Terry Reynolds 500 Flash Cards Rcs Study Guide

500 Question Study by Terry Reynolds, BS, RDCS 1. The parasternal long-axis view allows identification of all the following wall segments EXCEPT: A. Basal and mid-interventricular septum B. Basal and mid-posterior wall of the left ventricle C. Infero-lateral wall of the left ventricle D. Left ventricular apex. 2. Wall segments that are visualized in the parasternal short-axis view of the left ventricle at the level of the papillary muscles include all the following EXCEPT: A. Anterior septum B. Anterior wall C. Antero-inferior wall D. Antero-lateral wall 3. Left ventricular wall segements that are usually visualized in the apical fourchamber view include all of the following EXCEPT: A. Anterior wall of the left ventricle B. Apex C. Interventricular septumza D. Lateral wall of left ventricle 4. Wall segments and structures that may be visualized in the apical twochamber view include all of the following EXCEPT: A. Anterior wall of the left ventricle B. Coronary sinus C. Free wall of the right ventricle D. Inferior wall of the left ventricle 5. The boundaries of the functional left ventricular outflow tract are best described as extending from the: A. Anterior aortic valve annulus to the posterior aortic valve annulus B. Anteromedial position of the tricuspid valve annulus to the pulmonic valve annulus C. Free edge of the anterior mitral valve leaflet to the aortic valve annulus D. Tips of the left ventricular papillary muscles to the edge of the anterior mitral valve leaflet 6. The landmarks used to identify the anatomic and functional right ventricular outflow tract are the: A. Anterior mitral valve leaflet to the left edge of the interventricular septum B. Aortic valve annulus to the tricuspid valve annulus C. Tricuspid valve annulus to the aortic valve annulus D. Tricuspid valve annulus to the pulmonary valve annulus 7. All A. B. C. D.

of the following are considered atrioventricular valves EXCEPT: Aortic Mitral Bicuspid Tricuspid

500 Question Study by Terry Reynolds, BS, RDCS 8. All A. B. C. D.

of the following are names for pulmonic valve leaflets EXCEPT: Anterior Left Non-coronary Posterior

9. All A. B. C. D.

the following events are considered to occur in late diastole EXCEPT: A-dip of the pulmonic valve leaflet on M-mode A-point of the anterior mitral valve leaflet on M-mode A-point of the mitral valve Doppler waveform E-point of the anterior mitral valve leaflet on M-mode

10.The __________ mitral valve leaflet is continuous with the _________ aortic root, while the _____________ is continuous with the __________ aortic root. A. Anterior, anterior, posterior mitral valve leaflet, posterior B. Anterior, posterior, interventricular septum, anterior C. Posterior, anterior, interventricular septum, posterior D. Posterior, posterior, anterior mitral valve leafleft, anterior 11.Structures of the mitral valve apparatus include all of the following EXCEPT: A. Mitral annulus B. Sinuses of Valsalva C. Left ventricular walls D. Papillary muscles 12.The normal mitral valve area is: A. 1 to 3 cm2 B. 3 to 5 cm2 C. 4 to 6 cm2 D. 7 to 9 cm2

13.All A. B. C. D.

the following are considered pulmonary vessels EXCEPT: Main pulmonary artery Pulmonary capillaries Pulmonary veins Vena cava

14.The upper limit of normal for the aortic root diameter in adults as measured by M-mode echocardiography ranges from: A. 1.3 to 2.4 cm B. 2.2 to 2.5 cm C. 25 to 32 mm D. 33 to 37 mm

500 Question Study by Terry Reynolds, BS, RDCS 15.The three branches that normally originate from the aortic arch include all the following EXCEPT: A. Brachiocephalic artery B. Left common carotid artery C. Left subclavian artery D. Right subclavian artery 16.The point at which the descending aorta and the aortic arch join is called the aortic: A. Bifurcation B. Bulb C. Isthmus D. Sinus 17.The thickest layer of an aterial wall is the tunica: A. Adventitia B. Intima C. Media D. Vasorum 18.The anatomic landmark that demarcates the end section of the descending thoracic aorta and the beginning of the abdominal aorta is the: A. Aortic isthmus B. Diaphragm C. Ligamentum arteriosum D. Renal arteries

19.The section of the aorta that is located between the diaphragm and the iliac arteries is called the: A. Abdominal aorta B. Aortic isthmus C. Descending thoracic aorta D. Transverse aorta 20.The correct order for the branches of the aortic arch is: A. Left subclavian, right subclavian, left common carotid B. Right brachiocephalic, left brachiocephalic, left common carotid C. Right brachiocephalic, left common carotid, left subclavian D. Sinus of Valsalva, right innominate, left innominate 21.The normal fetal vascular channel that connects the descending thoracic aorta and the main pulmonary artery is the: A. Dustus venosus B. Ductus arteriosus C. Ligamentum venosus D. Ligamentum arteriosum

500 Question Study by Terry Reynolds, BS, RDCS 22.The coronary artery that has a branch called the circumflex artery is the: A. Left anterior descending coronary artery B. Left coronary artery C. Posterior descending coronary artery D. Right coronary artery 23.The coronary artery that predominantly supplies blood to the right ventricle is the: A. Acute marginal branch B. Anterior descending coronary artery C. Circumflex coronary artery D. Left main coronary artery 24.Normal pressure values in millimeters of mercury for the listed cardiac chambers or great vessels include all the following EXCEPT: A. Right atrial pressure: 0 to 5 mean B. Right ventricle: 25 systolic, 0 to 5 diastolic C. Pulmonary artery: 25 systolic, 10 to 15 diastolic D. Left ventricle: 120 systolic, 80 diastolic

25.The moderator band is found in the: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle 26.The Eustachian valve is found in the: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle 27.The Chiari network is found in the: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle 28.The normal volume of clear serous fluid in the pericardial sac is: A. 20 to 50 cc B. 20 to 50 L C. 200 to 500 cc D. 200 to 500 L 29.A potential space behind the left atrium where pericardial effusion could accumulate is the: A. Sinus of Valsalva B. Pleural potential space

500 Question Study by Terry Reynolds, BS, RDCS C. Oblique sinus D. Coronary sinus 30.The normal left atrium to right atrium ratio is: A. 1:1 B. 1.3:1 C. 2:1 D. 3:1 31.The volume or pressure that exists in the ventricle at end-diastole is called: A. Preload B. Afterload C. No-load D. Sumload 32.The resistance to ejection of blood encountered by the contracting ventricle is called: A. Preload B. Afterload C. No-load D. Sumload 33.In general, and outside certain disease states, the greater the stretch of the muscle cell, the greater the force of contraction. This principle is called: A. Frank’s law of the heart B. Frank-Starling law of the heart C. Force-velocity relationship D. Interval-length relationship 34.The percentage of blood pumped out of the heart per beat is called: A. Stroke volume B. Cardiac output C. Cardiac index D. Ejection fraction 35.Failed fusion of the superior and inferior endocardial cushions is associated with all of the following EXCEPT: A. Partial atrioventricular canal defect B. Complete atrioventricular canal defect C. Isolated inlet ventricular septal defect D. Isolated supracristal ventricular septal defect 36.The imaginary boundaries that define the mid-left ventricle are the: A. Mitral annulus to the tip of the papillary muscles B. Base of the papillary muscles to the cardiac apex C. Tip of the papillary muscles to the base of the papillary muscles D. Aortic annulus to the edge of the mitral valve

500 Question Study by Terry Reynolds, BS, RDCS 37.The coronary sinus can be differentiated from the descending thoracic aorta with pulsed-wave Doppler because coronary sinus flow is predominantly diastolic, while aortic flow is: A. Equiphasic B. Phasic C. Predominantly diastolic D. Predominantly systolic 38.In standard imaging (M-mode and two-dimensional echocardiography), the control that determines the amount of electrical energy transmitted to the transducer from the pulser is: A. Overall gain B. Radiofrequency gain C. Time gain compensation D. Transmit power 39.Amplification of received signals is controlled by: A. Output power B. Overall gain C. Pulser power D. Transmit power 40.A method used to compensate for the attenuation of signals as a function of time/depth along the ultrasound beam is: A. Overall gain B. Pulser power C. Time gain compensation D. Transmit power 41.The control that selects the minimum signal amplitude to be displayed is: A. Depth B. Far gain C. Output power D. Reject 42.The control that sets the upper limit to which ultrasound information will be processed and displayed is: A. Depth B. Far gain C. Overall gain D. Reject 43.The control used when information from a precise point in the cardiac cycle is required is the: A. Electrocardiogram trigger B. Overall gain C. Reject D. Time gain compensation

500 Question Study by Terry Reynolds, BS, RDCS

44.The Doppler control that eliminates low-level frequency shifts is: A. Filter B. Gain C. Output power D. Sample volume length 45.The control labeled Doppler sample volume depth: A. Sets the range gate location for pulsed-wave Doppler B. Does not affect the pulse repetition frequency C. Does not affect the maximum velocity that can be displayed without signal aliasing D. Is useful in continuous-wave Doppler 46.The preferred transducer frequency for imaging a barrel-chested patient is: A. 2.5 MHz B. 3.5 MHz C. 5.0 MHz D. 7.0 MHz 47.A maneuver that results in a decrease in venous return is: A. Inspiration B. Squatting C. Straight leg raising D. Valsalva 48.A maneuver that results in an acute increase in blood pressure is: A. Inhalation of amyl nitrate B. Supine to standing C. Isometric handgrip D. Inspiration 49.A maneuver that will result in tachycardia and a transient decrease in blood pressure is: A. Inhalation of amyl nitrate B. Squatting C. Standing to supine D. Straight leg raising 50.A maneuver that will increase venous return is: A. Expiration B. Squatting to standing C. Straight leg raising D. Supine to standing 51.A maneuver that increases the obstruction in patients with hypertrophic obstructive cardiomyopathy is: A. Leg raising B. Standing to supine C. Valsalva

500 Question Study by Terry Reynolds, BS, RDCS D. Inspiration 52.Possible pharmacologic treatments for hypertrophic obstructive cardiomyopathy include: A. Propanolol B. Epinephrine C. Dobutamine D. Lasix 53.The method that would best allow visualization of shunt flow across an atrial septal defect is: A. M-mode echocardiography B. Two-dimensional echocardiography C. Contrast echocardiography D. Stress echocardiography 54.The most common location for beginning the adult echocardiographic examination is: A. Apical B. Left parasternal C. Right parasternal D. Subcostal 55.The three basic planes of a complete two-dimensional echocardiographic examination are: A. Long-axis, diagonal-axis, four-chamber B. Long-axis, short-axis, four-chamber C. Long-axis, short-axis, subcostal D. Long-axis, short-axis, two-chamber 56.The two-dimensional echocardiographic view that best visualizes the proximal segments of the coronary arteries is the: A. Parasternal long-axis view of the left ventricle B. Parasternal short-axis view of the aortic valve C. Parasternal short-axis view of the left ventricle of papillary muscles D. Subcostal four-chamber view

57.The two-dimensional echocardiographic view that permits examination of the aortic arch is: A. Parasternal long axis B. Apical two chamber C. Subcostal four chamber D. Suprasternal long axis 58.The recommended method for determining left ventricular volumes by twodimensional echocardiography is:

500 Question Study by Terry Reynolds, BS, RDCS A. B. C. D.

Method of discs Single plane area-length Bullet method Prolate ellipse method

59.The ellipsoid single-plane method for determining left ventricular volumes by two-dimensional echocardiography is also called: A. Area-length method B. Bullet method C. Length-diameter method D. Simpson’s rule 60.A bright horizontal echo that gives the edge of an atrial or ventricular septal defect a broadened appearance is referred to as the: A. A sign B. Fo sign C. T sign D. W sign 61.When attempting to determine the presence of a perimembranous ventricular septal defect in the parasternal long-axis view, the echocardiographer should tilt the probe: A. Anteriorly B. Posteriorly C. Medially D. Laterally 62.When attempting to determine whether an inlet ventricular septal defect from the apical four-chamber view is present, the echocardiographer should tilt the probe: A. Anteriorly B. Posteriorly C. Medially D. Laterally 63.The two-dimensional echocardiographic view that is the best approach for ruling out coarctation of the aorta is: A. Parasternal long-axis view B. Parasternal short-axis view of the aortic valve C. Subcostal five-chamber view D. Suprasternal long-axis view of the aortic arch 64.The two-dimensional echocardiographic views used to determine whether truncus arteriosus is present are the parasternal long-axis view and the: A. Apical five-chamber view B. Parasternal right ventricular inflow tract view C. Parasternal short-axis view of the aortic valve D. Parasternal short-axis view of the left ventricle

500 Question Study by Terry Reynolds, BS, RDCS 65.The two-dimensional view that may be used to directly visualize a patent ductus arteriosus is the: A. Parasternal long-axis view of the left ventricle B. Parasternal short-axis view at the base C. Apical five-chamber view D. Subcostal four-chamber view 66.The best two-dimensional view for determining mitral valve area is the: A. Apical four-chamber view B. Parasternal long-axis view C. Parasternal short-axis view D. Subcostal four-chamber view 67.The gold-standard two-dimensional echocardiographic view for diagnosing mitral valve prolapsed is the: A. Apical four-chamber view B. Parasternal long-axis view C. Parasternal short-axis view of the mitral valve D. Subcostal four-chamber 68.Excellent two-dimensional views for imaging the tricuspid valve include all the following EXCEPT: A. Parasternal long-axis view B. Parasternal short-axis view of the aortic valve C. Apical four-chamber view D. Subcostal four-chamber view

69.The smallest vegetation that transthoracic two-dimensional echocardiography can detect is: A. 1 mm B. 2 mm C. 3 mm D. 4 mm 70.The hump or break occasionally seen on the M-mode of the mitral valve between the E and F points is designated: A. B notch B. f wave C. Fo D. h wave 71.The left atrial dimension is measured on M-mode during: A. Systole B. End-systole C. Diastole D. End-diastole

500 Question Study by Terry Reynolds, BS, RDCS 72.The method used most often for calculating ejection fraction by M-mode echocardiography is: A. Ellipsoid biplane method B. Simpson’s method of discs C. Single-plane area-length method D. Teichholtz regression 73.A quantitative measure of left ventricular systolic wall thickening is: A. DT – ST ÷ DT B. ST – DT ÷ DT x 100 C. DT + ST D. DT + ST ÷ DT 74.The top normal left ventricular internal dimension at end diastole in an adult by M-mode is: A. 16 mm B. 26 mm C. 36 mm D. 56 mm

75.The normal range for the interventricular septum and the posterior wall of the left ventricle at end-diastole by M-mode is: A. 6 to 11 mm B. 6 to 11 cm C. 0.6 to .011 mm D. 60 to 110 mm 76.The E-F slope of the M-mode of the anterior mitral valve leaflet reflects the: A. Opening rate of the anterior mitral valve leaflet B. Rate of diastolic filling of the left ventricle C. Rate of left atrial emptying during diastasis D. Rate of systolic filling of the left ventricle 77.The E-F slope of the M-mode of the anterior mitral valve leaflet in mitral valve stenosis is: A. Decreased B. Increased C. Notched D. Unaffected 78.The mitral valve M-mode points that denote the beginning and the end of diastole are: A. C to D B. D to C C. D to E D. E to F

500 Question Study by Terry Reynolds, BS, RDCS 79.The anterior mitral valve leaflet E-F slope is decreased in: A. Left atrial myxoma B. Left ventricular volume overload C. Mitral valve prolapse D. Mitral valve vegetation 80.The pulmonic valve leadlet most commonly recorded by M-mode is the: A. Anterior B. Left C. Septal D. Right

81.On M-mode, the abrupt downward motion of the pulmonary valve leaflet following atrial contraction is called the: A. “a” dip B. “b” dip C. “c” dip D. “d” dip 82.The geometric shape of the right ventricle is: A. Prolate ellipse B. Pyramid C. Rectangle D. Circle 83.A pressure overload of the right ventricle may produce all the following echocardiographic findings EXCEPT: A. D-shaped left ventricle B. Right ventricular dilatation C. Right ventricular hypertrophy D. Small, protected right ventricle 84.A right ventricle volume overload pattern is associated with all the following echocardiographic findings EXCEPT: A. Abnormal interventricular septal motion B. Dilatation of the right ventricle C. Pancaking of the interventricular septum during ventricular diastole D. Pancaking of the interventricular septum during ventricular systole 85.The echocardiographic examination that would be the first choice to delineate a suspected left atrial clot is: A. Stress echocardiogram B. Intracardiac echocardiogram C. Transesophageal echocardiogram D. Transthoracic echocardiogram

500 Question Study by Terry Reynolds, BS, RDCS 86.The formula used to calculate ejection fraction is: A. EDD-ESD B. EDV-ESV C. EDD-ESD ÷EDD x 100 D. EDV-ESV ÷ EVD x 100 87.The formula used for calculating stroke volume is: A. EDV + ESV B. EDV - ESV C. ESV - EDV D. (EDV – ESV) ÷ EDV 88.The mean velocity of circumferential fiber shortening (Vcfm) may be calculated by: A. EDD – ESD ÷ EDD B. EDD – ESD ÷ LVET x EDD C. EDV – ESV D. EDV – ESV ÷ EDV 89.The pressure obtained by a pulmonary artery wedge reflects the pressure in the: E. Left atrium F. Pulmonary artery G. Right atrium H. Right ventricle 90.Maneuvers that will increase the duration and severity of mitral valve prolapsed include all of the following EXCEPT: A. Inhalation of amyl nitrate B. Valsalva maneuver C. Supine to standing D. Squatting 91.A saline contrast injection to rule out atrial septal defect is performed. Contrast appears in the left atrium 4 to 8 cycles after the appearance of contrast in the right atrium. The best explanation is: A. Left-to-right atrial septal defect shunt B. Right-to-left atrial septal defect shunt C. Left ventricle-to-right atrium shunt D. Pulmonary arteriovenous fistula 92.A maneuver that will increase venous return is: A. Supine to standing B. Standing to walking C. Valsalva maneuver D. Quiet expiration

500 Question Study by Terry Reynolds, BS, RDCS

93.The effect inspiration has on venous return to the right atrium is: A. Decrease B. Increase C. Depends on the depth of inspiration D. No effect 94.The recommended maneuver to use when performing a transesophageal contrast examination in a patient with a possible patent foramen ovale is: A. Inhalation of amyl nitrate B. Squatting C. Supine to standing D. Valsalva maneuver 95.Possible complications of chronic mitral regurgitation include all the following EXCEPT: A. Atrial fibrillation B. Congestive heart failure C. Increased risk of sudden death D. Pulmonary hypertension 96.Congestive heart failure in a patient with significant mitral regurgitation occurs because of increased pressure in the: A. Left atrium B. Right atrium C. Right ventricle D. Aorta 97.The left atrial cardiac catheterization pressure tracing in a patient with significant mitral regurgitation may demonstrate an increase in the: A. “a” wave B. “v” wave C. “x” wave D. “y” wave 98.Diastolic mitral regurgitation is associated with: A. Flail mitral valve B. Mitral valve prolapse C. Severe aortic insufficiency D. Severe tricuspid regurgitation 99.In patients with mitral regurgitation, cardiac catheterization measurements include all the following EXCEPT: A. Left ventricular systolic/diastolic pressure B. Mitral valve area C. Pulmonary artery pressures D. Pulmonary capillary wedge pressure

500 Question Study by Terry Reynolds, BS, RDCS 100.

A heart sound associated with significant chronic pure mitral regurgitation is: A. Loud S1 B. Fixed split S2 C. S3 D. S4

101.A cardiac catherization technique used to determine the severity of mitral regurgitation is: A. Cardiac fluoroscopy B. Coronary arteriography C. Left ventriculography D. Supravalvular angiography 102.Possible complications of acute, severe mitral regurgitation include: A. Syncope B. Hemoptysis C. Pulmonary edema D. Systemic embolization 103.Possible presenting symptoms of significant chronic mitral regurgitation include: A. Angina pectoris B. Ascites C. Fatigue D. Syncope 104.A common finding associated with a regurgitant murmur in the elderly is: A. Aortic valve stenosis B. Mitral annular calcification C. Mitral valve stenosis D. Mitral valve vegetation

105.Chronic mitral regurgitation results in all the following EXCEPT: A. Left atrial enlargement B. Left ventricular enlargement C. Left ventricular volume overload pattern D. Mitral annular calcification 106.Possible etiologies for mitral regurgitation include all the following EXCEPT: A. Mitral annulus calcification B. Mitral valve endocarditis C. Papillary muscle dysfunction D. Pulmonary hypertension

500 Question Study by Terry Reynolds, BS, RDCS 107.Possible electrocardiographic findings for patients with significant mitral regurgitation include all the following EXCEPT: A. Left atrial enlargement B. Left ventricular hypertrophy C. Right atrial enlargement D. Right ventricular hypertrophy 108.In patients with significant mitral regurgitation, the isovolumic relaxation time may be: A. Increased B. Decreased C. Affected by respiration D. Unaffected 109.The effects of chronic mitral regurgitation on interventricular septal motion include: A. Akinesis B. Dyskinesis C. Hyperkinesis D. Paradoxical motion 110.M-mode findings associated with significant chronic mitral regurgitation include all the following EXCEPT: A. Left atrial enlargement B. Left ventricular enlargement C. Fine diastolic flutter of the mitral valve D. Flying W of the pulmonic valve

111.A two dimensional echocardiographic finding that may indicate significant chronic mitral regurgitation is: A. Fine diastolic oscillations of the mitral valve B. Left ventricular enlargement C. Left ventricular hypertrophy D. Premature closure of the mitral valve 112.Systolic bowing of the interatrial septum toward the right atrium may be an indication of: A. Atrial septal defect B. Mitral regurgitation C. Tricuspid regurgitation D. Tricuspid stenosis 113.The effect significant mitral regurgitation has on the pulsed-wave Doppler tracing of the pulmonary veins may be described as: A. S wave increases, D wave decreases B. S wave increases, D wave increases C. S wave decreases, D wave increases

500 Question Study by Terry Reynolds, BS, RDCS D. Unaffected 114.Possible secondary echocardiographic/Doppler findings in patients with severe chronic mitral regurgitation include all the following EXCEPT: A. Increased mitral valve E velocity B. Increased peak aortic valve velocity C. Increased right ventricular dimension D. Shortened time too peak velocity of the right ventricular outflow tract 115.The Doppler finding of mitral valve regurgitation in coronary artery disease is most likely due to: A. Flail mitral valve B. Mitral valve prolapsed C. Papillary muscle dysfunction D. Subaortic stenosis 116.An accepted method for the semi-quantitation of mitral regurgitation with pulsed-wave Doppler is: A. Mapping technique B. Maximum velocity of the mitral regurgitation C. Peak A velocity D. Pressure half-time 117.An accepted method for determining the severity of mitral regurgitation by continuous-wave Doppler is spectral: A. Length B. Strength C. Velocity D. Width 118.A color flow Doppler method for semi-quantitating mitral regurgitation is regurgitant jet: A. Area B. Height C. Length D. Turbulence 119.The radius of a mitral regurgitation flow convergence hemisphere is 1.1 cm. The proximal isovelocity surface area (PISA) is: A. 1.21 cm2 B. 3.8 cm2 C. 7.6 cm2 D. 15.2 cm2 120.The proximal isovelocity surface area of a mitral regurgitant jet is 7.6 cm 2. The aliasing flow velocity is 24 cm/sec. The time velocity integral (TVI) of the mitral regurgitation jet is 150 cm. The maximum velocity of the mitral regurgitation jet is 580 cm/sec. The mitral regurgitant stroke volume is: A. 24 cc

500 Question Study by Terry Reynolds, BS, RDCS B. 47 cc C. 150 cc D. 580 cc 121.The peak mitral reguritant velocity reflects the: A. Direction of the regurgitant jet B. Etiology of the mitral regurgitation C. Maximum pressure difference between the left atrium and the left ventricle D. Severity of the mitral regurgitation 122.In patients with significant mitral regurgitation, the continuous-wave Doppler tracing of the regurgitant lesion may demonstrate a(n): A. Asymmetrical shape of the mitral regurgitation flow velocity spectral display B. Jet area of 20% C. Jet duration of less than 85 msec D. Symmetrical shape of the mitral regurgitation flow velocity spectral display 123.Cardiac Doppler evidence of severe mitral regurgitation includes all the following EXCEPT: A. Darkly stained continuous-wave Doppler tracing B. Mitral valve E velocity 8.0 cm2 124.Flail mitral valve can be differentiated from severe mitral valve prolapsed on two-dimensional echocardiography because flail mitral valve leaflet demonstrates: A. A thicker mitral valve B. Chronic mitral regurgitation C. Leaflet tips that point toward the left ventricle D. Leaflet tips that point toward the left atrium 125.In patients with severe acute mitral regurgitation, the continuous-wave Doppler maximum velocity of the regurgitant jet is: A. Decreased B. Dependent largely upon left ventricular function C. Increased D. Unaffected 126.The most common etiology of mitral valve stenosis is: A. Congenital B. Left atrial myxoma C. Rheumatic fever D. Severe mitral annular calcification 127.The cardiac valves listed in decreasing order as they are affected by rheumatic heart disease are:

500 Question Study by Terry Reynolds, BS, RDCS A. Aortic, pulmonic, tricuspid, and mitral B. Mitral, aortic, tricuspid, and pulmonic C. Pulmonic, aortic, tricuspid, and mitral D. Tricuspid, mitral, pulmonic, and aortic 128. Signs and symptoms of mitral valve stenosis secondary to rheumatic heart disease include: A. Angina pectoris B. Cyanosis C. Pulmonary Hypertension D. Vetigo

129. Auscultatory findings for mitral valve stenosis include all the following EXCEPT: A. B. C. D.

Diastolic rumble at the apex Loud first heart sound Opening snap Systolic ejection murmur heard at the base

130. A 23-year-old woman complaining of dyspnea presents to the cardiologist. Upon examination, a diastolic rumble and opening snap are heard. The patient remembers having rheumatic fever at the age of 10. Her electrocardiogram demonstrated left atrial enlargement and right ventricular hypertrophy. The diagnosis is: A. B. C. D.

Aortic valve stenosis Mitral regurgitation Rhumatic mitral valve stenosis Valvular pulmonic valve stenosis

131. Patients with mitral valve stenosis, left atrial enlargement, and atrial fibrillation are at increased risk for the development of: A. B. C. D.

Left Left Left Left

atrial myxoma atrial thrombus ventricular dilatation ventricular thrombus

132. The valvular disease with which atrial fibrillation is most commonly associated is: A. B. C. D.

Acute aortic insufficiency Aortic valve stenosis Mitral valve prolapse Rheumatic mitral valve stenosis

500 Question Study by Terry Reynolds, BS, RDCS 133. Conditions that may lead to clinical symptoms that mimic those associated with rheumatic mitral valve stenosis include: A. B. C. D.

Aortic insufficiency Left atrial myxoma Pericardial effusion Ventricular septal defect

134. Auscultatory findings in rheumatic mitral valve stenosis include: A. B. C. D.

Austin Flint murmur Fixed splitting of S2 Loud S1 Mid-systolic click

135. Left atrial thrombus is most often associated with: A. B. C. D.

Cor triatriatum Infective endocarditis Mitral valve prolapsed Rheumatic mitral valve stenosis

136. In pure rheumatic mitral valve stenosis, the left atrium is _______ and the left ventricle is _______. A. B. C. D.

Decreased, decreased Increased, decreased Increased, increased Unchanged, increased

137. The formula used to determine mitral valve area in the cardiac catheterization laboratory is: A. B. C. D.

CO CO CO CO

÷ BSA ÷ MPG ÷ DFP ÷ 38 x √MPG ÷SEP ÷44.3 x √MPG

138. M-mode findings for the mitral valve in patients with rheumatic mitral valve stenosis include all the following EXCEPT: A. B. C. D.

Anterior motion of the posterior mitral valve leaflet B notch of the anterior mitral valve leaflet Decreased E-F slope of the anterior mitral valve leaflet Thickened mitral valve leaflets

500 Question Study by Terry Reynolds, BS, RDCS 139. In the M-mode echocardiogram, features of mitral valve stenosis include all the following EXCEPT: A. B. C. D.

Anterior motion of the posterior mitral valve leaflets Decreased aortic root dimension Systolic anterior motion of the mitral valve leaflets Left atrial dilatation

140. In mitral valve stenosis, the posterior mitral valve leaflet on M-mode moves: A. B. C. D.

Anteriorly Laterally Medially Posteriorly

141. Critical mitral valve stenosis is said to be presented if the mitral valve area is reduced to: A. B. C. D.

220 msec

153. Secondary echocardiographic/Doppler findings in patients with rheumatic mitral stenosis include all the following EXCEPT: A. B. C. D.

Abnormal interventricular septal wall motion Increased right heart dimensions Increased tricuspid regurgitant jet velocity Left ventricular dilatation

154. A key word that is often used to describe the characteristics of the valve leaflets in mitral valve prolapsed is: A. B. C. D.

Dense Doming Redundant Sclerotic

155. The term myxomatous degeneration is associated with mitral valve: A. B. C. D.

Flail leaflet Prolapse Stenosis Vegetation

156. The associated auscultatory findings for mitral valve prolapsed include: A. B. C. D.

Ejection click Friction rub Mid-systolic click Pericardial knock

157. Secondary causes of mitral valve prolapsed include all the following EXCEPT:

500 Question Study by Terry Reynolds, BS, RDCS A. B. C. D.

Atrial septal defect Bicuspid aortic valve Cardiac tamponade Primary pulmonary hypertension

158. Echocardiographic characteristics of mitral valve prolapsed include all the following EXCEPT: A. B. C. D.

Increased mitral valve annulus Systolic bowing of the mitral valve toward the left atrium Systolic doming of the leaflets Thickened, redundant leaflets

159. When performing an echocardiogram on a patient with a thoracic skeletal abnormality (e.g., pectus excavatum), the echocardiographer must be careful to rule out: A. B. C. D.

Atrial septal defect Bicuspid valve prolapsed Coarctation of the aorta Mitral valve prolapsed

160. A redundant mitral valve leaflet is considered present when the leaflet thickness on M-mode/two-dimensional echocardiography is: A. B. C. D.

≥ ≥ ≥ ≥

2 3 4 5

mm mm mm mm

161. Mitral valve leaflet chordal rupture usually results in: A. B. C. D.

Aortic insufficiency Mitral regurgitation Pulmonary insufficiency Tricuspid regurgitation

162. Possible causes of ruptured chordae tendineae of the mitral valve include all the following EXCEPT: A. B. C. D.

Carciniod heart disease Infective endocarditis Mitral valve prolapsed Trauma

163. Conditions that may affect the left ventricle in the same way as aortic insufficiency include all the following EXCEPT:

500 Question Study by Terry Reynolds, BS, RDCS A. B. C. D.

Atrial septal defect Mitral regurgitation Patent ductus arteriosus Ventricular septal defect

164. Valvular annuloplasty is best accomplished by the following device: A. B. C. D.

Ballon Ring Stent Coil

165. An M-mode of the aortic root demonstrates fine vibrations in the left atrium. The most likely cause is: A. B. C. D.

Flail mitral valve Left atrial myxoma Left atrial thrombus Mitral valve prolapsed

166. On M-mode/two-dimensional echocardiography, dense echoes are noted posterior to normal mitral valve leaflets. The probable diagnosis is mitral valve: A. B. C. D.

Annular calcification Fibrosis Papilloma Vegetation

167. The most likely etiology of aortic valve stenosis in a 47-year-old patient is: A. B. C. D.

Annular Congenital Endocarditis Senile

168. Classic symptoms associated with severe valvular aortic stenosis include all the following EXCEPT: A. B. C. D.

Angina pectoris Atypical chest pain Congestive heart failure Syncope

169. An effect of significant aortic valve stenosis on the left ventricle is: A. B. C. D.

Asymmetrical septal hypertrophy Concentric left ventricular hypertrophy Eccentric left ventricular hypertrophy Protected in significant aortic valve stenosis

500 Question Study by Terry Reynolds, BS, RDCS

170. Pathologies that may result in a left ventricular pressure overload include all the following EXCEPT: A. B. C. D.

Discrete subaortic stenosis Mitral valve stenosis Systemic hypertension Valvular aortic stenosis

171. Secondary echocardiographic findings associated with severe valvular aortic stenosis include all the following EXCEPT: A. B. C. D.

Decreased left ventricular systolic function (late in course) Left ventricular hypertrophy Post-stenotic dilatation of the ascending aorta Right ventricular hypertrophy

172. The pulse that is characteristic of significant valvular aortic stenosis is: A. B. C. D.

Pulsus Pulsus Pulsus Pulsus

alternans bisferiens paradoxus parvus et tardus

173. The cardinal symptoms of valvular aortic stenosis include all the following EXCEPT: A. B. C. D.

Angina pectoris Congestive heart failure Palpitations Syncope

174. Heart sounds associated with significant valvular aortic stenosis include: A. B. C. D.

Loud S1 Fixed split S2 S3 S4

175. The murmur of aortic valve stenosis is best described as a: A. B. C. D.

Holodiastolic decrescendo murmur heard best at the left sterna border Holosystolic murmur heard at the apex radiating to the axilla Midsystolic murmur heard best at the right upper sterna border Midsystolic murmur heard best at the left upper sterna border

500 Question Study by Terry Reynolds, BS, RDCS 176. The principle electrocardiographic finding in severe valvular aortic stenosis is: A. B. C. D.

Atrial fibrillation Left atrial enlargement Left ventricular hypertrophy Right ventricular hypertrophy

177. The aortic valve area considered critical aortic valve stenosis is: A. B. C. D.

< < < <

3 cm2 2 cm2 1 cm2 0.75 cm2

178. The formula used to determine aortic valve area in the cardiac catheterization laboratory is the: A. B. C. D.

Bernoulli equation Continuity equation Doppler equation Gorlin equation

179. When M-mode evaluation of a systolic ejection murmur reveals thickened aortic valve leaflets and an aortic cusp excursion of 2.0 cm, the most likely diagnosis is aortic valve: A. B. C. D.

Insufficiency Sclerosis Stenosis Vegetation

180. The etiology of aortic valve stenosis includes all the following EXCEPT: A. B. C. D.

Bacterial Congenital Degenerative Rheumatic

181. The characteristic M-mode findings for aortic valve stenosis include all the following EXCEPT: A. B. C. D.

A lack of systolic flutter of the aortic valve leaflets Diastolic flutter of the aortic valve leaflets Reduced leaflet separation in systole Thickening of the aortic valve leaflets

500 Question Study by Terry Reynolds, BS, RDCS 182. The M-mode echocardiogram demonstrates multiple echoes within the aortic root. The aortic valve excursion as determined by two-dimensional echocardiography is 7 mm. On physical examination, a crescendo-decrescendo systolic ejection murmur and a diastolic decrescendo murmur were heard. The most likely diagnosis is aortic valve: A. B. C. D.

Insufficiency Stenosis Stenosis and aortic insufficiency Stenosis and mitral valve stenosis

183. Possible two-dimensional echocardiographic findings in significant aortic valve stenosis include all the following EXCEPT: A. B. C. D.

Aortic valve calcification Left ventricular hypertrophy Post-stenosic dilatation of the ascending aorta Post-stenotic dilatation of the descending aorta

184. In the parasternal long-axis view, severe aortic valve stenosis is defined as an aortic valve leaflet separation that measures: A. B. C. D.

≥ ≤ ≤ ≤

14 mm 12 mm 10 mm 8 mm

185. Cardiac Doppler parameters used to assess the severity of valvular aortic stenosis include all the following EXCEPT: A. B. C. D.

Aortic pressure half-time Aortic velocity ratio Mean pressure gradient Peak aortic valve velocity

186. The intracardiac pressure that will most likely be increased in patients with severe valvular aortic stenosis is: A. B. C. D.

Left ventricular pressure at end-diastole Pulmonary artery pressure Right atrial pressure Right ventricular pressure at end-diastole

187. The onset of flow to peak aortic velocity Doppler tracing in severe valvular aortic stenosis is:

500 Question Study by Terry Reynolds, BS, RDCS A. B. C. D.

Increased Decreased Decreased with expiration Increased with inspiration

188. A Doppler mean pressure gradient of 18 mmHg is calculated in a patient with valvular aortic stenosis. The severity of the stenosis is: A. B. C. D.

Mild Moderate Moderately severe Severe

189. The severity of aortic valve stenosis may be underestimated if only the maximum velocity measurement is used in the following condition: A. B. C. D.

Anemia Doppler intercept angle of 0° Low cardiac output Significant aortic insufficiency

190. The two-dimensional view that best visualizes systolic doming of the aortic valve leaflets is the: A. B. C. D.

Apical five-chamber view Parasternal long-axis view Parasternal short-axis view of the aortic valve Subcostal short-axis view of the aortic valve

191. Of the three pressure gradients that can be measured in the cardiac catheterization laboratory, the largest is: A. B. C. D.

Maximum peak instantaneous gradient Mean transvalvular systolic gradient Peak-to-peak gradient Peak-to-mean gradient

192. Of the transvalvular pressure gradients that can be measured in the echocardiography laboratory, the most useful in examining aortic valve stenosis is probably: A. B. C. D.

Mean diastolic gradient Mean systolic gradient Peak instantaneous pressure gradient Peak-to-peak gradient

193. The echocardiographer may differentiate between the similar systolic flow pattern seen in coexisting severe aortic valve stenosis and mitral regurgitation by all the following methods EXCEPT:

500 Question Study by Terry Reynolds, BS, RDCS A. The aortic ejection time is shorter than the mitral regurgitation time B. Mitral regurgitation flow always lasts until mitral valve opening, whereas aortic valve stenosis flow does not C. Mitral diastolic filling profile should be present during recording of the mitral regurgitation, whereas no diastolic flow is observed in aortic valve stenosis D. Since both are systolic flow patterns, it is not possible to separate mitral regurgitation from aortic valve stenosis 194. The most common etiology for chronic aortic insufficiency is: A. B. C. D.

Idiopathic dilatation of the aortic root and aortic annulus Infective endocarditis Marfan’s syndrome Trauma

195. The characteristic feature of the murmur of aortic insufficiency is a: A. Diastolic decrescendo blowing murmur heard best along the left sterna border B. Diastolic crescendo-decrescendo murmur heard best along the left upper sterna border C. Diastolic rumble following an opening snap D. Harsh systolic ejection murmur heard best at the right upper sterna border 196. The murmur associated with severe aortic insufficiency is: A. B. C. D.

Austin Flint murmur Carvallo’s murmur Graham Steell murmur Still’s murmur

197. A technique used in the cardiac catheterization laboratory that determines the severity of aortic insufficiency is: A. B. C. D.

Austin Flint technique Judkin’s technique Left ventriculography Supravalvular aortography

198. In significant chronic aortic insufficiency, M-mode/two-dimensional evidence includes all the following EXCEPT: A. Hyperkinesis of the interventricular septum B. Hyperkinesis of the posterior wall of the ledt ventricle

500 Question Study by Terry Reynolds, BS, RDCS C. Left ventricular dilatation D. Paradoxical interventricular septal motion 199. Low-frequency diastolic fluttering of the aortic valve closure line on the Mmode of the aortic valve is: A. B. C. D.

A normal finding Indicative of cusp rupture or flail aortic valve Pathognomonic for bicuspid aortic valve Pathognomonic for significant aortic valve stenosis

200. Septal motion in significant aortic insufficieny often demonstrates: A. B. C. D.

Anterior motion during systole Exaggerated early diastolic dip Normal motion Thinning with dyskinesis during systole

201. Premature closure of the mitral valve is associated with all the following EXCEPT: A. B. C. D.

Acute severe mitral regurgitation Acute severe aortic insufficiency First-degree atrioventricular block Loss of sinus rhythm

202. Echocardiographic evidence of severe, acute aortic insufficiency includes all the following EXCEPT: A. B. C. D.

Premature closure of the mitral valve Premature opening of the aortic valve Premature opening of the mitral valve Reverse doming of the anterior mitral valve leaflet

203. The M-mode measurements that have been proposed as an indicator for aortic valve replacement in patients with chronic severe aortic insufficiency are left ventricular: A. B. C. D.

End-diastolic dimension ≥ 55 mm and fractional shortening of ≤25% End-diastolic dimension ≤ 55 mm and fractional shortening of ≥ 25% End-diastolic dimension ≥70 mm and left atrial dimension ≥ 55 mm End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%

204. Reverse diastolic doming of the anterior mitral valve leaflet is associated with: A. Flail mitral valve B. Papillary muscle dysfunction C. Rheumatic mitral valve stenosis

500 Question Study by Terry Reynolds, BS, RDCS D. Severe aortic insufficiency 205. The hallmark M-mode finding for aortic insufficiency is: A. B. C. D.

Coarse diastolic flutter of the anterior mitral valve leaflet Fine diastolic flutter of the anterior mitral valve leaflet Chaotic diastolic flutter of the mitral valve Systolic flutter of the aortic valve

206. A pulsed-wave Doppler blood flow velocity profile of aortic insufficiency obtained from the apical five-chamber view will demonstrate a diastolic: A. B. C. D.

Laminar high-velocity flow signal Laminar low-velocity flow signal Turbulent high-velocity flow signal Turbulent low-velocity flow signal

207. The simplest semiquantitative technique for determining the severity of aortic insufficiency using pulsed-wave Doppler is: A. Comparing the detected jet height to the left ventricular outflow tract height B. Detecting a laminar diastolic flow pattern, which indicates severe aortic insufficiency C. Examining the spectral strength of the regurgitant jet D. Flow mapping of the left ventricle 208. Severe aortic insufficiency can be diagnosed by continuous-wave Doppler by all the following criteria EXCEPT: A. B. C. D.

A maximum velocity of > 3 m/sec A pressure half-time of ≤ 300 msec Aortic insufficiency deceleration slope ≥ 3 m/sec Darkened spectrum of the regurgitant jet

209. The severity of aortic insufficiency may best be determined with color flow Doppler by the following method: A. Measuring the aortic insufficiency jet aliasing area in the parasternal longaxis view B. Comparing the aortic insufficiency jet height with the left ventricular outflow tract height C. Measuring the aortic insufficiency jet maximal height D. Noting the temporal pattern of color variance 210. A color flow Doppler technique that permits detection of 3+ to 4+ aortic insufficiency is: A. Early diastolic flow reversal in the abdominal aorta B. Early diastolic flow reversal in the descending thoracic aorta C. Holodiastolic flow reversal in the descending thoracic aorta

500 Question Study by Terry Reynolds, BS, RDCS D. Holosystolic flow reversal in the abdominal aorta 211. Proximal flow convergence of an aortic insufficiency jet as seen on color flow Doppler may represent: A. B. C. D.

Physiologic insufficiency Mild (1+) aortic insufficiency Moderate (2+) aortic insufficiency Moderately severe (3+ 4+) aortic insufficiency

212. The mitral valve inflow pattern often associated with severe acute aortic insufficiency is stage: A. B. C. D.

I II III IV

213. The Doppler signal of aortic insufficiency may be differentiated from the Doppler signal of mitral stenosis by the following guideline: A. If the diastolic flow pattern commences before mitral valve opening, then the signal is due to aortic insufficiency B. If the diastolic flow pattern commences after mitral valve opening, then the signal is due to aortic insufficiency C. The Doppler flow velocity pattern of mitral valve stenosis is laminar, while the Doppler flow velocity pattern of aortic insufficiency is turbulent D. Since both mitral valve stenosis and aortic insufficiency are diastolic, it is not possible to differentiate the Doppler flow velocity patterns. 214. The M-mode finding that indicates severe acute aortic insufficiency is premature aortic valve: A. B. C. D.

Closure Diastolic flutter Mid-systolic closure Opening

215. Posterior displacement of aortic valve leaflet(s) into the left ventricular outflow tract during diastole is called aortic valve: A. B. C. D.

Prolapsed Sclerosis Stenosis Vegetation

500 Question Study by Terry Reynolds, BS, RDCS 216. A two-dimensional echocardiographic finding in a patient with pure aortic insufficiency is: A. B. C. D.

Left atrial enlargement Left ventricular enlargement Right atrial enlargement Right ventricular hypertrophy

217. High-frequency diastolic flutter of the aortic valve with echoes extending into the left ventricular outflow tract during diastole on M-mode echocardiographic represents: A. B. C. D.

Ascending aortic aneurysm Flail aortic valve leaflet Valvular aortic sclerosis Valvular aortic stenosis

218. The most common etiology of acute aortic insufficiency is: A. B. C. D.

Aortic ballon valvuloplasty Hypertension Infective endocarditis Rheumatic fever

219. A pulse that is associated with significant aortic insufficiency is: A. B. C. D.

Pulsus Pulsus Pulsus Pulsus

alternas bisferiens paradoxus parvus et tardus

220. M-mode reveals diastolic flutter of the anterior mitral valve and a left ventricular end-systolic dimension of 58 mm. Two-dimensional echocardiography demonstrates an aortic root that is 4.5 cm in diameter with aortic valve sclerosis. The aortic insufficiency jet is mapped to the level of the papillary muscles by pulsed-wave Doppler. The pressure half-time of the continuous-wave Doppler tracing of the aortic insufficiency jet is 280 m/sec. The jet height to left ventricular outflow tract height ratio is 53%. The severity of the aortic insufficiency in this case is: A. Physiologic insufficiency

500 Question Study by Terry Reynolds, BS, RDCS B. Mild (1+) C. Moderate (2+) D. Moderately severe (3+) 221. The most common etiology of tricuspid valve stenosis is: A. B. C. D.

Carcinoid heart disease Infective endocarditis Rheumatic fever Right atrial myxoma

222. The M-mode findings for tricuspid valve stenosis include all the following EXCEPT: A. B. C. D.

Anterior motion of the posterior tricuspid valve leaflet Decreased E-F slope of the anterior tricuspid valve leaflet Increased leaflet thickness Systolic doming of the anterior tricuspid valve leaflet

223. The typical two-dimensional echocardiographic findings in rheumatic tricuspid stenosis include all the following EXCEPT: A. B. C. D.

Diastolic doming of the anterior tricuspid valve leaflet Leaflet thickening Restricted motion of the tricuspid leaflets Systolic bowing of the posterior tricuspid valve leaflet

224. Causes of tricuspid regurgitation include all the following EXCEPT: A. B. C. D.

Carcinoid heart disease Ebstein’s anomaly Pulmonary hypertension Sinus of Valsalva aneurysm

225. Signs and symptoms of significant tricuspid regurgitation include all the following EXCEPT: A. B. C. D.

Hepatomegaly Jugular venous distention Pulsus paradoxus Right ventricular failure

226. The murmur of tricuspid regurgitation is best described as a: A. Holodiastolic murmur heard best at the lower left sternal border

500 Question Study by Terry Reynolds, BS, RDCS B. Pansystolic murmur heard best at the lower left sterna border C. Pansystolic murmur heard best at the cardiac apex with radiation to the axilla D. Systolic ejection murmur heard best at the upper right sterna border 227. Causes of organic tricuspid regurgitation include all the following EXCEPT: A. B. C. D.

Rheumatic heart disease Right ventricular infarct Tricuspid valve prolapsed Flail tricuspid valve

228. In significant chronic tricuspid valve regurgitation, all the following are dilated EXCEPT: A. B. C. D.

Hepatic veins Inferior vena cava Pulmonary veins Right atrium

229. The M-mode finding for ruptured chordae tendineae of the tricuspid valve is: A. Coarse diastolic flutter of the anterior tricuspid valve leaflet B. Fine diastolic flutter of the anterior tricuspid valve leaflet C. Irregular low-frequency diastolic fluttering of the anterior tricuspid valve leaflet D. Right atrial enlargement 230. On M-mode echocardiographic finding of the tricuspid valve, systolic coarse chaotic oscillation of the tricuspid valve leaflets may indicate: A. B. C. D.

A normal echocardiographic finding Atrial fibrillation/atrial flutter Flail tricuspid valve leaflet Pulmonic valve insufficiency

231. M-mode and two-dimensional echocardiograophic findings for chronic tricuspid regurgitation include: A. B. C. D.

Left ventricular volume overload Paradoxical septal motion Protected right ventricle Right ventricular hypertrophy

232. Methods for determining the severity of tricuspid regurgitation with pulsedwave Doppler include all the following EXCEPT: A. Increased E wave velocity for the tricuspid valve B. Mapping technique

500 Question Study by Terry Reynolds, BS, RDCS C. Maximum velocity of the tricuspid regurgitant jet D. Systolic flow reversal in the hepatic vein 233. Cardiac Doppler findings associated with significant chronic tricuspid regurgitation include all the following EXCEPT: A. B. C. D.

Concave late systolic configuration of the regurgitant signal Increased E velocity of the tricuspid valve Systolic flow reversal in the hepatic vein Systolic flow reversal in the pulmonary vein

234. Systolic reflux of saline contrast noted by two-dimensional echocardiography in the inferior vena cava denotes the presence of: A. B. C. D.

Cardiac tamponade Constrictive pericarditis Pulmonary insufficiency Tricuspid regurgitation

235. An intracardiac pressure may be determined from the continuous-wave tricuspid regurgitation signal is: A. B. C. D.

Mean pulmonary artery pressure Pulmonary artery end-diastolic pressure Systolic pulmonary artery pressure Total pulmonary vascular resistance

236. Tricuspid valve leaflets that are in a fixed semi-open position with diffuse thickening are found in: A. B. C. D.

Carcinoid heart disease Cardiac amyloidosis Cardiac hemochromatosis Cardiac sarcoidosis

237. Possible echocardiographic/Doppler findings in a patient with carcinoid heart disease include all the following EXCEPT: A. B. C. D.

Pulmonic valve insufficiency Pulmonic valve stenosis Tricuspid valve prolapse Tricuspid valve regurgitation

238. The most common cause of pathologic pulmonary insufficiency is:

500 Question Study by Terry Reynolds, BS, RDCS A. B. C. D.

Carciniod heart disease Infective endocarditis Pulmonary hypertension Rheumatic heart disease

239. Pulmonary insufficiency is associated with: A. B. C. D.

Left ventricular volume overload Right atrial hypertrophy Right ventricular hypertrophy Right ventricular volume overload

240. When pulmonary artery systolic pressure exceeds 70 mmHg, dilation of the pulmonic annulus results in a regurgitation jet of high velocity which is responsible for the murmur called: A. B. C. D.

Austin Flint Rivero-Carvallo Graham Steell Lillehei-Kaster

241. An end-diastolic velocity of 2 m/sec for pulmonary insufficiency was obtained with an estimated right atrial pressure of 7 mmHg. The pulmonary artery enddiastolic pressure (PAEDP) is: A. B. C. D.

2 mmHg 16 mmHg 23 mmHg 26 mmHg

242. The normal pulmonary artery end-diastolic pressure (PAEDP) is: A. B. C. D.

0 to 5 mmHg 4 to 12 mmHg 9 to 18 mmHg 18 to 25 mmHg

243. Fine diastolic flutter of the tricuspid valve is a characteristic finding for: A. B. C. D.

Infundibular stenosis Primary pulmonary hypertension Pulmonary insufficiency Pulmonary valve stenosis

244. The most common type of right ventricular outflow tract obstruction is: A. Subinfundibular B. Subvalvular

500 Question Study by Terry Reynolds, BS, RDCS C. Supravalvular D. Valvular 245. The most common etiology of pulmonic valve stenosis is: A. B. C. D.

Carcinoid Congenital Infective endocarditis Rheumatic

246. The characteristic M-mode pulmonic valve leaflet pattern in pulmonic valve stenosis is: A. B. C. D.

Absent “a” dip Deep “a” dip Reversed “a” dip Shallow “a” dip

247. On M-mode echocardiography, the effect of infundibular pulmonic stenosis on the pulmonic valve is: A. B. C. D.

Absent “a” dip Coarse systolic flutter Deep “a” dip Shallow “a” dip

248. Possible two-dimensional echocardiographic findings for valvular pulmonic stenosis include all the following EXCEPT: A. B. C. D.

Pulmonic valve prolapsed Right ventricular hypertrophy Systolic doming of the pulmonic valve leaflets Valvular thickening

249. Post-stenotic dilatation of the main pulmonary artery is a two-dimensional echocardiographic finding for: A. B. C. D.

Pulmonary insufficiency Pulmonary turmor Tricuspid regurgitation Valvular pulmonic stenosis

250. The right ventricular outflow tract obstruction associated with poststenotic dilatation of the main pulmonary artery is: A. Valular B. Subvalvular C. Supravalvular

500 Question Study by Terry Reynolds, BS, RDCS D. Subinfundibular 251. Pulmonary artery banding may result in all the following EXCEPT: A. B. C. D.

Pseudoaneurysm formation Right ventricular hypertrophy Supravalvular pulmonary stenosis Valvular pulmonic stenosis

252. The most common symptom of infective endocarditis is: A. B. C. D.

Chest pain Dyspnea Fever Orthopnea

253. The complications of infective endocarditis include all the following EXCEPT: A. B. C. D.

Congestive heart failure Embolization Valve ring abscess Valvular prolapsed

254. The classic manifestation of infective endocarditis is cardiac valve: A. B. C. D.

Doming Sclerosis Tumor Vegetation

255. Infective endocarditis is a greater risk in patients with: A. B. C. D.

Atrial fibrillation Coronary artery disease Left ventricular aneurysm Prosthetic heart valve

256. A patient with a history of mitral valve prolapsed presents to the echocardiography laboratory with the complaints of fever, night sweats, and weight loss. The most likely explanation is: A. B. C. D.

Congestive heart failure Coronary artery disease Infective endocarditis Kawasaki disease

257. The mitral valve is considered to be prematurely closed due to severe acute insufficiency when the C point of mitral valve closure occurs:

500 Question Study by Terry Reynolds, BS, RDCS A. B. C. D.

On or before inception of the Q wave Less than 0.05 seconds after the Q wave 0.05 to 0.07 seconds after the Q wave of the electrocardiogram On or before inception of the T wave

258. The usual site of attachment for vegetations on the mitral and tricuspid valves is the: A. B. C. D.

Annulus Atrial side of the valve leaflets Papillary muscles Ventricular side of valve leaflets

259. The vegetation diameter as determined by two-dimensional echocardiography that is most often associated with systemic emboli is: A. B. C. D.

3 mm 5 mm 7 mm 10 mm

260. The essential two-dimensional echocardiographic finding of valve ring abscess secondary to infective endocarditis may be best described as: A. B. C. D.

Echolucent Hyperechoic Pendunculated Sessile

261. Aortic ring abscess is usually caused by: A. B. C. D.

Infective endocarditis Rheumatic fever Valvular prolapsed Valvular regurgitation

262. Complications associated with infective endocarditis that may be indications for surgery include all the following EXCEPT: A. B. C. D.

Congestive heart failure Dyspnea Myocardial or annular abscess Recurrent systemic emboli

263. The M-mode appearance of mitral valve and aortic valve vegetations is described as: A. Doming B. Prolapsing C. Shaggy

500 Question Study by Terry Reynolds, BS, RDCS D. Relapsing 264. Another term for a hemograft prosthetic valve is: A. B. C. D.

Allograft Autograft Biograft Heterograft

265. All the following are porcine tissue prosthetic valves EXCEPT: A. B. C. D.

Bjork-Shiley Carpentier-Edwards Hancock Intact

266. An example of bovine pericardium tissue valve is: A. B. C. D.

Bjork-Shiley Intact Ionescu-Shiley Starr-Edwards

267. A pulmonic valve relocated to the aortic position is called a(n): A. B. C. D.

Allograft Autograft Heterograft Homograft

268. Coarse fluttering of a tissue prosthetic valve leaflet on M-mode is associated with: A. B. C. D.

Insufficiency Normal function Stenosis Vegetation

269. Abnormal rocking motion of a prosthetic valve by two-dimensional echocardiography indicates prosthetic valve: A. B. C. D.

Dehiscence Stenosis Thrombus Vegetation

270. Prosthetic valve prolapsed as seen by two-dimensional echocardiography is associated with prosthetic valve:

500 Question Study by Terry Reynolds, BS, RDCS A. B. C. D.

Insufficiency Normal function Stenosis Vegetation

271. A shortened interval between the aortic second sound (A2) and mitral valve opening recorded for a mitral valve prosthesis may indicate all the following EXCEPT: A. B. C. D.

Perivalvular leak Poor left ventricular function Prolonged PR interval on the electrocardiogram Prosthetic mitral valve dysfunction

272. Bioprosthetic leaflet degeneration and calcification occurs: A. B. C. D.

Only in adults More frequently in children Equally in children and adults Primarily in women 40 years of age or older

273. A prosthetic heart valve is associated with a relatively high rate of outlet strut fracture is: A. B. C. D.

Bjork-Shiley Carpentier-Edwards Ionescu Shiley Starr-Edwards

274. An example of a bileaflet tilting disc prosthetic heart valve is: A. B. C. D.

Medtronic-Hall Omniscience St. Jude’s Starr-Edwards

275. The cardiac Doppler formula that accurately determines the pressure gradient in the prosthetic aortic valve is: A. B. C. D.

4 x (V22) 4 x (V12 – V22) 4 x (V22 – V12) Area x V1

276. The best Doppler formula for calculating the effective orifice area (EOA) in a patient with mitral valve replacement is: A. 4 x (V2) 2

500 Question Study by Terry Reynolds, BS, RDCS B. 4 x (V2 2– V12) C. (CSA LVOT x TVI LVOT) ÷ TVI MV D. 220 ÷ pressure half-time 277. The best Doppler method for evaluating an aortic valve replacement is probably: A. B. C. D.

Deceleration slope Maximum peak instantaneous gradient Pressure half-time Velocity ratio

278. Doppler evaluation of a prosthetic mitral valve should include all the following EXCEPT: A. B. C. D.

Effective orifice area (continuity equation) Peak A velocity Peak and mean pressure gradients Pressure half-time

279. Complications associated with prosthetic heart valve dysfunction include all the following EXCEPT: A. B. C. D.

Dehiscence Leaflet degeneration Thrombosis Tumor

280. A regurgitant jet area