ARDMS AE Exam 163 Questions with Verified Answers,100% CORRECT

ARDMS AE Exam 163 Questions with Verified Answers What structure can be seen in the RV? - CORRECT ANSWER Moderator band What structure can be seen in the LV? - CORRECT ANSWER False tendon PV cusps - CORRECT AN ...

ARDMS AE Exam 163 Questions with Verified Answers What structure can be seen in the RV? - CORRECT ANSWER Moderator band What structure can be seen in the LV? - CORRECT ANSWER False tendon PV cusps - CORRECT ANSWER anterior, right, left TV cusps - CORRECT ANSWER anterior, posterior, septal layers of the heart (inner to outer) - CORRECT ANSWER endocardium, myocardium, epicardium, pericardium layers of the pericardium (inner to outer) - CORRECT ANSWER serosal, fibrous layers of the serous pericardium - CORRECT ANSWER visceral, pericardial space, parietal 3 head vessels - CORRECT ANSWER innominate artery, left common carotid, left subclavian where is the coronary sinus located? - CORRECT ANSWER posterior in the AV sulcus What valve covers the coronary sinus in the RA? - CORRECT ANSWER Thebesian valve Names/location of the papillary muscles in PSAX - CORRECT ANSWER posteromedial (screen left), anterolateral (screen right) which walls does the LAD supply? - CORRECT ANSWER Left and right anterior walls and superior septum which walls does the left circumflex supply? - CORRECT ANSWER left lateral and inferior walls which walls does the right posterior descending supply? - CORRECT ANSWER left and right posterior walls and inferior septum which walls does the right marginal supply? - CORRECT ANSWER RV free wall which walls does the right SVC branch supply? - CORRECT ANSWER posterior RA and SA node what layer of the heart do the coronary arteries run through? - CORRECT ANSWER epicardium 4 chamber LV wall segments - CORRECT ANSWER basal inferoseptum, mid inferoseptum, apical septum, apex, apical lateral, mid anterolateral, basal anterolateral 2 chamber LV wall segments - CORRECT ANSWER basal inferior, mid inferior, apical inferior, apex, apical anterior, mid anterior, basal anterior 3 chamber LV wall segments - CORRECT ANSWER basal inferolateral, mid inferolateral, apicsl lateral, apex, apical anterior, mid anteroseptum, basal anteroseptum PSAX mid/basal LV wall segments (12 o'clock clockwise) - CORRECT ANSWER anterior, anterolateral, inferolateral, inferior, inferoseptum, anteroseptum PSAX apex LV wall segments (12 o'clock clockwise) - CORRECT ANSWER anterior, lateral, inferior, septal 3 factors of stroke volume - CORRECT ANSWER preload, contractility, afterload preload - CORRECT ANSWER volume and pressure in LV at end diastole afterload - CORRECT ANSWER resistance the ventricles encounters during systole (aortic pressure) frank-starlings law - CORRECT ANSWER myocardial contractile force is proportional to myocardial fiber length a pressure overload will lead to what? - CORRECT ANSWER hypertrophy a volume overload will lead to what? - CORRECT ANSWER dilation normal aortic root measurement - CORRECT ANSWER 2-4 cm normal aortic cusp separation measurement - CORRECT ANSWER 1.5-2.6 cm normal LA diameter measurement - CORRECT ANSWER <= 4 cm normal LA volume measurement - CORRECT ANSWER <20 cm^2 normal LVIDd measurement - CORRECT ANSWER 3.7-5.7 cm normal LVIDs measurement - CORRECT ANSWER 2.8-3.8 cm normal IVS measurement - CORRECT ANSWER .6-1.1 cm normal posterior LV wall measurement - CORRECT ANSWER .6-1.1 cm phases of the cardiac cycle - CORRECT ANSWER passive filling (early diastole), atrial contraction (late diastole), isovolumetric contraction, ventricular systole, isovolumetric relaxation when does S3 occur? - CORRECT ANSWER passive filling (early diastole) when does S4 occur? - CORRECT ANSWER atrial contraction (late diastole) when does S1 occur? - CORRECT ANSWER isovolumetric contraction when does S2 occur? - CORRECT ANSWER isovolumetric relaxation LV EF methods - CORRECT ANSWER Teicholtz, Area-length, modified Simpson's Teicholtz - CORRECT ANSWER uses m-mode dimensions to calculate EF area-length - CORRECT ANSWER uses LV diameter to calculate EF modified Simpson's - CORRECT ANSWER uses planimetry for LV volumes to calculate EF FS equation - CORRECT ANSWER (ED-ES)/ED x 100% (internal diameter) normal FS% - CORRECT ANSWER >25% EF equation - CORRECT ANSWER (ED-ES)/ED x 100% (volumes) normal EF% - CORRECT ANSWER >55% Mild AS (valve area, velocity, pressure) - CORRECT ANSWER 1.5-2 cm^2, 2.5-3 m/s, <25 mmHg Mod AS (valve area, velocity, pressure) - CORRECT ANSWER 1.0-1.5 cm^2, 3-4 m/s, 25-40 mmHg Severe AS (valve area, velocity, pressure) - CORRECT ANSWER .6-1 cm^2, >4 m/s, >40 mmHg normal MV area - CORRECT ANSWER 4-6 cm^2 Mild MS (valve area, pressure, PA pressure) - CORRECT ANSWER >1.5 cm^2, <5 mmHg, < 30mmHg Mod MS (valve area, pressure, PA pressure) - CORRECT ANSWER 1-1.5 cm^2, 5-10 mmHg, 30-50 mmHg Severe MS (valve area, pressure, PA pressure) - CORRECT ANSWER <1.0 cm^2, >10 mmHg, >50 mmHg clenching fist - CORRECT ANSWER acute increase BP, increase HR, increase CO; decrease AS, increase MR amyl nitrate - CORRECT ANSWER decrease BP, increase HR, decrease venous return, increase CO, increase SV; decrease AI, decrease MR valsalva - CORRECT ANSWER increase BP, decrease HR, decrease venous return, decrease CO, decrease SV; increase IHSS exercise - CORRECT ANSWER increase BP, increase HR, increase CO inspiration - CORRECT ANSWER increases venous return, decrease MV velocity expiration - CORRECT ANSWER decreases venous return standing - CORRECT ANSWER decreases venous return, decreases SV which valve is least affected by rheumatic fever? - CORRECT ANSWER PV which type of stenosis is most common? - CORRECT ANSWER AS what is a typical sign of MS? - CORRECT ANSWER hockey stick sign pressure half time - CORRECT ANSWER time it takes the peak gradient to become half PHT equation using MV decel time - CORRECT ANSWER PHT = decel time x .29 pressure half time equation for finding MV area - CORRECT ANSWER MV area = 220/PHT normal PHT - CORRECT ANSWER 30-90 msec mild MS by PHT - CORRECT ANSWER 90-150 msec mod MS by PHT - CORRECT ANSWER 150-219 msec severe MS by PHT - CORRECT ANSWER >220 msec mild MR by PISA - CORRECT ANSWER <= .1 ERO mod MR by PISA - CORRECT ANSWER .2-.3 ERO severe MR by PISA - CORRECT ANSWER >.4 ERO mild MR by vena contracta - CORRECT ANSWER <3 mm moderate MR by vena contracta - CORRECT ANSWER 4-6 mm severe MR by vena contracta - CORRECT ANSWER >7 mm what is an indicator of severe MR? - CORRECT ANSWER systolic flow reversal in the Pulm veins what's MVP also known as? - CORRECT ANSWER Barlow's syndrome, systolic click syndrome which leaflet is more commonly affected in MVP? - CORRECT ANSWER posterior 2 types of MVP - CORRECT ANSWER holo-systolic, mid-systolic continuity equation - CORRECT ANSWER LVOT area/LVOT velocity = AV area/AS velocity what is the continuity equation usually used to grade? - CORRECT ANSWER degree of AS how do you find the LVOT area given the LVOT diameter? - CORRECT ANSWER LVOT area = pir^2 (r=d/2) a steep slope signifies worse _____ - CORRECT ANSWER AI a steep slope signifies better _____ - CORRECT ANSWER MS mild AI by PHT - CORRECT ANSWER >500 msec mod AI by PHT - CORRECT ANSWER 250-500 msec severe AI by PHT - CORRECT ANSWER <250 msec equation for RVSP? - CORRECT ANSWER 4 (TR) ^2 + RA pressure mild PS (velocity, pressure) - CORRECT ANSWER <3 m/s, <36 mmHg mod PS (velocity, pressure) - CORRECT ANSWER 3-4 m/s, 36-64 mmHg severe PS (velocity, pressure) - CORRECT ANSWER >4 m/s, >64 mmHg normal MV decel time - CORRECT ANSWER <220 msec 6 conditions to do a TEE - CORRECT ANSWER prosthetic valve, aortic dissection, endocarditis, embolism, suboptimal TTE, other 6 safety problems of TEE - CORRECT ANSWER pt discomfort, airway compromise, vagal response, electrical/temperature, esophageal/tracheal trauma, infection at what temperature is it unsafe to use TEE - CORRECT ANSWER 40-45 degrees C how does depolarization move through the heart layers? - CORRECT ANSWER endo-epi how does coronary perfusion move through the heart layers? - CORRECT ANSWER epi-endo what is a normal QRS duration? - CORRECT ANSWER .1 sec what is a normal PR interval? - CORRECT ANSWER <.2 sec what factors increase preload? - CORRECT ANSWER MR, TR, PI, AI, ASD, VSD, PDA, any volume overload what factors increase afterload? - CORRECT ANSWER AS, PS, HTN what is a normal SV? - CORRECT ANSWER 70-110 mL SV equation using Doppler - CORRECT ANSWER VTI x CSA when on ekg does isovolumetric contraction occur? - CORRECT ANSWER after R wave when on ekg does isovolumetroc relaxation occur? - CORRECT ANSWER after T wave how long do isovolumetric contraction and relaxation last? - CORRECT ANSWER 70 msec how much less is right sided pressure than left? - CORRECT ANSWER 1/5 what will AS eventually lead to? - CORRECT ANSWER LVH and increased LA pressure pulse pressure - CORRECT ANSWER difference between systolic and diastolic pressures takayasu arteritis - CORRECT ANSWER aortic arch syndrome equation for peak LVSP - CORRECT ANSWER 4 (AV) ^2 + systolic BP when should you use VTI - CORRECT ANSWER decreased LV function, mod-severe AI which are higher, echo or cath gradients? - CORRECT ANSWER echo what murmur is heard with AI - CORRECT ANSWER diastolic blow murmur what is a normal LV dp/dt? - CORRECT ANSWER >1200 msec how big do vegetations need to be to be seen on echo? - CORRECT ANSWER => 3 mm pannus - CORRECT ANSWER host-tissue over growth 2 types of valve replacements - CORRECT ANSWER mechanical valves, bioprosthetic valves types of mechanical valves - CORRECT ANSWER ball and cage (starr-edwards), caged disc (beall-surgitool, kay-suzuki), tilting disc (bjork-shilley, lillehei-kaster), bileaflet tilting discs (st. jude) types of bioprosthetic valves - CORRECT ANSWER heterograft (hancock, carpentier-edwards), homograft, autograft characteristics of mechanical valves - CORRECT ANSWER require blood thinners, do not need to be replaced characteristics of bioprosthetic valves - CORRECT ANSWER replaced every 10-15 years, always has 3 leaflets type of valve repair - CORRECT ANSWER carpentier ring venturi effect - CORRECT ANSWER modifiction of Bernoulli principle for HCM LVOT obstruction causes what to happen to the AV? - CORRECT ANSWER premature closure chagas' disease - CORRECT ANSWER posterior/apical thinning but normal septum where is the oblique sinus of the pericardium located? - CORRECT ANSWER posterior to LA in PLAX pulsus alternans - CORRECT ANSWER systolic dysfunction with LV dilated cardiomyopathy beck's triad - CORRECT ANSWER increased venous pressure, decreased BP, increased HR RA pressure, normal IVC w/ collapse - CORRECT ANSWER 10 mmHg RA pressure, dilated IVC >2 cm w/ 50% collapse - CORRECT ANSWER 15 mmHg RA pressure, dilated IVC >2cm w/o collapse - CORRECT ANSWER 20 mmHg indications for stress echo - CORRECT ANSWER diagnosing CP, CAD, arrythmias how many days for the heart to develop in embyology? - CORRECT ANSWER 43 when does the truncus divide in utero? - CORRECT ANSWER day 31 most common location for a pseudoaneurysm? - CORRECT ANSWER basal inferior most common primary malignant cardiac tumor, most often seen in the RA - CORRECT ANSWER angiosarcoma LA myxomas are usually attached to where? - CORRECT ANSWER IAS the PV leaflet most commonly recorded by Mmode is? - CORRECT ANSWER left during what phase will the IVS flatten with RV volume overload? - CORRECT ANSWER diastole Mean velocity of circumferential fiber shortening (Vcfm) - CORRECT ANSWER determines the rate of change of left ventricular circumference in systole relative to its circumference at end-diastole Normal Vcfm - CORRECT ANSWER 1.02 to 1.94 circumferences per second The pressure obtained by a pulmonary artery wedge reflects the pressure in the: - CORRECT ANSWER left atrium which maneuvers increase MVP? - CORRECT ANSWER any maneuver that decreases venous return Which M mode finding is considered to be a specific indicator of a fenestrated AV - CORRECT ANSWER diastolic flutter of the aortic valve The premature opening of the pulmonary valve may be seen in - CORRECT ANSWER Constrictive Pericarditis A patient is sent to the echo lab with the diagnosis of constrictive pericarditis. You perform a contrast study to look for - CORRECT ANSWER presystolic appearance of contrast in the IVC A pt is referred to the echo lab because of positional and respiratory variation in chest pain, Which of the disease are they likely to have - CORRECT ANSWER Pericarditis A pt with has a higher BP in the right arm than the left may have - CORRECT ANSWER coarctation of the aorta Type of murmur associated with AI - CORRECT ANSWER Austin Flint Dressler's syndrome - CORRECT ANSWER A delayed form of pericarditis, occurs after 1-12 weeks after an MI on M mode the aorta is measured at - CORRECT ANSWER end systole diastasis - CORRECT ANSWER The slow filling phase of diastole Symp of MVP - CORRECT ANSWER Palpitations, sharp pain unrelated to exercise. Fatigue, dyspnea. Dizzy spells. Can cause turbulent flow of blood in the aorta, increase in CO. The DeBakey classification divides dissections into 3 types, as follows: - CORRECT ANSWER Type I involves the ascending aorta, aortic arch, and descending aorta. Type II is confined to the ascending aorta. Type III is confined to the descending aorta distal to the left subclavian artery. grade 1 diastolic dysfunction - CORRECT ANSWER impaired relaxation, reduced E an increased A, increased decel time, normal pulm venous flow, reduced E' grade 2 diastolic dysfunction - CORRECT ANSWER pseudonormal, normal E/A ratio, do valsalva to reverse E and A, elevated D wave in pulm vein, decreased E', E/E' >15 grade 3 diastolic dysfunction - CORRECT ANSWER restrictive filling, severely increased E wave, very short decel time, low A velocity, tall D wave and barely an S wave in pulm venous flow, E' velocity is low, E/E' >15 LA pressure using MV inflow and TDI - CORRECT ANSWER LA pressure = E/E' + 4 mmHg