. papilloma
c. rhabdomyoma
d. sarcoma

A

Pulmonic stenosis is often associated with:
a. tetralogy of Fallot
b. mitral valve prolapse
c. Ebstein's anomaly
d. marfan's syndrome

A

A cause of constrictive pericarditis may be:

a. hypertension
b. lack of exercise
c. high cholesterol
d. post cardiac surgery

D

Severe aortic stenosis is considered when the aortic peak pressure gradient is:
a. \>64 mmHg
b. \>45 mmHg
c. \>75 mmHg
d. \>39 mmHg

A

Severe aortic regurgitation is suggested when:

a. The pressure half time of the AI is \>600 msec
b. Holodiastolic flow reversal is seen in the descending aorta
c. The regurgitation spectral tracing has a box-like appearance
d. Holodiastolic flow reversal is seen in the pulmonary artery

B

A "B" bump on a mitral valve M-mode tracing often seen in patients with a DCM may indicate:

a. mitral regurgitation
b. Elevated left ventricular end diastolic pressure
c. mitral stenosis
d. systolic anterior motion

B

Which exam is more diagnostic for ischemic heart disease compared to routine echocardiography:

a. stress echo
b. contrast echo
c. color flow
d. TEE

A

Cardiac tamponade is usually associated with moderate to severe pericardial effusion but can occur in small effusions with rapid accumulation.
a. true b. false

A

Which of the following is not a common finding in systemic hypertension?
a. aortic root dilation
b. aortic valve sclerosis
c. concentric left ventricular hypertrophy
d. increased LV systolic function

D

The result of metastasizing tumors with excretion of a tar-like material causing valve to stick opening best describes:

a. carcinoid syndrome
b. endomyocardial stenosis
c. tricuspid atresia
d. fibroelastosis

A

Significant mitral stenosis will exhibit the following 2D finding:
a. LAE
b. pericardial effusion
c. thickened tricuspid leaflet
d. dilated aorta

A

What percent of patients with Marfan's syndrome have mitral valve prolapse?
a. 40-60%
b. 0-20%
c. 60-80%
d. 20-40%

C

Bicuspid aortic valve causing aortic stenosis usually becomes symptomatic at age:
a. 50-70
b. 20-50
c. greater than 80
d. greater than 70

B

A sinus of Valsalva aneurysm most commonly ruptures into the:
a. Right ventricle
b. Left atrium
c. Right atrium
d. Left ventricle

A

The single most effective way to decrease the spread of infection is
a. sanitizing everything
b. taking a shower
c. do nothing
d. hand washing

D

Risk factors for ischemic heart disease may be:
a. high cholesterol
b. family history of CAD
c. hypertension
d. all the above

D

A patient presents to the echo lab with the following symptoms: fever, night sweats, chills, and new onset murmur. The patient had dental work performed three weeks ago. When scanning the patient you would look for:

a. vegetations on the valve
b. calcified valves
c. pericardial effusion
d. asymmetrical septal hypertrophy

A

A cause for acute mitral regurgitation might be:
a. Mitral stenosis
b. Infective endocarditis
c. Aortic stenosis
d. Hypertrophic cardiomyopathy

B

A grade III holosystolic blowing murmur best heard at the apex describes:
a. aortic insuficiency
b. tricuspid stenosis
c. mitral regurgitation
d. aortic stenosis

C

When measuring 2D LV measurements, the perpendicular plane from the 2D image is measured at this level
a. mitral chordal
b. papillary
c. mitral valve
d. apical

A

Calculate the pressure gradient from this Doppler tracing
a. 95 mmHg
b. 85 mmHg
c. 100 mmHg
d. 37 mmHg

B

When measuring the left atrium on M-mode, the correct measurement is taken during which part of the cardiac cycle

a. end of ventricular systole
b. beginning of ventricular systole
c. beginning of ventricular diastole
d. end diastole

A

While a patient is on the treadmill they experience a significant increase in blood pressure and blurred vision. What do you do?

a. tell the patient its normal
b. immediately terminate
c. continue the test
d. go into the next stage and then stop the test

B

When obtaining pulmonary vein flow for the detection of diastolic dysfunction, this pulmonary vein should be used to obtain Doppler information:
a. left superior
b. right inferior
c. left inferior
d. right superior

D

A ventricular septal defect seen on the PSAX view of the aorta between 1-3 o'clock is this type of VSD?
a. Trabecular
b. Inlet
c. Membranous
d. Outlet

D

A finding of holodiastolic flow reversal in the descending aorta may be a false positive finding of severe aortic regurgitation if the patient has:
a. Ebstein's anomaly
b. An atrial septal defect
c. A PDA
d. A VSD

C

Which of the following may demonstrate septal wall motion abnormality due to right ventricular volume overload and/or pressure overload?
a. Mitral stenosis
b. Mitral regurgitation
c. Aortic stenosis
d. Aortic regurgitation

A

A normal left ventricular measurement during diastole should be:
a. 6-11 mm
b. 35-55 mm
c. 20-40 mm
d. 45-65 mm

B

The velocity time integral measurement calculates
a. mean pressure gradients
b. mitral valve area
c. aortic valve area
d. peak pressure gradients

A

The "A" wave on the M-mode of the mitral valve represents:
a. atrial systole
b. slow filling
c. diastasis
d. rapid filling

A

A LV pacing wire is placed in the coronary sinus in conjunction with a RV pacing wire, this procedure best describes:

a. internal cardiac defibrillator
b. harmonic imaging
c. tissue doppler imaging
d. cardiac resynchronization therapy

D

The combination of hypertrophy and right ventricular dilation due to PHTN is associated with:

a. Pectus exacavatum
b. Cyanosis
c. Cor pulmonale
d. Cachexia

C

What abnormality accompanies mitral valve prolapse in 50% of patients?
a. Hypertension
b. Aortic stenosis
c. Dilated cardiomyopathy
d. Tricuspid valve prolapse

D

What is the LVEDP with the given information:

blood pressure 160/80
AI peak velocity 3.5 m/sec

31 mmHg

The fractional shortening for the given information:

LVIDd\= 55 mm
LVIDs\= 41 mm

a. 17%
b. 50%
c. 25%
d. 15%

C

Volume measurements for the LV are most accurately performed using this method:
a. Simpson's
b. Starling's
c. Ohm's
d. Poiesulle's

A

When performing a stress echo, images should be obtained within 30 seconds post exercise.

true or false?

False

When measuring 2D measurements, end systole is defined as:
a. the frame after the aortic valve opening
b. the frame after mitral valve opening
c. the frame preceding aortic valve opening
d. the frame preceding mitral valve opeing

D

The pulser determines:
a. amplitude
b. PRP
c. PRF
d. all the above

d

Saline contrast technique is useful in determining the following cardiac abnormality:
a. aortic stenosis
b. endocardial definition
c. atrial septal defect
d. mitral regurgitation

C

A load dependent index of LV systolic performance identifies this measurement:
a. RVSP
b. AVA
c. dP/dt
d. VTI

C

Which statement regarding color aliasing is MOST correct?
a. it occurs when red and blue colors are separated by black
b. it occurs when the mean velocity exceeds the nyquist limit
c. it is always indicative of severe disease
d. none of the above

B

The mitral valve Doppler inflow shows a normal E/A wave. TDI shows E'/A' reversal. The most accurate diagnosis would be:
a. Pseudo-normalization
b. Restrictive physiology
c. relaxation abnormality
d. normal

A

What valve when determining the Regurgitant jet area/left atrial area indicates mild mitral regurgitation?
a. \>40%
b. 40-60%
c.

C

Which of the statements below regarding spectral Doppler is true?
a. the Doppler shift is dependent on the transducer frequency
b. the Doppler shift is independent of the velocity of the moving particles in the blood
c. the optimum angle is always 60 degrees
d. sample depth and PRF are directly proportional

A

Conventional color Doppler can display all of the following except:
a. direction of blood flow
b. flow quality
c. volume of blood flow
d. mean frequency shift

C

When a sound wave travels in the body, a small amount of energy is converted from the fundamental frequency to harmonic frequency. This conversion causes:
a. contrast harmonics
b. negative harmonics
c. tissue harmonics
d. scattering harmonics

C

In severe cases of aortic stenosis the aortic root may:
a. Dilate
b. Decrease in size
c. Decrease in echogenicity
d. Hypertrophy

A

Which cardiomyopathy is often associated with AIDS:
a. Dilated
b. Hypertrophic
c. Infiltrative
d. Restrictive

A

A mitral valve "E" velocity of greater than \_______ may indicate severe MR.
a. 0.8 m/s
b. 1.0 m/s
c. 1.2 m/s
d. 0.6 m/s

C

36. The spectral Doppler of the mitral valve inflow in patients with cardiac tamponade will display:

a. A high E/A deceleration time
b. A 25% decrease in the MV velocity with inspiration
c. A 25% increase in the MV velocity with inspiration
d. A high E/A ratio

B

Which of the following is not a probable Doppler finding with a DCM?
a. Pulmonic stenosis
b. Mitral regurgitation
c. Tricuspid regurgitation
d. Pulmonic regurgitation

A

The tricuspid regurgitation murmur may increase with inspiration. This is known as:
a. Murphy's sign
b. Epstein's sign
c. Derosier's sign
d. Carvallo's sign

D

The most common risk factor for an aortic dissection is:
a. Bicuspid valve
b. Atherosclerosis
c. Trauma
d. Chronic hypertension

D

A PISA calculation can not be performed to determine the severity of mitral regurgitation when this is present:
a. tricuspid stenosis
b. LAE
c. multiple jets
d. decreased cardiac output

C

In echocardiography how many focuses are typically used:
a. 3
b. 2
c. 1
d. 4

C

When determining the size of the flow convergence, this calculation is performed:

a. Proximal isovelocity surface area (PISA)
b. effective regurgitant opening (ERO1)
c. fractional shortening
d. continuity equation

A

A saline contrast study may be performed on patients with an atrial septal aneurysm to rule out

a. VSD
b. ASD
c. cardiomyopathy
d. wall motion abnormalities

B

To obtain a dP/dt value the following color abnormality is used:
a. Aortic insufficiency
b. Pulmonic insufficiency
c. MR spectrum
d. TR

C

What is the primary advantage of CW Doppler over PW Doppler?
a. does not alias
b. no crosstalk artifact
c. range ambiguity
d. less spectral broadening or window filling

A

What is the RVSP with the given information:

VSD peak velocity \= 4 m/sec
BP \= 130/80

a. 56 mmHg
b. 75 mmHg
c. 66 mmHg
d.85 mmHg

C

During a pericardiocentesis, the needle tip can be identified on echo by using:

a. green dye
b. ionized contrast
c. saline contrast
d. Air

C

Which statement regarding infective endocarditis is incorrect:

a. Vegetations seen on a valve leaflet will not usually restrict valve motion

b. Ruptured chordae tendinae may result from infection

c. May demonstrate signs of congestive heart failure on chest x-ray

d. Vegetations usually found on ventricular side of the mitral and/or tricuspid valves

D

Gradual closure of the aortic valve suggesting decrease in cardiac output is often associated with this abnormality:

a. Infiltrative cardiomyopathy
b. Dilated cardiomyopathy
c. Restrictive cardiomyopathy
d. Hypertrophic obstructive cardiomyopathy

B

Which of the following is not a possible M-mode finding in patients with constrictive pericarditis?
a. Paradoxical septal motion
b. Enlarged left ventricle
c. Pericardial thickening
d. Flattening of the mid-diastolic posterior wall motion

B

An indicator on 2D echo suggesting an old myocardial infarction might be:

a. Thickening of the wall only with systole
b. Hypertrophy of the affected wall segment
c. Hyperkinesis of the affected wall
d. Thin, bright wall segment that appears hypokinetic or akinetic

D

Mid systolic notching of the right ventricular outflow tract can be found with abnormality:
a. Right heart failure
b. Pulmonary hypertension
c. Pulmonary stenosis
d. Right heart pressure overload

B

A true aneurysm can be differentiated from a pseudo aneurysm on 2D echocardiography by:

a. the color flow pattern through the mitral valve
b. the size of the neck of the aneurysm
c. the familial Hx of CAD
d. the presence of thrombus

B

The most common secondary cause of a DCM is:

a. smoking
b. hereditary
c. post-partum
d. alcohol

D

What happens to the left ventricular walls when significant AI is present:

a. thickening of the walls
b. walls show decreased echogenicity
c. walls maintain normal thicknes
d. thinning of the walls

A

Coarctation of the aorta is most commonly associated with:

a. tetralogy of fallot
b. VSD
c. ASD
d. bicuspid aortic valve

D

A tear in the aortic intimal layer through which a collection of blood enter the aortic wall necrosis of the media layers best describes this type of aortic aneurysm:
a. Fusiform
b. Pseudo
c. Dissection
d. Saccular

C

Smaller size prosthetic valves give \________ Doppler velocities.

a. higher
b. lower

A

Disease in the left anterior descending artery affects all of the following heart walls except:

a. Apex
b. septum
c. RV free wall
d. anterior wall

C

What happens to the pressure gradient in patients with aortic stenosis who have a decreased systolic function:
a. Increases
b. Stays same
c. Decreases

C

The most common area for a sinus of Valsalva aneurysm is:
a. Left coronary cusp
b. Medial coronary cusp
c. Right coronary cusp
d. Non coronary cusp

C

The most common color abnormality in a dilated cardiomyopathy is:
a. MR
b. AR
c. PR
d. TR

A