ARDMS PRACTICE EXAM Correct 100%

The congenital cardiac anaomaly seen most frequently in adults is: A. Ebstein's anomaly B. Bicuspid aortic valve C. Ventricular septal defect D. Endocardial cushion defect - Answer B. Bicuspid aortic valve Which endocardiographic window is used in the detection and assessment of the inferior vena cava? A. apical B. subcostal C. parasternal D. suprsternal - Answer B. Subcostal What is the number and location of the papillary muscles of a normal mitral valve? A. one; the posteromedial B. two; the posterolmedial and anterolateral C. two; the inferolateral and posteromedial D. three; the anterolateral, posteromedial, and inferolateral - Answer B. two; the posterolateral and anterolateral Clinically, prolapse of the mitral valve is associated with: A. Opening snap and systolic murmur B. Diastolic murmur and third heart sound C. Fixed splitting of the second heart sound D. Midsystolic click and/or late systolic murmur - Answer D. Midsystolic click and/or late systolic murmur Papillary muscle dysfunction usually results from: A. Dressler's syndrome B. Ischemic heart disease C. Bacterial endocarditis D. Rheumatic heart disease - Answer B. Ischemic heart disease In order to record the vegetation's of endocarditis by echo, the vegetation's must have a diameter of at least: A. One centimeter B. Three millimeters C. Three centimeters D. Five millimeters - Answer B. Three millimeters How many veins connect the pulmonary vascular bed with the left atrium in the normal heart? A. one B. two C. three D. four - Answer D. four Which M-mode finding is considered to be a specific indicator of a fenestrated aortic valve? a. diastolic flutter of the mitral valve b. premature opening of the aortic valve c. diastolic flutter of the aortic valve d. eary systolic closure of the aortic valve - Answer c. diastolic flutter of the aortic valve Which cardiac abnormalities are frequently noted on the echocardiogram of patients with Marfan's syndrome? A. mitral stenosis and pericardial effusion B. mitral valve prolapse and aortic dilatation C. left ventricular aneurysm and thrombus formation D. dilatation of the pulmonary artery and pulmonic stenosis - Answer b. mitral valve prolapse and pericardial effusion Which term is used to describe a segment of ventrcular wall that exhibits no motion? A. akinesis B. dyskinesis C. hypokinesis D. hyperkinesis - Answer A. akinesis A true aneurysm of the left ventricle can usually be distinguished from a pseudoaneurysm because a pseudoaneurysm: A. has a smaller, more narrow neck than a true aneurysm B. never contain thrombi whereas a true aneurysm always contain a layered thrombus C. is always larger in overall size than a true aneurysm - Answer A. has a smaller, more narrow neck than a true aneurysm Which type of cardiomyopathy is associated with amyloidosis? a. congestive b. restrictive c. hypertrophic d. infiltrative - Answer d. infiltrative In a patient with carcinoid heart disease, the cardiac sonographer must devote special attention to identifying abnormalilties of the: a. aortic arch b. aortic valve c. mitral valve d. tricuspid valve - Answer d. tricuspid Which two-dimensional echocardiographic view is best for identifying the malformed tricuspid valve apparatus that characterizes Ebstein's anomaly: a. apical two chamber b. apical four chamber c. parasternal long axis d. parasternal short axis - Answer b. apical four chamber Infundibular pulmonary stenosis is uncommon as an isolated lesion and is usually associated with: a. tricuspid atresia b. atrial septal defect c. coarctation of the aorta d. ventricular septal defect - Answer d. Ventricular septal defect Which two-dimensional echocardiographic view is best for the assessment of the interatrial septum? a. apical long axis b. apical four chamber c. parasternal short axis d. subcostal four chamber - Answer d. subcostal The most common type of atrial septal defect is the: a. ostium primum b. sinus venosus c. coronary sinus d. ostium secundum - Answer d. ostium secundum M-mode echo demenstration of mid-systolic closure of the pulmonary valve along with a decreased "a" wave is most consistent with: a. pulmonary hypertension b. pulmonary insufficiency c. valvular pulmonary stenosis d. infundibular pulmonary stenosis - Answer a. pulmonary hypertension False overriding of the aorta may be produced on the M-mode echo by: a. using a transducer with too low a frequency b. failure to turn the patient into a left decubitus position c. positioning the transducer in too high an intercostal space d. positioning the transducer in too low an intercostal space - Answer c. positioning the transducer in too high an intercostal space Atrial fibrillation is most commonly associated with which valvular disease? a. bicuspid aortic valve b. mitral valve prolapse c. calcific aortic stenosis d. rheumatic mitral stenosis - Answer d. rheumatic mitral stenosis Which is an example of a bioprosthetic cardiac valve? a. Starr-Edwards ball b. Bjork-Shiley tilting disc c. St.Jude Medical bileaflet d. Ionescu-Shiley bovine pericardial - Answer D. Ionescu-Shiley bovine pericardial Doppler measures a pressure drop (gradient) by the Bernoulli equation. This equation actually measures the ___gradient across the valve. a. mean b. peak to peak c. peak instantaneous d. pressure half-time - Answer c. peak instantaneous When a patient has a clinical diagnosis of pericarditis: a. a pericardal effusion is always present on echo b. a pericardial effusion may not be present on echo c. pericardial thickening is always present on echo d. pericardial thickening must not be present on echo - Answer B. a pericardial effusion may not be present on echo In normal patients, most ventricular filling occurs: a. with atrial contraction b. in the first third of diastole c. in the middle third of diastole d. during the PR interval of the ECG - Answer b. in the first third of diastole The patient you are examining has clear cut auscultatory and angiographic evidence for mital prolapse, yet the resting echocardiogram is normal. You should then: a. raise the patient's leg b. perform a cold pressor test c. echo the patient in the standing position d. have the patient hold his breathe in deep inspiration - Answer c. echo the patient in the standing position Tricuspid valve closure normally occurs: a. before mitral closure b. simultaneous with mitral closure c. less than 0.06 seconds after mitral closure d. more than 0.06 seconds after mitral closure - Answer c. less than 0.06 seconds after mitral closure Kawasaki's disease may lead to: a. aortic valve prolapse b. tricuspid regurgitation c. coronary artery aneurysm d. ruptured chordae tendineae - Answer c. coronary artery aneurysm Which echocardiographic techinique is best for the detection of mitral regurg? a. M-mode b. pulsed Doppler c. two-dimensional d. apexcardiogram - Answer b. pulsed Doppler A two-dimensional echocardiogram shows increased thickness of the ventricular walls but normal LV size. The myocardium has a speckled appearance. Which type of cardiomyopathy might this represent? a. ischemic b. congestive c. infiltrative d. hypertrophic obstructive - Answer c. infiltrative Atrial myxomas are usually attached to the: a. left atrial appendage b. mitral valve leaflets c. posterior left atrial free wall d. fossa ovalis region of the atrial septum - Answer d. fossa ovalis region of the atrial septum Which 2-D views are best for direct imaging of the discrete subaortic membrane? a. parasternal long and short axis views b. apical five chamber and apical long axis views c. subcostal long axis and apical four chamber views d. parasternal long axis and apical two chamber views - Answer b. apical five chamber and apical long axis views The 2-D echocardiogram of a teenage boy shows that the mid-portion of the atrial septum cannot be seen. Which type of congenital heart disease might this patient have? a. supra-mitral ring b. cor triatrium c. ostium primum ASD d. ostium secundum ASD - Answer d. ostium secundum ASD Which is the best placement of the Doppler transducer for recording maximum velocities of flow across a bioprosethtic valve in the mitral position? a. apical four chamber b. parasternal long axis c. subcostal four chamber d. parasternal cross sectional - Answer a. apical four chamber Premature opening of the pulmonary valve may be seen in: a. cardiac tamponade b. pulmonary insufficiency c. constritive pericarditis d. acute severe pulmonary hypertension - Answer c. constrictive pericarditis When the velocity of blood flow exceeds the Doppler nyquist limit, the following occurs: a. dampening b. aliasing c. mirroring d. contouring - Answer b. aliasing