ARDMS ECHO COMPREHENSIVE ANSWERS AND
QUESTIONS SET A+
✔✔How are phased array transducer the transmitted sound beam is swept - ✔✔Varying
the timing of pulses to the transducer elements
✔✔To improve the axial resolution of a transducer a manufacturer must do what to the
pulse- - ✔✔Shorten it
✔✔If the distance to the reflector doubles, the time between pulse transmission and
echo detection at the transducer will - ✔✔Double
✔✔The 2D image of a phased array echo is produced by- - ✔✔Sequentially activating a
series of adjacent crystals to angulate the US beam.
✔✔T/F, Pulmonary atresia with a VSD (pseudo truncus) is associated with an overriding
aorta - ✔✔True
✔✔T/F, Pulmonary atresia with an intact VSD is associated with an overriding aorta -
✔✔False
✔✔List some conditions associated w/ an overriding aorta - ✔✔TOF, Truncus
arteriosus, Double outlet RV, Pulmonary atresia with VSD.
✔✔RVSP = - ✔✔PAP
✔✔What causes a pericardial knock? - ✔✔classic constrictive pericarditis. Similar in
timing to a very loud S3. It's caused by an abrupt cessation of early diastolic inflow.
✔✔Thin filiform strands (fronds) that form on the edges of the AoV leaflets - ✔✔Lambl's
✔✔Name 2 layers of the pericardium - ✔✔visceral and parietal
,✔✔Which pericardial layer is the serous? - ✔✔visceral or epicardial
✔✔What is a common finding in coarctation - ✔✔Bi cuspid valves ( 50%)
✔✔When is a mitral pressure half time NOT accurate - ✔✔post valvuloplasty
✔✔Which embryonic aortic arch (1-6) develops into the transverse arch - ✔✔Fourth
✔✔In patients with A-Fib which heart sound would be missing- - ✔✔The fourth- occurs
during atrial contraction
✔✔Type of transposition of the great vessels where aorta is connected to Right
Ventricle and body receives deoxygenated blood. - ✔✔D-TGA Cyanosis, D=Die
✔✔Vegetation's of the Mitral Valve and/or Tricuspid Valve are seen on the __________
side of the valves - ✔✔Atrial
✔✔Vegs typically cause______ not______ - ✔✔regurg, not stenosis
✔✔What is the formula most often used to obtain MVA? - ✔✔P1/2t, Planimetry most
accurate but sonographer limitations and technical areas make P1/2t more common.
✔✔Time it takes for the pressure gradient to drop to half of its original valve- - ✔✔P1/2t
✔✔The most common secondary cause of dilated cardiomyopathy- - ✔✔Alcohol
✔✔The most common type of infiltrative restrictive cardiomyopathy- - ✔✔Amyloidosis
✔✔What is a classic finding of patients with restrictive cardiomyopathy? - ✔✔Bi-Atrial
enlargement caused by restricted diagnostic filling and leading to atrial overload
✔✔Complete endocardial cushion defects consist of what? - ✔✔An osmium primum
ASD, an inlet VSD, and a common AV valve
✔✔T/F, downs syndrome is associated with endocardial cushion defect - ✔✔True
✔✔________ valves are more durable. - ✔✔Mechanical. Tissue valves have a higher
failure rate.
✔✔The Ross procedure can be an intervention for congenital ________
________________. - ✔✔AS, AoV removed and replaced with the PV
,✔✔What is the most common place for an ASD? - ✔✔Area of the foramen Ovale also
known as the septum secundum
✔✔What maneuvers can cause a decrease in Left Ventricle volume and provoke mitral
valve prolapse - ✔✔Valsalva, administration of amyl nitrite
✔✔Type of murmur associated with Aortic Insufficiency - ✔✔Austin Flint
✔✔A delayed form of pericarditis - ✔✔Dressler's syndrome. Occurs after 1-12 weeks
after an MI
✔✔Endocardial cushion defects also known as AV septal defects occur in ______ % of
Down syndrome patients. - ✔✔40%
✔✔The most common echo finding in pts with AIDS is- - ✔✔Pericardial effusion,
cardiomyopathy is also common
✔✔------- to ------ % of pts with coarctation of the aorta also have a bicuspid valve. -
✔✔50 to 80
✔✔The steeper the slope of an AI P1/2t jet the more ----- the AI. - ✔✔Severe. This
means the LOWER the number the more SEVERE the AI.
✔✔An AI p1/2 of <_____ is severe AI - ✔✔<200 ( >500, mild)
✔✔Most common conduction abnormality with DCM- - ✔✔LBBB
✔✔What is a common arrhythmia associated with MVP? - ✔✔Paroxysmal
Supraventricular Tachycardia. It is believed this may be due to the stress and anxiety of
feeling chest pain, etc. This in turn provokes SVT.
✔✔Can transducers be heat sterilized? - ✔✔NO
✔✔Why should you look for a PFO is you are looking for an embolus? - ✔✔A PFO can
shunt a clot from the right side through the PFO into the left heart.
✔✔VTI Doppler traces gives information on what - ✔✔Mean velocities-- it can give both
peak and mean but only method of providing a mean pressure gradient
✔✔A ratio used to calculate the severity of a shunt- - ✔✔Qp/Qs--- Depending on the
location of the shunt a SV is determined for pulmonary blood flow vs. systemic blood
flow
, ✔✔What is the name of the procedure in which a pacer wire is placed in both the RV
and the CS? - ✔✔Cardiac resynchronization. LVF can improve with simultaneous
ventricular function
✔✔The normal wall thickness should be? - ✔✔<11 mm or <1.1 cm
✔✔Simpsons rule is used for measuring what? - ✔✔ejection fraction
✔✔What is the most accurate measurement for assessing LVF? - ✔✔Simpson's
✔✔The formula for the quantification of pulmonary blood volume vs systemic volume- -
✔✔Qp/Qs
✔✔With Qp/Qs, L to R shunts with volume overload to the right heart. When the right
heart or Qp volume is greater than ----- of the left heart or the Qs volume, the shunt is
significant. - ✔✔1.5
✔✔On M-Mode the aorta is measured at- - ✔✔End systole
✔✔External focusing of the transducer is done with what? - ✔✔The lens
✔✔Internal focusing of the transducer is with the - - ✔✔Curved element and phased
array focusing is with the electronics of the US system
✔✔Aliasing occurs when the velocity reaches more than____ of the PRF? - ✔✔1/2
✔✔Contrast can be used to _____ the Doppler signal in order to obtain an adequate
display - ✔✔Highlight
✔✔When using a contrast media the sonographer must _____ acoustic power -
✔✔Decrease, Higher power will burst the bubbles of contrast
✔✔Type of artifact caused by the regular periodic spacing of elements within the array.
They create artifacts by measuring time of flight to an object located outside the main
beam and placing the detected echo as if the interface were located along the US path
of the main beam - ✔✔Grating lobes
✔✔Grating lobes are found in ----- transducers. - ✔✔Array
✔✔An associated finding of Interatrial septal aneurysm is an - ✔✔ASD, An intertribal
septal aneurysm is bulging of the fossa ovals region of the interatrial septum. Septal
aneurysms have a high likelihood of fenestration (up to 90%)
QUESTIONS SET A+
✔✔How are phased array transducer the transmitted sound beam is swept - ✔✔Varying
the timing of pulses to the transducer elements
✔✔To improve the axial resolution of a transducer a manufacturer must do what to the
pulse- - ✔✔Shorten it
✔✔If the distance to the reflector doubles, the time between pulse transmission and
echo detection at the transducer will - ✔✔Double
✔✔The 2D image of a phased array echo is produced by- - ✔✔Sequentially activating a
series of adjacent crystals to angulate the US beam.
✔✔T/F, Pulmonary atresia with a VSD (pseudo truncus) is associated with an overriding
aorta - ✔✔True
✔✔T/F, Pulmonary atresia with an intact VSD is associated with an overriding aorta -
✔✔False
✔✔List some conditions associated w/ an overriding aorta - ✔✔TOF, Truncus
arteriosus, Double outlet RV, Pulmonary atresia with VSD.
✔✔RVSP = - ✔✔PAP
✔✔What causes a pericardial knock? - ✔✔classic constrictive pericarditis. Similar in
timing to a very loud S3. It's caused by an abrupt cessation of early diastolic inflow.
✔✔Thin filiform strands (fronds) that form on the edges of the AoV leaflets - ✔✔Lambl's
✔✔Name 2 layers of the pericardium - ✔✔visceral and parietal
,✔✔Which pericardial layer is the serous? - ✔✔visceral or epicardial
✔✔What is a common finding in coarctation - ✔✔Bi cuspid valves ( 50%)
✔✔When is a mitral pressure half time NOT accurate - ✔✔post valvuloplasty
✔✔Which embryonic aortic arch (1-6) develops into the transverse arch - ✔✔Fourth
✔✔In patients with A-Fib which heart sound would be missing- - ✔✔The fourth- occurs
during atrial contraction
✔✔Type of transposition of the great vessels where aorta is connected to Right
Ventricle and body receives deoxygenated blood. - ✔✔D-TGA Cyanosis, D=Die
✔✔Vegetation's of the Mitral Valve and/or Tricuspid Valve are seen on the __________
side of the valves - ✔✔Atrial
✔✔Vegs typically cause______ not______ - ✔✔regurg, not stenosis
✔✔What is the formula most often used to obtain MVA? - ✔✔P1/2t, Planimetry most
accurate but sonographer limitations and technical areas make P1/2t more common.
✔✔Time it takes for the pressure gradient to drop to half of its original valve- - ✔✔P1/2t
✔✔The most common secondary cause of dilated cardiomyopathy- - ✔✔Alcohol
✔✔The most common type of infiltrative restrictive cardiomyopathy- - ✔✔Amyloidosis
✔✔What is a classic finding of patients with restrictive cardiomyopathy? - ✔✔Bi-Atrial
enlargement caused by restricted diagnostic filling and leading to atrial overload
✔✔Complete endocardial cushion defects consist of what? - ✔✔An osmium primum
ASD, an inlet VSD, and a common AV valve
✔✔T/F, downs syndrome is associated with endocardial cushion defect - ✔✔True
✔✔________ valves are more durable. - ✔✔Mechanical. Tissue valves have a higher
failure rate.
✔✔The Ross procedure can be an intervention for congenital ________
________________. - ✔✔AS, AoV removed and replaced with the PV
,✔✔What is the most common place for an ASD? - ✔✔Area of the foramen Ovale also
known as the septum secundum
✔✔What maneuvers can cause a decrease in Left Ventricle volume and provoke mitral
valve prolapse - ✔✔Valsalva, administration of amyl nitrite
✔✔Type of murmur associated with Aortic Insufficiency - ✔✔Austin Flint
✔✔A delayed form of pericarditis - ✔✔Dressler's syndrome. Occurs after 1-12 weeks
after an MI
✔✔Endocardial cushion defects also known as AV septal defects occur in ______ % of
Down syndrome patients. - ✔✔40%
✔✔The most common echo finding in pts with AIDS is- - ✔✔Pericardial effusion,
cardiomyopathy is also common
✔✔------- to ------ % of pts with coarctation of the aorta also have a bicuspid valve. -
✔✔50 to 80
✔✔The steeper the slope of an AI P1/2t jet the more ----- the AI. - ✔✔Severe. This
means the LOWER the number the more SEVERE the AI.
✔✔An AI p1/2 of <_____ is severe AI - ✔✔<200 ( >500, mild)
✔✔Most common conduction abnormality with DCM- - ✔✔LBBB
✔✔What is a common arrhythmia associated with MVP? - ✔✔Paroxysmal
Supraventricular Tachycardia. It is believed this may be due to the stress and anxiety of
feeling chest pain, etc. This in turn provokes SVT.
✔✔Can transducers be heat sterilized? - ✔✔NO
✔✔Why should you look for a PFO is you are looking for an embolus? - ✔✔A PFO can
shunt a clot from the right side through the PFO into the left heart.
✔✔VTI Doppler traces gives information on what - ✔✔Mean velocities-- it can give both
peak and mean but only method of providing a mean pressure gradient
✔✔A ratio used to calculate the severity of a shunt- - ✔✔Qp/Qs--- Depending on the
location of the shunt a SV is determined for pulmonary blood flow vs. systemic blood
flow
, ✔✔What is the name of the procedure in which a pacer wire is placed in both the RV
and the CS? - ✔✔Cardiac resynchronization. LVF can improve with simultaneous
ventricular function
✔✔The normal wall thickness should be? - ✔✔<11 mm or <1.1 cm
✔✔Simpsons rule is used for measuring what? - ✔✔ejection fraction
✔✔What is the most accurate measurement for assessing LVF? - ✔✔Simpson's
✔✔The formula for the quantification of pulmonary blood volume vs systemic volume- -
✔✔Qp/Qs
✔✔With Qp/Qs, L to R shunts with volume overload to the right heart. When the right
heart or Qp volume is greater than ----- of the left heart or the Qs volume, the shunt is
significant. - ✔✔1.5
✔✔On M-Mode the aorta is measured at- - ✔✔End systole
✔✔External focusing of the transducer is done with what? - ✔✔The lens
✔✔Internal focusing of the transducer is with the - - ✔✔Curved element and phased
array focusing is with the electronics of the US system
✔✔Aliasing occurs when the velocity reaches more than____ of the PRF? - ✔✔1/2
✔✔Contrast can be used to _____ the Doppler signal in order to obtain an adequate
display - ✔✔Highlight
✔✔When using a contrast media the sonographer must _____ acoustic power -
✔✔Decrease, Higher power will burst the bubbles of contrast
✔✔Type of artifact caused by the regular periodic spacing of elements within the array.
They create artifacts by measuring time of flight to an object located outside the main
beam and placing the detected echo as if the interface were located along the US path
of the main beam - ✔✔Grating lobes
✔✔Grating lobes are found in ----- transducers. - ✔✔Array
✔✔An associated finding of Interatrial septal aneurysm is an - ✔✔ASD, An intertribal
septal aneurysm is bulging of the fossa ovals region of the interatrial septum. Septal
aneurysms have a high likelihood of fenestration (up to 90%)
