CCI RCS Registry- URR Exam Prep Questions and Answers, Exams of Cardiology

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CCI RCS Registry- URR Exam Prep Questions and Answers

Questions Assessment; The peak velocity of aortic regurgitation indicates Lhe maximum pressure gradient between: the aorta and the LV in systole the aorta and the LV in diastole the LV and the LA in diastole the LV and the LA in diastole - ANSWER-the aorla and the LV in diastole Which type of image resolution improves with proper placement of the focal zone at the area of interest? temporal latoral contrast clovational - ANSWER-Latcral The Lissue of the interventricular septum will be best visualized when: the US beam is parallel to the long axis of the septum the US beam is perpendicular to the long axis of the septu the dynamic range is increased harmonics is turned off- ANSWEFthe US beam is perpendicular to the long axis of the septum A 38yr old male presents for an echo due to a systolic murmur and has no other cardiac symptoms. Due to patient habitus, 2D imaging is significantly limited but the EF% appears normal. The aortic valve velc y is 4m/s with a peak pressure gradient of 64mmH¢g and no aortic insufficiency is detected. Which of the following is the most likely etiology of the aortic slonasis? bicuspid AV infective endocarditis degenerative disease Marlans syndrome - ANSWER-bicuspid AV All of the following are ovalualcd on a cardiac MRI, except: regurgilant volume of mitral regurgilation lof. ventricular mass mitral valve prolapse left ventricular systolic volume - ANSWEF-mitral valve prolapse Flattening of the IVS is least likely to be associated with which of the following? 3mm muscular VSD Congestive heart failure Large ASD Pulmonary HTN - ANSWER-3mm muscular VSD Which of the following correctly describes the way to tell the difference between a vasovagal response and anaphylaxis caused by contrast injection? Hypertension is a sign of vasovagal response, while hypotension is a sign of anaphy la» Tachycardia is a sign of vasovagal response, while bradycardia is a sign of anaphylaxis. A feeling of impending doom is a sign of vasovagal response, while dizziness and near syncope are signs of anaphylaxis. erythema is a sign of anaphylaxis. - ANSWER- Pallor is asign of vasovagal response, while erythema is a sign of anaphylaxis. Pallor is a sign of vasovagal response, while The right coronary artery supplies which of the following with blood? LY anterior wall LV apox ventricular septum interatrial septum - ANSWEICinteratrial septum The right coronary artery supplies the RV free wall, RV apex, inferior LV wall and interatrial septum with blood. All of the following describe Pompe disease, except? type of infiltrative discase of the myocardium involves abnormal storage of glycogen in the muscle tissues autosomal recessive disease involves abnormal storage of fat in the muscle tissues - ANSWER-involves abnormal storage of fat in the muscle tissues Pompe disease is an autosomal recessive disorder that causes the abnormal storage of glycogen in the myocardial tissue. It causes increased ventricular thickening. If the peak v sment of the septal annulus indicates a peak velocity of E’ of 6em/s, the LV diastolic filling slocity of the E wave on the mitral tracing is 1.2m/s and the tissue Doppler ass pressures are it is equivalent to the mean left atrial pressure it is defined as LV preload - ANSWER-is normally at least 3X the right ventricular diastolic pressure Left ventricular diastolic pressure is equivalent to the mean left atrial pressure. LV preload is defined as the diastolic pressure in the left ventricle. Significant Al will increase the diastolic pressure in the left ventricle. The diastolic pressure in the normal RV is usually less than ammHg below the LV diastolic pressure. Which of the following best describes the primary reason why the TEE probes are soaked ina disinfectant for a specified amount of ume? Soaking the probe Loo long in a disinfectant solution can damage the bonding cffeel of the glue used to assemble the probes. Soaking the probe too long ina disinfectant solution will decrease the flexibility of the rubber coated portion of the probe causing cracks. Soaking the probe too long ina disinfectant solution will cause the disinfectant to be absorbed inside the probe and damage the electrical components. Soaking the probe too long in a disinfectant solution will degrade the imaging capabilities of the piezoelectric element. - ANSWER-Soaking the probe too long in a disinfectant solution can damage the bonding effect of the glue used to assemble the probes. adjusts the brightness of the entire image where adjusts the brightness of specific portions of the image. overall gain, output power monitor contrast, time-gain compensation post processing, pre processing overall gain, time-gain compensation - ANSWEF-overall gain, time-gain compensation The least common type of ASD seen in patients today is?- ANSWER-coronary sinus defect Septum Secundum: most common, mid septal area Septum Primum: 2nd most common, close to AV valves Sinus Venosus: near SVC entrance Coronary Sinus Defects: inferior portion of septum, rare If the peak velocity of the E wave on the mitral tracing is 1.2m/s and the tissue Doppler assessment of the septal annulus indicates a peak velocity of E’ of 6em/s, the LV diastolic filling pressures are decroasod it is defined as LV preload - ANSWER-is normally at least 3X the right ventricular diastolic pressure Left ventricular diastolic pressure is equivalent to the mean left atrial pressure. LV preload is defined as the diastolic pressure in the left ventricle. Significant Al will increase the diastolic pressure in the left ventricle. The diastolic pressure in the normal RV is usually less than SmmHg below the LV diastolic pressure. The least common type of ASD seen in patients today is? seplum primum septum secundum sinus vonasus coronary sinus defect - ANSWER-coronary sinus defect Which of the following patients would benefit from a TEE exam? Suspected IVC thrombus Muscular VSD at the left ventricular apex St Jude AVR with suspected slenosis Suspected apical left ventricular thrombus- ANSWER-St Jude AVR with suspected stenosis After you complete an echo, you are creating the preliminary report and need to score the systolic motion of the wall segments. If the basal inferior wall was akinetic, what score will you give this segment? 4- ANSWER-3 Wall Motion Scoring used to grade systolic wall function. Score Index calculated by adding the scores from the walls and dividing by the number of segments. 1 = Normal or hyperdynamic 2 = Hypokinesis 3 = Akinesis 4=Dyskinesis d= Aneurysmal Which method of mitral regurgitation assessment is most accurate for evaluating a mechanical MVR in the apical 4 chamber view? poak pressure gradient by CW Doppler presence of bypass grafts within affected segment motion of unaffected wall segments presence/absence of thrombus - ANSWER-motion of unaffected wall segments FeedBack: The unaffected wall segments will be used to recreate the lefl ventricular wall once the aneurysmal section is removed. Which imaging technique will provide the best evaluation of a 2mm vegetation on the aortic valve? tissue Doppler transesophageal echo transthoracic echo with saline contrast transthoracic echo with perfluorocarbon contrast - ANSWEF-transesophageal echo All of the following are advantages of bioprosthetic valves over incchanical valves, execpt: no noise heard from apparatus no anticoagulation nocd more durable A porcine valve can be used to replace any cardiac valve but there are numerous kinds of mechanical valves designed for each native valve. - ANSWER-more durable The the pulse packet used in color doppler, the better the flow sensitivity. larger more perpendicular more parallel smaller - ANSWER-larger How can a contrast echo help to confirm the diagnosis of constrictive pericarditis? d to evaluate the IVC for the appearance of presystolic contrast reversal at the RA junction contrast will increase the “bounce” motion of the IVS used to better delineate the LV walls to assess for LV compaction which is a common complication of constrictive pericarditis used Lo beltcr evaluate the flow velocilics in the IVC - ANSWERuised 1o ovaluale the IVC for the appearance of presystolic contrast reversal at the RA junction valuating the IVC. The appearance of presystolic contrast reversal at the RA junction is a posilive indication for A contrast echo can aid in the diagnosis of constrictive pericarditis by constrictive pericarditis. Which of the following describes findings associated with asymmetrical septal hypertrophy seen with hypertrophic obstructive cardiomyopathy? seplal to posterior wall thickness ratio of 1.3:1 or greater seplal Lo posterior wall thickness ratio of 3:1 or greater seplal to posicrior wall thickness ratio of 2:1 or greater posterior to septal wall thickness ratio of 1.3:1 or greater - ANSWERseptal to posterior wall thickness ratio of 1.3:1 or greater Asymmetrical septal hypertrophy is diagnosed when the thickness of the septal wall is greater than the posterior wall with a septal to posterior wall ratio of 1.3:1 or greater. Which of the following vessels drains the coronary blood from the apex and septum of the left ventricle? thebesian vein great cardiac vein small cardiac vein middle cardiac vcin- ANSWER great cardiac vein The greal cardiac vcin drains blood from the myocardium thal. is supplied by the left anterior descending artery. The apex and septum are supplied with blood by the LAD artery. The pulmonary capillary wedge pressure evaluated on a right heart cath represents the pressure in the right atrium pulmonary artery lof atrium left ventricle - ANSWER left atrium shift the color baseline down to between 20 - 40em/s to allow aliasing increase the power output setting to increase aliasing switch to a variance color map before freezing the image - ANSWER-shift the color baseline up to between 20 - 40em/s to allow aliasing nee color map before Ircezing the image Reducing the color baseline improves the aliasing and aids in visualization of the hemispheric radius. IMPORTANT: when performing PISA on MR for TEE exams, the color baseline is shifted UP due to differcnec in approach. All of the following are considered critical findings on an echocardiogram, execpt: flail MV leaflet aortic dissection 2 flail chordae of the anterior leaflet of the MV apical LV thrombus - ANSWER-2 flail chordae of the anterior leaflet of the MV There are multiple chordae tendinae that connect each mitral leaflet to the papillary muscles. The disruption of 2 chordae may cause some mitral regurgitation but does not present a critical risk to the patient. A patient that stands 5 ft 2in and weighs 2251bs will have a more cardiac axis compared to a patient that stands 6ft and weighs 185lbs. horizontal superior vorlical inferior - ANSWEF-horizontal Tall thin palicnts tend Lo have a more vertical axis Lo their heart compared Lo shorter, obesc patients who have a more horizontal cardiac position. Considering body surface area when you also know the cardiac output allows you to calculate the pulsatility index pressure gradient in the LY stroke volume cardiac index - ANSWER-cardiac index