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85 Cards in this Set

  • Front
  • Back
LV mass (weight) remains normal in chronic:
Mitral stenosis
High angulation of an M-mode transducer beam equals
pseudo bicuspid aortic valve
What is the primary effect of long -standing aortic regurgitation
decreased ejection fraction
Which of the following syndromes fit with AR, Ao dilatation Ao dissections & Ao aneurysms?

Dresslers
Borlow
Marfan
Noonans
Marfan's Syndrome
Why follow chronic AI patients?
Check left ventricle size
Systolic reversal flow is also called
retrograde
Lambl's Excrescences are sometimes listed as potential answers...
they are thin filiform strands (fronds) that form on tbe edges of valve leaflets
RVSP =
PAP
What causes pericardial knock?
abrupt cessation of early diastolic inflow (classic in constrictive percarditis) similar in timing to a very loud S3
What accompanies bicuspid aortic valves?
coarctation of the aorta (50% of coarcts have a bicuspid valve
When is mitral pressure half time NOT accurate?
post valvuloplasty
Given TR and RA pressure, what can you calculate
right ventricular systolic pressure
RVSP
Shown a LAX view, dilated LV, thin septum, what is probably going on with the patient
severe mitral regurgitation
What is the best way to determine the severity of mitral regurgitation?
pulmonary venous flow
Name the 2 layers of the pericardium
visceral and parietal
Which percardial layer is the serous
visceral or epicardial
Which cardiac pathology affects the valves

amyloid
sarcoid
carcinoid
hemochromatosis
carcinoid
Cardiac tamponade is rapid filling of fluid:

A. with diastole
B. causing restrictive filling
C. causing restrictive diastolic filling
D. causing restrictive systolic filling
C. causing restrictive diastolic filling
HINT

BE AWARE OF NORMAL DROP-OUT VS SECUNDUM ASD ON APICAL 4CH
BE AWARE OF NORMAL DROP-OUT VS SECUNDUM ASD ON APICAL 4CH
Kids with Tuberous Sclerosis develop what type of cardiac tumors
rhabdomyomas
HINT:

Might show a left or right pulmonary artery filled with clot
Might show a left or right pulmonary artery filled with clot
What is meant by automaticity?
the ability of initiate an elective impulse or beat intrinsic means pertaining exclusively to a part
HINT

Question about an indication of tamponade and the best answer was RA/RV collapse in diastole
Question about an indication of tamponade and the best answer was RA/RV collapse in diastole
HINT

For contrast studies know acyanotic shunt is L-R and cyanotic is R-L
For contrast studies know acyanotic shunt is L-R and cyanotic is R-L
Peripheral contrast NOT useful in:

A. ASD
B. AI
D. VSD
B. AI
Which view shows the coronary sinus in long axis?
Apical 4-ch with posterior angulation
What is the valve of the IVC
Eustachian valve
What does amyl nitrite do to HR?
increases HR
Why are the right and left coronaries called right and left?
the left artery supplies most of the L and the right artery most of the RV
Where does the left anterior descending coronary artery originate?

A. atriovenricular sulcus
B. coronary sinus
C. posterior inter-ventricular sulcus
D. anterior inter-ventricular sulcus
E. coronary sulcus
D. anterior inter-ventricular sulcus
Know the difference on 2-D between a pacer wire and a catheter.
pacer wire goes to the RV apex
central venous lines stay in the RA
Swan-Ganz catheters usually do not go to the RV apex
Why are the RCC, LCC and NCC called what they are
because of the coronaries
A systolic rumble might be
tricuspid regurgitation
If you are doing an echo on a supine patient who becomes short of breath, what should you do first
sit the patient upright
What is a superimposed respiratory tracing
a spirometer
Asked about (no picture) the A-wave on MV (m-mode or Doppler) in A-fib
Answer: there is not an A-wave in A-fib
What do you do first of an apneic patient after giving sedation
check their airway
Why do the IVC sniff test
to check for elevated RA pressures
What type of shunts cause cyanosis in newborns
Right to left shunt
What is a "pressure drop"?
same as a gradient across valves
In the cath lab the Gorlin Formula is used to calculate?
Valvular areas
Mitral inflow velocity should not be effected by:
gender
HINT:

Shown a study with LVH, biatrial enlargement and a perciardial effusion
Restrictive (infiltrative)
With what disease should you NOT rely on M-mode for quantifiying left ventricular EF?

aortic stenosis
mitral stenosis
apical infarction
posterior infarction
apical infarction
An MI of the inferior wall involves which coronary artery?
right coronary artery
Which valve is most likely to regurgitate in normals?
tricuspid
An effusion is usually on the video exam
An effusion is usually on the video exam
What % of normals will have a PFO
20-30%
Causes of acute mitral regurgitation
Endocarditis, Ruptured chordae, Pap muscle dysfx, Prosthetic valve dysfx
Case of 2 chamber with post/inf pseudo-aneurysm is sometime on video exam
Case of 2 chamber with post/inf pseudo-aneurysm is sometime on video exam
Where do the coronaries drain?
into the coronary sinus
Which coronary supplies the LV apex
left anterior descending
What 2D finding would you see in a patient with PLSVC
a dilated coronary sinus
What is Kyphosis?
exaggerated anterior spinal curvature. Skeletal deformity may compress PA and cause PA hypertension
What is UHl's anomaly?
congenital absent RV myocardium also called "parchment heart" may be confused clinically with Ebstein's
Shown in Aorta. Asked if it's Marfan or Takaysau's
Marfan will be dilated while Takaysau's is normal in size with narrowed area
What can cause a contrast to dissipate too quickly?
A. low MI
B. high MI
C. low frequency
D. high frequency
B. high MI
Name the 3 heart layers
1. epicardium - thin outer layer
2. myocardium - mid wall (thickest)
3. endocardium - inside
Normally how much pericardial fluid is there?
40 cc
in M-mode

Diastole measure at onset of QRS. Systole at smallest diameter of LV
Diastole measure at onset of QRS. Systole at smallest diameter of LV
All of the following may result in jugular venous distension EXCEPT:
a) cardiac tamponade
b) pulmonary hypertension
c) tricuspid stenosis
d) hypovolemia
e) constrictive percarditis
d) hypovolemia
How do cardiac problems cause renal failure, jugular venous pulsations and peripheral edema?
Mostly through systolic failure and low perfusion causing multi system complications
How many weeks until the heart is developed?
6 weeks
Which embryonic aortic arch (1-6) develops into tranverse arch?
4th
If a patients has Cor Pulmonale which of the following conditions are MOST likely to exist?

a) left ventricular increase
b) right ventricular increase
c) left ventricular decrease
d) right ventricular decrease
b) right ventricular increase
An enlarged heart on chest x-ray could be all the following except:
a) pericardial effusion
b) pleural effusion
c) aortic stenosis
d) hypertrophic cardiomyopathy
b) pleural effusion
Question about what view to us in patients with COPD/asthma
subcostal window
Know persistent fetal circulation
PTHN with R to L shunting across the foramen and ductus
HINT
Preload = volume = thin walls

Afterload = pressure = thick walls
HINT
Preload = volume = thin walls

Afterload = pressure = thick walls
Are right sided pressures elevated with a Valsalva Maneuver?
during the strain phase - NO
during the release phase - YES
What clinical finding is associated with friction rub?
pericaridal effusion
Aortic regurgitation starts at the beginning of
beginning of IVRT
What kind of murmur will a patient with a VSD have?
harsh holosystolic
A patient with a secundum ASD has a bubble study. It will show all the following except

A. bubbles from RA to LA
B. Bubbles from RV to LV
C. Neg. contrast jet in RA
D. bubble in pulmonary artery
Bubbles from RV to LV
BiPlane Simpsons rule is used for calculating:

regurgitant fraction
aortic valve area
ejection fraction
mitral stenosis
ejection fraction
What causes a left parasternal friction rub
pericarditis
In the apical four chamber view where would you see reverberation artifact?
Apex
All the following can lead to a false diagnosis of pericardial effusion on M-Mode except:

a. descending aorta
b. calcified mitral annulus
c. ascites
d. mitral valve prolapse
d. mitral valve prolapse
The reason for using ultrasound gel is to:
keep the air out
Asked if an ascending Ao dissection can cause severe MR?
No - not severe, maybe mild
Know that the QRS complex equals depolariztion
Know that the QRS complex equals depolariztion
Where are most fibroelastomas found?
Usually on the valves (mitral and aortic). May be described as "frond like" (feathery)
What might you see in a patient with scleroderma?
Usually pulmonary hypertension or a pericaridal effusion is the 2nd thing
How many years are echo records to be kept
seven
What is the most common type of pediatric cardiac tumor?
rhabdomyomas