Tv Echo Board Questions Set 2

Front 1

When is asymptomatic AVR indicated in severe AS?

Back 1

AVR is indicated for pts with severe LV dysfunction and EF <0.50 or when getting other surgery

Front 2

When is AVR indicated in patients with severe AS

Back 2

if symptoms

Front 3

How often should you echo patients with AS

Back 3

Echo for change in symptoms, yearly in severe AS, reeval pts every 1-2y for moderate, and 3-5 for mild AS

Front 4

What about vasodilators in AR?

Back 4

Vasodilator therapy is indicated or chronic therapy in patients with severe AR who have symptoms or LV dysfunction when in operable

Front 5

What do the guidelines state about AR and AVR regarding function

Back 5

AVt is indicated for symptomatic pts with sever AR irrespective of LV fxn

Front 6

What about aortic root therapy in setting of AVR

Back 6

Concomintant Aortic Root placement if root >5.0cm, or increasing rate >0.5cm/yr

Front 7

How often do patients with aortic roots > 4.0 need echos?

Back 7

Pt’s with Asc Aort >4.0cm need yearly echos

Front 8

When should bicuspids getting heart surgery get AVR also

Back 8

Pt with Bicuspids underoing repair for seve AR or AS, should have repair or replacement of root if > 4.5cm

Front 9

What do the guideliens state about anticoag and patients with MS and Afib, and what about MS patietns without afib?

Back 9

Anticoag is indicated in pts with MS and Afib (parox, persis or perm) Anticoag is indicated in pts with MS and prior embolic event or presence of LA thrombus (even in SR) Class I loe b

Front 10

What are the effects of radiation on the heart?

Back 10

Radiation heart disease..typically 5 years after therapy, assoc with caclificaitoon of valves and fibrous structure…AR with AI most common, MR and TR also common. Restrictive cardiomyopathy, aortic and other vascular calcification, coronary arter stenosis (often at OS) pericardial lesions and conduction abnormalities

Front 11

List valvular lesions of MItral that are associated with high materal or fetal risk in pregnancy

Back 11

MS FC II-IV and MR with FC III-IV, any MV dz with severe pulm htn (p pressures that are >75% of systemic pressure), mitral valve disease iwht EF less than 40%, mechanical prosthetic valve requiring anticoag

Front 12

List valvular lesions of AORTA that are associated with high materal or fetal risk in pregnancy

Back 12

Severe AS with or without symptoms, AR with FC II-IV, aortic disease with p hten with pressure >75% of systemic) Aortic disease with EF < 40%, marfan syndrome with or without AR

Front 13

IS balloon aortic valvuloplasty useful in children?

Back 13

yes and should be tried 1-2x before surgery

Front 14

AVR for AR in asymptomatic pts with

Back 14

pts with LV dysfxn , especially if severe, also recommend if EF is normal an End diast Dim > 7.5

Front 15

Asymptomatic patients with AR monitor three things:

Back 15

symptoms, depressed EF (<0.5) or increased volume >7.5 diastt, >5.5 Systd

Front 16

WILKINS (not the BLOCK SCORE)

Back 16

4…8 Below valve + leaflet thickness or calcification, kinesis of valve

Front 17

Carvallo’s sign:

Back 17

A lower left parasternal systistolic murmur that may increase on inspiration… characterstic of Severe

Front 18

Pergolide

Back 18

(for Parkinson’s) excess frequency of carcinoid –like vasculopathy.

Front 19

Gaucher diseasee

Back 19

Gaucher disease = heritable deficiency of b-glucosidase, w/accumulation of cerebrosides in spleen, liver, bone marrow, lymph nodes, brain, and heart.

Front 20

Davies disease

Back 20

Davies disease= Endomyocardial fibrosis or

Front 21

Löffler endocarditis,

Back 21

Löffler endocarditis parietalis fibroplastica= hypereosinophilic syndrome,

Front 22

ECHINOCOCCUS (HYDATID CYST):

Back 22

ECHINOCOCCUS (HYDATID CYST): sheep-raising areas, mebendazole and albendazole, surgical excision is generally recommended

Front 23

Trichinella spiralis:

Back 23

Trichinella spiralis: reatment is with anthelmintics and corticosteroids, heart may be dilated and flabby

Front 24

hypersensitivity myocarditis:

Back 24

hypersensitivity myocarditis: Myocardial biopsy may reveal eosinophilic or lymphocytic infiltrates

Front 25

SMALLPOX VACCINATION:

Back 25

SMALLPOX VACCINATION: myopericarditis, military recruits…

Front 26

clozapine,

Back 26

clozapine, currently indicated for resistant schizophrenia:::::rapid-onset hypersensitivity myocarditis

Front 27

tricyclic antidepressants

Back 27

tricyclic antidepressants: sinus tachycardia, postural hypotension, disturbances in rhythm, abnormalities of atrioventricular conduction, and even sudden death

Front 28

phenothiazines:

Back 28

phenothiazines:

Front 29

Radiation therapy:

Back 29

Radiation therapy: related to the cumulative dose of the radiation and the mass of heart irradiated. Fibrosis, coronary stenosis (at os) occas acute pericarditis

Front 30

Hypothermia:

Back 30

Hypothermia: cardiac dilation, microinfarcts, sinus brady, conduction disturbances, a and f fib, osburn waves,

Front 31

Giant cell myocarditis:

Back 31

Giant cell myocarditis: extremely malignant and aggressive course, many respond to immunosuppr, many need Tx

Front 32

Dallas criteria:

Back 32

Dallas criteria: for diagnosis of myocarditis by histology, allow low sens 2nd to patchy nature. 4 categories : based on Clinical, CMR, (echo,angio or lab) and biopsy

Front 33

Treatment for Myocarditis:

Back 33

Treatment for Myocarditis: Diuretics, vasodilators, Acei, ARb, if unstable all shock Rx, immune therapy,

Front 34

marantic endocarditis

Back 34

marantic endocarditis nonbacterial thrombotic endocarditis, large friable, sterile vegations on valves, assoc with DIC and system embolism, commong in HIV

Front 35

NAME syndrome:

Back 35

NAME syndrome: (Nevi, Atrial myxoma, Myxoid neurofibroma, and Ephelides

Front 36

LAMB syndrome

Back 36

LAMB syndrome (Lentigines, Atrial Myxoma, and Blue nevi),

Front 37

Carney syndrome, w

Back 37

Carney syndrome, which includes myxomas arising in a noncardiac location (breast or skin), nonmyxomatous extracardiac tumors (e.g., pituitary adenoma), skin pigmentation, and hyperendocrine states

Front 38

At the starting point, how wide is the sound beam width?

Back 38

The sound beam's width is the same as the transducer diameter

Front 39

As the sound beam gets further from the transducer, what happens to it?

Back 39

The sound beam narrows, like a funnel

Front 40

After the sound beam narrows, what happens to its shape?

Back 40

The sound beam expands

Front 41

What is the location where the beam diameter is the narrowest called?

Back 41

Focus or Focal Point

Front 42

What is the region from the transducer to the focus called?

Back 42

Near Zone

Front 43

At the far end of the near zone, what is the diameter of the near zone?

Back 43

1/2 the diameter of the active element

Front 44

The distance from the transducer to the focus is called what?

Back 44

Focal Length

Front 45

The region starting at the focus and extending deeper is called what?

Back 45

Far Zone

Front 46

When the beam is two near zone lengths from the transducer, how wide is it?

Back 46

The beam is as wide as the active element again

Front 47

What happens to the sound beam width beyond two near zone lengths from the transducer?

Back 47

The beam widens beyond the width of the active element, and continues expanding

Front 48

The region around the focus where the beam is relatively narrow is called what?

Back 48

Focal Zone

Front 49

Why is the focal zone important to sonographers?

Back 49

Reflections arising from the focal zone create images of superior detail, compared to other depths

Front 50

What marks the end of the near zone?

Back 50

Focus

Front 51

At what point does the sound beam first begin to widen?

Front 52

The focal zone is found where?

Back 52

Half in the near zone

Front 53

The distance from the transducer to the focus is called what?

Back 53

Focal Depth

Front 54

Is focal depth adjustable by sonographers on most modern ultrasound systems? If so, what is this called?

Back 54

Yes. Adjustable focus systems are called Phased Array

Front 55

For a fixed-focus transducer, what two characteristics determine the focal depth?

Back 55

1. Transducer Diameter and Sound Frequency

Front 56

What is the relationship between transducer diameter and focal depth?

Back 56

Directly Related

Front 57

What is the relationship between frequency and focal depth?

Back 57

Directly Related

Front 58

High frequency transducers are used to image superficial, or shallow structures. How can this be when a high frequency beam will produce a deep focus (direct relationship)?

Back 58

Transducer manufacturers overcome this by making exceptionally small diameter crystals for high frequency transducers in order to locate the focus shallower for superior images

Front 59

The gradual spread of the sound beam beyond the focus is called what?

Back 59

Beam Divergence

Front 60

What two characteristics of a transducer determine beam divergence?

Back 60

Transducer and Sound Frequency

Front 61

What is the relationship between crystal diameter and beam divergence?

Back 61

Inversely Related

Front 62

(Smaller|Larger) crystals produce beams that spread out (more|less) in the far field

Back 62

Small|more and Larger/less