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85 Cards in this Set
- Front
- Back
LV mass (weight) remains normal in chronic:
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Mitral stenosis
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High angulation of an M-mode transducer beam equals
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pseudo bicuspid aortic valve
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What is the primary effect of long -standing aortic regurgitation
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decreased ejection fraction
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Which of the following syndromes fit with AR, Ao dilatation Ao dissections & Ao aneurysms?
Dresslers Borlow Marfan Noonans |
Marfan's Syndrome
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Why follow chronic AI patients?
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Check left ventricle size
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Systolic reversal flow is also called
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retrograde
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Lambl's Excrescences are sometimes listed as potential answers...
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they are thin filiform strands (fronds) that form on tbe edges of valve leaflets
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RVSP =
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PAP
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What causes pericardial knock?
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abrupt cessation of early diastolic inflow (classic in constrictive percarditis) similar in timing to a very loud S3
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What accompanies bicuspid aortic valves?
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coarctation of the aorta (50% of coarcts have a bicuspid valve
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When is mitral pressure half time NOT accurate?
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post valvuloplasty
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Given TR and RA pressure, what can you calculate
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right ventricular systolic pressure
RVSP |
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Shown a LAX view, dilated LV, thin septum, what is probably going on with the patient
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severe mitral regurgitation
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What is the best way to determine the severity of mitral regurgitation?
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pulmonary venous flow
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Name the 2 layers of the pericardium
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visceral and parietal
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Which percardial layer is the serous
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visceral or epicardial
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Which cardiac pathology affects the valves
amyloid sarcoid carcinoid hemochromatosis |
carcinoid
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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
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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
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Kids with Tuberous Sclerosis develop what type of cardiac tumors
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rhabdomyomas
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HINT:
Might show a left or right pulmonary artery filled with clot |
Might show a left or right pulmonary artery filled with clot
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What is meant by automaticity?
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the ability of initiate an elective impulse or beat intrinsic means pertaining exclusively to a part
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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
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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
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Peripheral contrast NOT useful in:
A. ASD B. AI D. VSD |
B. AI
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Which view shows the coronary sinus in long axis?
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Apical 4-ch with posterior angulation
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What is the valve of the IVC
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Eustachian valve
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What does amyl nitrite do to HR?
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increases HR
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Why are the right and left coronaries called right and left?
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the left artery supplies most of the L and the right artery most of the RV
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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
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Know the difference on 2-D between a pacer wire and a catheter.
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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 |
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Why are the RCC, LCC and NCC called what they are
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because of the coronaries
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A systolic rumble might be
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tricuspid regurgitation
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If you are doing an echo on a supine patient who becomes short of breath, what should you do first
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sit the patient upright
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What is a superimposed respiratory tracing
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a spirometer
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Asked about (no picture) the A-wave on MV (m-mode or Doppler) in A-fib
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Answer: there is not an A-wave in A-fib
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What do you do first of an apneic patient after giving sedation
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check their airway
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Why do the IVC sniff test
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to check for elevated RA pressures
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What type of shunts cause cyanosis in newborns
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Right to left shunt
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What is a "pressure drop"?
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same as a gradient across valves
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In the cath lab the Gorlin Formula is used to calculate?
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Valvular areas
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Mitral inflow velocity should not be effected by:
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gender
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HINT:
Shown a study with LVH, biatrial enlargement and a perciardial effusion |
Restrictive (infiltrative)
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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
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An MI of the inferior wall involves which coronary artery?
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right coronary artery
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Which valve is most likely to regurgitate in normals?
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tricuspid
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An effusion is usually on the video exam
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An effusion is usually on the video exam
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What % of normals will have a PFO
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20-30%
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Causes of acute mitral regurgitation
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Endocarditis, Ruptured chordae, Pap muscle dysfx, Prosthetic valve dysfx
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Case of 2 chamber with post/inf pseudo-aneurysm is sometime on video exam
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Case of 2 chamber with post/inf pseudo-aneurysm is sometime on video exam
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Where do the coronaries drain?
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into the coronary sinus
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Which coronary supplies the LV apex
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left anterior descending
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What 2D finding would you see in a patient with PLSVC
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a dilated coronary sinus
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What is Kyphosis?
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exaggerated anterior spinal curvature. Skeletal deformity may compress PA and cause PA hypertension
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What is UHl's anomaly?
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congenital absent RV myocardium also called "parchment heart" may be confused clinically with Ebstein's
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Shown in Aorta. Asked if it's Marfan or Takaysau's
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Marfan will be dilated while Takaysau's is normal in size with narrowed area
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What can cause a contrast to dissipate too quickly?
A. low MI B. high MI C. low frequency D. high frequency |
B. high MI
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Name the 3 heart layers
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1. epicardium - thin outer layer
2. myocardium - mid wall (thickest) 3. endocardium - inside |
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Normally how much pericardial fluid is there?
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40 cc
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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
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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
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How do cardiac problems cause renal failure, jugular venous pulsations and peripheral edema?
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Mostly through systolic failure and low perfusion causing multi system complications
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How many weeks until the heart is developed?
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6 weeks
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Which embryonic aortic arch (1-6) develops into tranverse arch?
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4th
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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
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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
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Question about what view to us in patients with COPD/asthma
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subcostal window
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Know persistent fetal circulation
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PTHN with R to L shunting across the foramen and ductus
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HINT
Preload = volume = thin walls Afterload = pressure = thick walls |
HINT
Preload = volume = thin walls Afterload = pressure = thick walls |
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Are right sided pressures elevated with a Valsalva Maneuver?
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during the strain phase - NO
during the release phase - YES |
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What clinical finding is associated with friction rub?
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pericaridal effusion
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Aortic regurgitation starts at the beginning of
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beginning of IVRT
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What kind of murmur will a patient with a VSD have?
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harsh holosystolic
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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
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BiPlane Simpsons rule is used for calculating:
regurgitant fraction aortic valve area ejection fraction mitral stenosis |
ejection fraction
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What causes a left parasternal friction rub
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pericarditis
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In the apical four chamber view where would you see reverberation artifact?
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Apex
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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
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The reason for using ultrasound gel is to:
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keep the air out
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Asked if an ascending Ao dissection can cause severe MR?
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No - not severe, maybe mild
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Know that the QRS complex equals depolariztion
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Know that the QRS complex equals depolariztion
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Where are most fibroelastomas found?
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Usually on the valves (mitral and aortic). May be described as "frond like" (feathery)
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What might you see in a patient with scleroderma?
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Usually pulmonary hypertension or a pericaridal effusion is the 2nd thing
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How many years are echo records to be kept
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seven
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What is the most common type of pediatric cardiac tumor?
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rhabdomyomas
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