Echo 1

1.

1 point

Which of the following m-mode measurements should be made at end diastole?

aortic cusp separation

mitral valve D-E

left atrium

right ventricular internal dimentsion

2.

1 point

Which is a possible differential diagnosis for a patient who presents with acute chest pain (angina)?

pericardial disease

aortic dissection

chronic myocardial infarction

congenital heart disease

3.

1 point

Which values are considered within normal range for 2-D measurements of the LVIDd?

1.5cm & 3.0cm

1.8cm & 4.5cm

2.4cm & 5.0cm

3.5cm & 5.5cm

4.

1 point

Which is the preferred method of performing m-mode measurements and was adopted in 1978 to ensure all labs use a consistent method?

Caliper Method

Standard Method

American Society of Echo Method

Penn Method

5.

1 point

What is the above method of performing m-mode measurements based on?

excludes endocardium and epicardium based on an anatomic point of view

measurements taken within the myocardium of the structures

switching from including to excluding the interface dependent on the structure measured

leading edge to leading edge of the structure being measured

6.

1 point

A patient presents with echo findings of significant MR and AI. Which parameters would be used to calculate the MV RF based on these findings?

CSAmv . VTImv & CSAlvot . VTIlvot

CSAlvot . VTIlvot & CSArvot . VTIrvot

CSAmv . VTImv & CSArvot . VTIrvot

CSAlvot . VTIlvot & CSAmv . VTImv

7.

1 point

Which is not an acceptable window to obtain tricuspid transvalvular flow waveforms?

PSAX

A4C

RVIT

A3 / Long

8.

1 point

Which of the following conditions may prompt an emergency room physician to order an emergency or "stat" echo?

Known Valve Disease

Pre-operative cardiac surgery evaluation

Heart Murmur

Heart Failure or Acute MI

9.

1 point

What is the normal velocity range for aortic flow in adults?

0.6-1.3 m/sec

0.7-1.1 m/sec

0.3-0.7 m/sec

1.0-1.7 m/sec

10.

1 point

Which is outside of the normal average velocity range for mitral flow in adults?

1.0 m/sec

0.7 m/sec

1.7 m/sec

1.2 m/sec

11.

1 point

Which pulmonary vein is not normally visualized in the A4C view?

right upper PV

right lower PV

left lower PV

left upper PV

all four veins are seen

12.

1 point

What information may be detected by color m-mode that is not detected from basic m-mode information?

the absence of flow

the acquisition of spatial information, motion and time

the timing and duration of jets

whether the valve is open or closed

13.

1 point

What is a rumbling, cresendo-decrescendo low pitch murmur indicative of?

pulmonary stenosis

tricuspid stenosis

mitral regurgitation

aortic regurgitation

14.

1 point

Which measurement required for the continuity equation will yield the highest risk of error if performed improperly?

LVOT diameter

CW AV velocity

PW LVOT velocity

They are all of equal importance

15.

1 point

the equation PG (p1-p2)=4v^2 represents which principle?

Poiseuilles Law

Doppler Equation

Bernoulli Equation

Doppler Effect

16.

1 point

What is the pressure gradient between the right ventricle and the right atrium in a patient with a tricuspid regurgitation velocity of 3.0 m/s?

36mmHg

3mmHg

9mmHg

46mmHg

17.

1 point

What is the most common cause of mitral stenosis?

congenital

calcific

rheumatic disease

degenerative

18.

1 point

Which m-mode finding is characteristic of of a stenotic pulmonic valve?

doming

an exaggerated A wave

notching (early closure)

absent A wave

19.

1 point

The severity of AI is often determined by using the PHT method. Which of the following is accurate concerning the AI deceleration slope?

the steeper the slope the less severe the AI

the shape of the slope does not determine severity

the flatter the slope the more severe the AI

the steeper the slope the more severe the AI

20.

1 point

Which statement is true regarding the PHT method for estimating MS?

the method provides estimation of MVA within 24 hours following mitral valvuloplasty

the method is a form of the continuity equation

the method can overestimate MVA if LV compliance is decreased

MVA cannot be estimated from the deceleration time alone

the method is accurate in the presence of AI

21.

1 point

Which echo finding is not indicative of severe MR

RV>60 ml/beat

RF <30%

systolic flow reversal in the PV

RF of >60%

22.

1 point

What is reversed systolic flow appearing in the IVC and hepatic veins indicative of?

decreased RAP

severe PI

tricuspid stenosis

tricuspid regurgitation

23.

1 point

How will significant prolonged, MS affect LA size and pressure?

decrease LA size and decrease pressure

increase LA size and decrease pressure

increase LA size and pressure

decrease LA size and increase pressure

24.

1 point

What is the normal MV PHT?

50-90 msec

20-50 msec

10-40 msec

30-60 msec

25.

1 point

What valve area is suggestive of a critically severe degree of MS?

8-10 cm^2

>4 cm^2

<1 cm^2

2-4 cm^2

26.

1 point

Which of the following will most likely be obscured by MAC?

PMVL

AMVL

epicardial echoes

LA size measurment

27.

1 point

What best describes the major difference in etiology of rheumatic AS opposed to degenerative AS?

LA dilatation

the AV leaflets become thickened

congenital bicuspid valve

the point of origin of the stenosis (leaflets vs. annulus)

28.

1 point

what is the most common etiology of TV stenosis?

ineffective endocarditis

carcinoid heart disease

rheumatic fever

RA myxoma

29.

1 point

what valve area would you expect with a MV PHT of 220 m/sec?

8.0 cm^2

1.0 cm^2

3.0 cm^2

0.6 cm^2

30.

1 point

which value is indicative of severe MS?

Deceleration Time > or = 220 m/s

PHT of > or = 220 m/s

MVA PHT of 759

PHT <200 m/s

31.

1 point

a patient presents to the echo lab with peripheral edema and jugular venous distention. the history indicates there is a holosystolic murmur that varies with respiration. the echo exam reveals a dilated RA with a RVSP of 65mmHg. what is indicated by these symptoms and findings?

mild to moderate TS

moderate to severe right heart pressures

moderate to severe PHTN

mild to moderate PI

32.

1 point

in distinguishing the spectral doppler signal of MR from AS what is the most useful characteristic of the jet?

location in regard to baseline

density of waveform

width of jet

velocity of jet

33.

1 point

what is the primary etiology for endocarditis?

sepsis

catheters

IV drug use

trauma

34.

1 point

according to the modified Duke criteria, how is endocarditis definitively diagnosed?

presence of 2 major criteria

presence of 1 major & 2 minor criteria

presence of 1 major plus 1 minor

presence of 3 minor criteria

35.

1 point

which is usually associated with Staph aureus infections?

chronic endocarditis that attacks an abnormal valve

acute endocarditis that attacks a normal valve

acute endocarditis that attacks and abnormal valve

chronic endocarditis that attacks a normal valve

36.

1 point

which of the following poses a high-risk to developing endocarditis?

cardiomyopathy

pacemaker

prosthetic heart valve

coronary artery disease

37.

1 point

which of the following may not be detected with a TTE to diagnose ineffective endocarditis?

vegetations less than 2mm

hyperdynamic LV function

flail leaflet

secondary regurgitation

38.

1 point

which of the following signs/symptoms is (are) suspicious for slowly developing sub-acute endocarditis (SBE)?

new heart murmur and tachycardia

positive blood cultures

anemia

weight gain and bradycardia

39.

1 point

which prosthetic valve may create peripheral circumferential jets with no flow through the center of the valve when complications occur?

Bjork-Stanley tilting disc

Porcine valve

Starr-Edwards ball & cage

St. Jude bileaflet

40.

1 point

what is the biggest problem sonographers encounter in evaluating mechanical heart valves?

dehiscence

thrombus formation

artifact

perivalvular leak