CCI Echocardiography Practice Exam Questions and Answers

These are hints straight from the ESP Ultrasound test prep. The writer of the book said these are some of the questions that came from the test itself. Obviously questions change, but he said these are questions you must know the answers to. Which Aortic leaflet is the superior one in the PSLA - Right Leaflet Name the tricuspid leaflets - Posterior and Anterior The coronary arteries come off of the.. - Sinus of Valsalva Name the vessels coming off the arch and the most proximal or distal. - Innominate (proximal), left carotid, and the left subclavian (distal) What cardiac pathology is associated with bicuspid aortic valves? - Coarctation of the Aorta Where do the most aortic Coarctation occur? - After the take-off of the left subclavian artery, or within the aortic isthmus Where are the pulmonary veins loca? Which ones are seen in this view? - Rights and left superior (upper) pulmonary veins Where is the coronary sinus located? - Posterior AV groove To visualize the coronary sinus in the apical 4 chamber view you should tilt the transducer.. - Posterior During which phase do the coronaries fill? - early diastole Where is the chiari network located? - RA What portion of the pulmonary venous PW Doppler represents atrial systole? - A wave Know frequency for TEE probes versus TTE - TTE probes are usually higher 5-7MGz, while TTE probes are 2-7MHz At what temperature is it unsafe to use a TEE probe? - 40-45C Know TEE views by esophageal level (know mid esophageal- ME and transgastric) and degrees. - 4ch- 0 degrees 2ch- 90 degrees LAX- 120 degrees Why is the SA node the primary pacemaker? - The SA node has the highest intrinsic rate of any cardiac tissue. The save of contraction (depolarization) moves from the endocardium to the epicardium. - Inside to outside. Look at the purkinje fibers above. What is the absolute refractory state? - That period when a muscle cell is not excitable- from phase 1 into phase 3; the 'relative refractory period' is during phase 3 and the muscle cell might contract if the stimulus is strong. Know what P wave, P-R interval, T wave represents - P wave- atrial systole P-R interval- includes P-R segment (from atrial to ventricular depolarization) QRS complex- ventricular diastole (repolarization) What is the normal duration for the QRS complex? - 0.10 sec Frank-Sterling Law - Increased volume= increased contractility RUBBER BAND THEORY Acute AI is hypercontractile because we shift up the Starling curve - Chronic AI is failure when we drop off the end Does a PDA (patent ductus arteriosus) increase LV preload? - yes (when shunt L-R) Echo finding for preload vs. afterload... - Preload= dilatation Afterload= hypertrophy Which study does not allows for the calculations of ejection fraction? - CXR Does venous return increase or decrease with inspiration? - Increase Mitral valve velocity during inspiration increases or decreases? - Increases Hepatic venous flow reveral indicates _______ TR. - Severe Given a TR velocity of 4.0m/sec what is the RVSP? - 70mmHg A patient has a RVSP of 60mmHg. One year later the RVSP is 30mmHg. What happened to the pt? - Coanda effect? Coanda Effect- Define. - Wall hugging effect Pulmonary venous systolic flow reversal is.. - Severe MR Which of the following is used in echo to measure dP/dt? - Mitral regurgitation dP/dt measurement of mitral regurgitation assesses what? - LV systolic dysfunction ______ is the rate of rise of LV pressure? - dP/dt LAP= - systolic BP- MR gradient Know pressure waveforms for MR (late systolic jump in LA pressure) pg. 97 - ... Know about Marfan's syndrome.. define - Congenital connective tissue disease causing aortic dilatation of MVP In Marfan syndrome, why does aortic dissection and MVP occue? - Connective tissue disorder Know Ehlers-Danlos. Another connecative tissue disorder - like Marfan's pts, you look for MVP dilated Ao dissection Severe Ao aneurysms are greater than: - 5.0cm Know libman-sachs= - Lupus and Marantic endocarditis St. Jude is a __________ valve - Bi-leaflet Autografts - means using pts own tissue Pannus - host tissue overgrowth What are all the cardiomyopathies? - Dilated, hypertrophic, restrictive, ischemic Which cardiomyopathy is autosomal dominant? - Hypertrophic Apical Hypertrophic Cardiomyopathy (AHCM) - Normal etiology (genetic) Typical spectral Doppler finding (flow acceleration in mid LV) Ratio for assessing asymmetric hypertrophy. - 1.3:1 LVOT obstruction cuases the aortic valve to... - close in mid systole Pts with a history of IV drug abuse may present with... - Tricuspid endocarditis The Venturi Effect can be associated with which cardiomyopathy? - Hypertrophic