CCI ECHO MOCK 1 EXAM

All of the above A pt presents with a transcatheter aortic valve replacement. What information must the sonographer obtain prior to performing the echocardiogram? Choose all answers that apply. Date of implantation Size of Valve Systemic blood pressure Prior LV Ejection Fraction Dilated Cardiomyopathy The double diamond sign on an M -mode tracing of the MV is indicative of mid diastolic closure caused by..... Acute MI Dressler Syndrome Pulmonary HTN Dilated cardiomyopathy E-F The slope between which two points of the Doppler tracing of the mitral valve are used to calculate the pressure half time? D-E E-F E-A E/E' The inability to detect two or more contiguous segments in any three of the apical windows Microbubble contrast evaluation of the LV is performed when standard 2D images are suboptimal. Suboptimal images are defined as: The inability to detect two or more contiguous segments in any of the apical windows The inability to detect two or more contiguous segments in any three of the apical windows dp/dt Which of the following calculations demonstrates the rate of increase in left ventricle pressure during systolic contraction? EF % Qp/Qs dp/dt Fractional Shortening Mitral valve waveform The image demonstrates a Doppler waveform from the mitral valve, A caliper is placed on the E peak velocity. The blue dot is placed where the second cursor would be placed. Papillary Muscle Which of the following should be omitted from the optimal parasternal long axis view of the left ventricle? Right ventricular outflow tract Papillary muscle Descending Aorta Coronary sinus The membranous type of VSD is located at the junction of the left ventricular outflow tract and the muscular portion of the septum. Which of the following regarding ventricular septal defects is true? Pulmonary HTN In tamponade the RV free wall will collapse in diastole, except in patients with significant: Systemic HTN Pulmonary HTN tricuspid regurgitation pericardial effusion Cardiac output / body surface area How is the cardiac index calculated ? Cardiac output / body surface area stroke volume / cardiac output cardiac output / stroke volume Stroke volume x cardiac output x body surface area Left arm, SVC In order to diagnose a persistent left SVC, the ultrasound enhancing agent should be injected in the _____ and it will be seen in the ____ before entering the right heart if the exam is positive. left arm, SVC right arm, LA Left arm, coronary sinus left arm, pulmonary veins LV posterior wall thickness 1.5 cm Which of the following is a characteristic of an athlete heart? sustained tachycardia at rest LV posterior wall thickness 1.5 cm moderate biatrial enlargement interventricular septal thickness 1.5 cm leading edge to leading edge, from the aortic sinus to the posterior atrial wall Which of the following correctly describes how to measure the left atrium in the parasternal view? Leading edge to leading edge, from the aortic sinus to the posterior atrial wall outer edge to inner edge, from the aortic sinus to the posterior atrial wall Leading edge to leading edge, from the LVOT to the posterior atrial wall 85% Which of the following is an expected EF% on a patient with advanced hypertrophic cardiomyopathy ? 45% 15% 85% 60% Takayasu arteritis and bicuspid aortic valve Which of the following abnormalities should include the supplemental evaluation of the abdominal aorta? Takayasu arteritis and bicuspid aortic valve EF% less than 20% or over 80% Kawasaki disease and Fabry disease Patent ductus arteriosus and septal defects suprasternal notch What echo view should be used to evaluate flow velocity in the descending aorta? Right parasternal border apical suprasternal notch subcostal Left to right, Eisenmenger IN MOST CASES, SHUNT FLOW ACROSS AN ASD IS FROM ____ UNLESS _____ SYNDROMW IS PRESENT AND THEN FLOW IS REVERSED. Right to left, Dressler Left to right, Eisenmenger right to left, Eisenmenger left to right, Dressler left circumflex artery There is akinesis of the anterolateral and inferolateral walls. These findings are most suggestive of occlusion of the: Posterior descending artery left anterior descending artery ramus intermedius left circumflex artery VSD Congenital pulmonary stenosis is most commonly associated with which of the following? Tricuspid atresia ASD PDA VSD acoustic impedance and incident angle The amount of reflection of the incident ultrasound beam varies with: Pulse repetition frequency and frame rate incident angle and propagation speed acoustic impedance and incident angle acoustic impedance and propagation speed mechanical heart valves Hemolytic anemia can be caused by: Systemic HTN mechanical heart valves CHF pulmonary HTN coarctation A 24 yr old pt presents for an echo due to a heart mumur. You identify mitral valve prolapse and a bicuspid aortic valve. What abnormality is commonly associated with these findings? Membranous subaortic stenosis coarctation pulmonary stenosis Tricuspid atresia should be NPO 4-6 hours prior to the exam Patients having a TEE or Stress echo: take all medications as prescribed on the day of the test should be NPO 4-6 hours prior to the exam will be sedated prior to the exam shave their chest before arriving for the appointment Table height should allow the sonographers arm to be slightly abducted with the wrist fully extended Which of the following describes the table placement for performing an ultrasound exam? The table height should allow.... 2MHz The lower the frequency, the better the penetration A pt presents for an echocardiogram that is 6'3 and 320 lbs. Which transducer would be the best transducer to use to perform the echo? 2MHz 3MHz 4MHz 5MHz ALL OF THE ABOVE Which of the following correctly describes the optimization of the 2D image prior to 3D dataset collection? Choose all that apply Move the focal zone to the area of interest adjust the gain settings to minimize area of overgaining Review the Bi-plane images in 2D to confirm the area of interest will be included in the 3D dataset Instruct the patient to maintain their current position once the optimal acoustic window is located Activate the zoom function over the aorta While scanning in the apical 2 chamber view, you are trying to assess flow in a possible aneurysm in the thoracic aorta. Which of the following adjustments will assist in improving color flow in the aorta? Activate the zoom function over the aorta change the velocity color map to a variance map increase the color sample size increase the wall filter setting 120mmHG Eisenmenger syndrome will usually occur when the right ventricular systolic pressure, exceeds; 40mmHG 70mmHG 100mmHG 120mmHG suprasternal notch and subcostal You document aortic regurgitation (AR) in the 5 chamber view that has a pressure half time of 230ms. What additional transducer positions should be used with PW doppler to determine the severity of the AR? parasternal long axis and subcostal right sternal border and suprasternal notch Apical 3 chamber and suprasternal notch suprasternal notch and subcostal hypertrophic subaortic stenosis A harsh, systolic crescendo-decrescendo murmur heard at the left sternal border is most suggestive of: Moderate-severe Ai hypertrophic subaortic stenosis Moderate-severe MS Cardiac tamponade Aortic stenosis Measuring the left ventricular ejection time is helpful when assessing patients with______. Pulmonary HTN a VSD Mitral stenosis Aortic stenosis shunt flow through a VSD Which of the following is usually better evaluated with doppler than with an exam using an ultrasound enhancing agent (UEA)? persistent left SVC shunt flow through an ASD shunt flow through a VSD thrombus formation in the LV apex pulmonary stenosis If ____ is present, the right ventricular systolic pressure calculation from the tricuspid regurgitation gradient is inaccurate as the measurement of the pulmonary artery pressure. pulmonary regurgitation pulmonary HTN CHF pulmonary stenosis aortic stenosis Which of the following will increase left ventricular systolic pressure? mitral stenosis aortic stenosis pulmonary HTN congestive heart failure tilt superiorly with slight clockwise rotation Which of the following correctly describes how to manipulate the transducer from the parasternal long axis view of the left heart to visualize the right ventricular outflow tract? 60 degree clockwise rotation angle inferior and medial with slight rotation 60 degree counterclockwise rotation tilt superiorly with slight clockwise rotation continuous flow toward the transducer in systole and diastole Which of the following best describes the doppler tracing from within a patent ductus arteriosus evaluated in the parasternal long axis view? continuous flow toward the transducer in systole and diastole Flow toward the probe during diastole with a small amount of systolic flow reversal flow toward the probe during systole with a small amount of diastolic flow reversal Biphasic flow that varies with respiration Mitral MR is the most common valvular regurgitation with DCM due to stretched papillary muscles. A pt presents for an echo after a recent diagnosis of dilated cardiomyopathy. Which valve will usually be affected first by the volume changes, causing regurgitation? Aortic tricuspid pulmonic mitral reduce the UEA infusion rate During an echo with ultrasound enhancing agent (UEA), shadowing obscures the basal segments of the left ventricle. How can you eliminate this artifact? Scan the patient in the upright position turn the overall gain down reduce the UEA infusion rate increase the output power transesophageal echo Which of the following cardiac exam techniques provides the best spatial resolution of the cardiac structures ? resting echo with ultrasound enhancing agent transesophageal echo cardiac catheterization stress echo measure the time it takes for the mitral regurgitation velocity to go from 1 m/s to 3 m/s How is the measurement of the dp / dt of the mitral regurgitation tracing performed? measure the velocity of the mitral regurgitation between 1 and 3 seconds from the onset measure the time it takes for the mitral regurgitation velocity to go from 1 m/s to 3 m/s Kawasaki disease Which of the following usually demonstrates a normal left ventricular mass? Systemic HTN Kawasaki disease Aortic coarctation Aortic stenosis left atrium When performing an echo with agitated saline ultrasound enhancing agent UEA to evaluate a patient for a suspected ASD, what cardiac chamber should be evaluated closely for the presence of the UEA? right atrium left atrium left ventricle right ventricle occlusion of the LAD coronary artery 2 weeks post coronary artery bypass surgery Paradoxical interventricular septal motion is an expected finding with which of the following? Choose all that apply occlusion of the LAD coronary artery ruptured anterior lateral papillary muscle ruptured posterior medial papillary muscle 2 weeks post coronary artery bypass surgery 2 weeks post coronary artery bypass surgery aids in obtaining accurate velocity information across the defect increases the strength of the doppler signal displayed on the tracing Which of the following are advantages of an ultrasound enhancing agent evaluation of shunt flow in the heart? choose all that apply assists in proper placement of doppler sample assists in proper placement of repair devices during corrective therapy aids in obtaining accurate velocity information across the defect increases the strength of the doppler signal displayed on the tracing parasternal long axis What echocardiographic view is best for differentiation of a pleural and pericardial effusion? subcostal parasternal short axis parasternal long axis apical 2 chamber IVC A pt presents for an echo due to a recent diagnosis of renal cell carcinoma. What cardiovascular structure should be closely evaluated for changes related to the recent diagnosis? Aorta IVC Interventricular septum left ventricular myocardium Hypokinesis of the lateral RV wall Reduced tricuspid annular plane systolic excursion Which of the following is an indication of right coronary artery disease on an exercise stress echo? choose all that apply Hypokinesis of the lateral RV wall Hypokinesis of the lateral LV wall Reduced tricuspid annular plane systolic excursion systolic blood pressure remains at baseline levels during exercise increased levels of transforming growth factor beta and decreased fibrillin-1 Pts with Marfan syndrome have abnormal levels of what proteins that affect the connective tissues of the body? Increased levels of transforming growth factor beta and fibrillin-1 increased levels of transforming growth factor beta and decreased fibrillin-1 height in centimeters and weight in kilograms What pt parameters are required to calculate the body surface area? Height in inches and systemic blood pressure height in centimeters and weight in kilograms height in centimeters and systemic blood pressure weight in pounds and systemic blood pressure