CCI ARDMS practice test Questions and answers, Graded A+, latest updates

CCI ARDMS practice test Questions and answers, Graded A+, latest updates On an apical 4 chamber view, if you move the color Doppler sample box from the mitral level to the pulmonary veins, _______________. A. the ...

CCI ARDMS practice test Questions and answers, Graded A+, latest updates On an apical 4 chamber view, if you move the color Doppler sample box from the mitral level to the pulmonary veins, _______________. A. the PRF increases B. temporal resolution will increase C. the frame rate decreases D. the sample size should be increased for better pulmonary venous flow evaluation - ✔✔c. the frame rate decreases Which of the following procedures can be performed during a left heart catheterization? A. ventriculogram B. pulmonary angiography C. pulmonary capillary wedge pressure assessment D. right ventricle systolic pressure assessment - ✔✔A. ventriculogram Which of the following is associated with a diastolic murmur? A. VSD B. persistent left SVC C. tricuspid stenosis D. tricuspid regurgitation - ✔✔c. tricuspid stenosis The pulmonary valve is best evaluated with Doppler in which echocardiography view? A. Subcostal B. Parasternal long axis C. Parasternal short axis D. Apical 3 - ✔✔c parasternal short axis If a patient suffers from a syncopal episode due to a vasovagal reaction after the contrast injection, how should you position the patient to help them recover? A. Place them in the lithotomy position B. Place them in Trendelenburg position C. Place them in Fowler position D. Roll them onto their left side with arms extended above their head - ✔✔b. place them in trendelenburg position Which transducer position provides the best view of the descending thoracic aorta for assessment of diameter? A. apical B. parasternal C. subcostal D. suprasternal - ✔✔a. apical Which of the following tasks is not normally performed prior to the start of the echo exam? A. obtain surgical history B. review prior studies and reports C. offer treatment options D. obtain medical history - ✔✔C. offer treatment options Motion of the right ventricular free wall is best evaluated in the ______________ view. A. apical 4 chamber B. parasternal short axis C. right ventricular inflow D. subcostal 4 chamber - ✔✔a. apical 4 chamber Adjustment of which of the following imaging controls would be best to assist in improving visualization of the descending aorta posterior to the left atrium on an obese patient? A. increase output power B. increase probe frequency C. move focal zone to the level of the aorta D. use saline contrast injection - ✔✔c. move focal zone to the level or the aorta Which sonographic view best demonstrates the LV inflow across a bioprosthetic mitral valve? A. Parasternal long axis B. Apical C. Subcostal D. Parasternal short axis - ✔✔b. apical Which of the following lab tests should be performed regularly for a patient with a StarrEdwards valve? A. white blood cell count B. eosinophil count C. prothrombin time D. staphylococcus aureus levels - ✔✔c. prothrombin time A 1cm round, solid hypoechoic tumor is attached to the chordae of the mitral valve in a 45yr old patient. The tumor is most likely: A. rhabdomyoma B. papillary fibroelastoma C. myxoma D. sarcoma - ✔✔b. papillary fibroelastoma Which of the following adjustments would improve the appearance of contrast on the echo image? A. Use multiple focal zones B. Turn off harmonic imaging C. Decrease output power D. Increase the thermal index - ✔✔c. decrease output power Which of the following statements regarding the conduction system of the heart is false? A. The Purkinje fibers are responsible for delivering the signal to the muscle of the ventricles. B. The AV node sends a signal across the right atrium through the Purkinje fibers. C. The SA node sends a signal to the left atrium through the Bachmann internodal pathways. D. The AV node delays the signal to the ventricles for 0.1sec to allow the atria time to contract - ✔✔B. The AV node sends a signal across the right atrium through the Purkinje fibers. The mitral valve can be evaluated with Doppler in the Apical 4 and 2 chamber views. How is the probe manipulated to obtain a 2 chamber view from a 4 chamber view? A. rotate clockwise 60 degrees B. rotate counterclockwise 30 degrees C. rotate counterclockwise 60 degrees D. rotate clockwise 30 degrees - ✔✔c. rotate counterclockwise 60 degrees Which of the following would cause increased preload? A. ASD B. systemic HTN C. pulmonary HTN D. aortic stenosis - ✔✔a. ASD Which of the following items would be administered to a patient who is suffering from anaphylactic response caused by a contrast injection? A. heparin B. hydrocortisone C. atropine D. dobutamine - ✔✔b. hydrocortisone The Bernoulli equation is used to calculate: A. the peak instantaneous velocity B. the mean pressure C. the peak instantaneous pressure D. the valve area - ✔✔c. the peak instantaneous pressure Which of the following right ventricular wall segments is seen on the subcostal 4 chamber view? A. Anterior B. Medial C. Inferior D. Lateral - ✔✔c. inferior Which of the following correctly describes how to differentiate pressure and volume overload of the right ventricle? A. Peak velocity of tricuspid regurgitation is always higher with pressure overload. B. Right ventricular volume overload will cause septal flattening throughout the cardiac cycle, while pressure overload will demonstrate septal flattening only in diastole. C. Peak velocity of tricuspid regurgitation is always higher with volume overload. D. Right ventricular pressure overload will cause septal flattening throughout the cardiac cycle, while volume overload will demonstrate septal flattening only in diastole. - ✔✔d. right ventricular pressure overload will cause septal flattening throughout the cardiac cycle, while volume overload will demonstrate septal flattening only in diastole Which type of ASD is most commonly associated with mitral valve prolapse? A. fossa ovalis B. ostium secundum C. sinus venosus D. ostium primum - ✔✔b. ostium secundum Which lab values are most important for the physician to review prior to scheduling a pericardiocentesis? A. White blood cell count B. Cardiac enzymes C. PT and INR D. Hematocrit - ✔✔c. PT and INR Which of the following coronary vessels courses through the anterior interventricular groove? A. Right circumflex B. Left circumflex C. Left anterior descending D. Coronary sinus - ✔✔c. left anterior descending The endocardial cushions are involved in the formation of which of the following cardiac structures? A. tricuspid valve B. eustachian valve C. aortic root D. crista terminalis - ✔✔a. tricuspid valve You are performing an echo on a patient with suspected mitral stenosis.The deceleration time is 500msec. What is the mitral valve area? A. 0.4cm2 B. 1.5cm2 C. 2.3cm2 D. 0.8cm2 - ✔✔B. 1.5cm2 - pressure 1/2 time = decel time x 0.29 Which of the following adjustments will change the image data that will be stored in the memory of the ultrasound system? A. preprocessing B. changing monitor contrast settings at the beginning of the exam C. postprocessing D. Both preprocessing and postprocessing - ✔✔a. preprocessing The majority of pulmonary venous flow into the left atrium occurs during: A. early diastole B. early systole C. late diastole D. late systole - ✔✔b. early systole If the mitral deceleration time is 500msec, what is the pressure half time? A. 250ms B. 145mmHg C. 250mmHg D. 145msec - ✔✔d. 145msec - = 0.29 x 500msec = 145 msec In the normal heart, all of the following empty their blood into the coronary sinus, except? A. small cardiac vein B. great cardiac vein C. left SVC D. middle cardiac vein - ✔✔c. left SVC A 62yr old female presents with dyspnea and HTN. The echo demonstrates a tricuspid regurgitation jet with a peak velocity of 3.2m/s and the right ventricular free wall measures 0.7cm. What is the most likely diagnosis for these findings? A. pulmonary HTN B. patent ductus arteriosus C. tricuspid stenosis D. hypertrophic cardiomyopathy - ✔✔a. pulmonary HTN The pericardium can cause lobe artifact due to __________________________ A. the high transmission rate of the beam through the tissue. B. the highly reflective nature of the tissue. C. nonspecular reflection of the smooth fibrous tissues. D. the close proximity to the diaphragm. - ✔✔b. the highly refelctive nature of the tissue A patient presents for an echo with a history of cor pulmonale. Which of the following is an expected finding on the exam? A. Pulmonary valve stenosis B. Congestive heart failure C. Pulmonary HTN D. Constrictive pericarditis - ✔✔c. pulmonary HTN Which of the following mmode measurements will increase in patients with dilated cardiomyopathy? A. end systolic diameter of the posterior wall and septum B. interventricular septal diameter in diastole C. E and A amplitude of the anterior mitral leaflet D. E point septal separation - ✔✔d. E point septal seperation Which of the following will improve tissue Doppler evaluation of the medial mitral annulus? A. decrease the Doppler baseline B. use a sample gate >5mm C. increase the velocity scale to >40cm/s D. increase the sweep speed - ✔✔d. increase the sweep speed Which of the following is NOT true regarding the IVC? A. Normal flow through the IVC demonstrates a triphasic Doppler waveform. B. The IVC should normally collapse to less than 50% of its original diameter with inspiration. C. The IVC courses superiorly through the abdomen on the right side of the aorta. D. The hepatic veins exit the liver and connect to the posterior aspect of the IVC. - ✔✔D. The hepatic veins exit the liver and connect to the posterior aspect of the IVC. You are performing the index of myocardial performance for the left ventricle. You have measured the time from mitral valve opening to mitral valve closing. What other parameter should you measure to complete the calculation? A. mean pressure gradient across the mitral valve B. mean pressure gradient across the LVOT C. mitral valve pressure half time D. LVOT ejection time - ✔✔d. LVOT ejection time A 40yr old presents with a history of dyspnea and fatigue. She was recently treated for alcoholism at a local inpatient center. What statement best describes the findings on the video? A. Dilated cardiomyopathy is the most likely diagnosis for the thinned walls and decreased function. B. The patient most likely has developed pulmonary HTN which explains the septal flattening in diastole. C. Restrictive cardiomyopathy is the most likely diagnosis for the thinned left ventricular walls and decreased function. D. The patient most likely has developed constrictive pericarditis due to the history of alcohol abuse. - ✔✔A. Dilated cardiomyopathy is the most likely diagnosis for the thinned walls and decreased function. - alcoholism is associated with DCM If the distance to a reflector decreases by one half, how does this affect the transmit and return time of the pulse? A. decreases exponentially B. decreases by 1/2 C. decreases by 1/4 D. doubles - ✔✔b. decreases by 1/2 Which statement regarding the atrioventricular valves is false? A. The tricuspid valve is normally positioned in the right ventricle within 8mm from the level of the mitral valve position in the left ventricle. B. Both valves contain three valve leaflets. C. The mitral valve is normally a bicuspid valve. D. The valves are closed during cardiac systole. - ✔✔b. both valves contain three leaflters - mitral has 2 What is the most common echo finding in HIV patients? A. aortic stenosis B. mitral stenosis C. vegetation formation D. pericardial effusion - ✔✔d. pericardial effusion Why does aliasing NOT occur with CW Doppler systems? A. CW probes are smaller and require a smaller area for footprint. B. CW probes are always lower frequency than PW probes and can penetrate deeper vessels without aliasing on Doppler tracings. C. CW probes have higher PRF ranges than PW probes. D. CW probes use two separate elements so they are not limited by pulse echo parameters like PRF and the Nyquist limit. - ✔✔d. CW probes use two seperate elements so they are not limited by pulse echo parameters like PRF and the nyquist limit Which of the following is a purpose for a perfluorocarbon microbubble contrast echo? A. evaluate persistent left SVC B. identify vegetations C. to increase cardiac output and stress the heart D. to enhance the Doppler signal in the LVOT with hypertrophic obstructive cardiomyopathy - ✔✔d. to enhance the doppler signal in the LVOT with hypertrophic obstructive cardiomyopathy Which of the following is an expected EF% on a patient with advanced hypertrophic cardiomyopathy? A. 45% B. 15% C. 85% D. 60% - ✔✔c. 85% - as the LV walls thicken, the systolic cavit dimensions decrease causing a higher EF% What effect will dilated cardiomyopathy have on the left ventricular outflow velocity? A. no change B. becomes dagger shaped C. decreased D. increased - ✔✔c. decreased An 8mm vena contracta is measured on a mitral regurgitation(MR) jet. What is the expected Doppler finding in the pulmonary veins of the same patient? A. increased S and D wave B. increased systolic flow reversal C. decreased systolic flow reversal D. increased D wave - ✔✔b. increased systolic flow reversal - severe MR = flow reversal into the veins during systole The ____________________ will _______________ in size with isolated moderate mitral regurgitation. A. right ventricle, increase B. left atrium, demonstrate no change C. right atrium, increase D. left ventricle, increase - ✔✔d. left ventricle, increase All of the following describe papillary fibroelastomas, except? A. Most common valvular tumor B. Usually attached to the surface of the aortic or mitral valve leaflets in adults C. Tumors can be found attached to the chordae of the mitral valve D. Very aggressive malignancy - ✔✔d. very aggressive malignancy While scanning an obese patient, you apply color Doppler to the mitral valve in the apical four chamber view. When you adjust the placement of the box, there is a delay between your adjustment and the box responding to the movement. How can you correct this? A. activate the zoom function over the mitral valve B. switch to a higher frequency probe C. decrease the color gain D. increase the sample size - ✔✔a. activate the zoom function over the mitral valve The ________________ refers to an internal ridge of tissue in the right atrium that extends vertically between the SVC and IVC. A. crista terminalis B. pulmonic root C. right ventricular inflow tract D. infundibulum - ✔✔a. crista terminalis Which of the following cardiac changes is most commonly associated with mitral valve stenosis? A. Right atrial enlargement B. Left ventricular hypertrophy C. Left ventricular enlargement D. Left atrial enlargement - ✔✔d. left atrial enlargement Which of the following is least likely to be associated with hypertrophic cardiomyopathy? A. systemic BP 176/100mmHg B. syncope C. systemic BP 92/48mmHg D. angina - ✔✔a. systemic BP 176/100mmHg - systemic BP will be decreased with HCM In order to diagnose a persistent left SVC, contrast should be injected in the ________________ and it will be seen in the ______________ before entering the right heart if the exam is positive. A. left arm, coronary sinus B. right arm, left atrium C. left arm, SVC D. left arm, pulmonary veins - ✔✔a. left arm, coronary sinus Which of the following should always be used in conjunction with the Doppler evaluation of the LV inflow in patients with suspected constrictive pericarditis? A. MUGA scan B. Cat scan C. stress echo D. respirometer - ✔✔d. respirometer The most common location of an aortic aneurysm is: A. transverse arch B. infrarenal abdominal C. proximal aortic root D. descending thoracic - ✔✔b. infrarenal abdominal The pulmonary artery flow normally demonstrates a _______________ due to ____________________ to flow when compared to the aortic flow. A. longer acceleration time, lower resistance B. higher mean pressure gradient, lower resistance C. shorter acceleration time, lower resistance D. higher mean pressure gradient, higher resistance - ✔✔a. longer acceleration time, lower resistance A patient presents for an echo and states that she has a history of Noonan syndrome. She also tells you that she had "surgery on an abnormal valve as a child" but she does not know which valve. Which valve abnormality did she most likely have repaired? A. tricuspid atresia B. unicuspid aortic valve C. double outlet mitral valve D. dysplastic pulmonic valve - ✔✔d. dysplastic pulmonic valve What Doppler measurement can be used to calculate the mean diastolic pressure in the pulmonary artery? A. peak diastolic velocity of tricuspid regurgitation B. average velocity of tricuspid regurgitation C. peak diastolic velocity of pulmonic regurgitation D. end diastolic velocity of pulmonic regurgitation - ✔✔C. peak diastolic velocity of pulmonic regurgitation Which of the following statements is true regarding the color flow evaluation of aortic stenosis? A. The Reynold's number will be 10001500 in the area just distal to the stenosis. B. When using a velocity map, aortic stenosis will cause a mosaic color pattern proximal to the stenosis. C. A variance color map will demonstrate a green color in the aortic root, just distal to the stenosis D. The greatest amount of turbulence seen with aortic stenosis is at the valve. - ✔✔c. a variance color map will demonstrate a green color in the aortic root, just distal to the sten