CCI ECHO REVIEW QUESTIONS AND
CORRECT ANSWERS
How does the administration of amyl nitrate or the Valsalva maneuver effect hypertrophic
obstructive cardiomyopathy's murmur ANSW✅✅The murmur associated with hypertrophic
obstructive cardiomyopathy is a harsh, systolic, Cresendo - decrescendo type. It is best heard cardiac
apex and left sternal border. It increases with the Valsalva maneuver and amyl nitrate
What are tge M-mode appearance of hypertrophic obstructive cardiomyopathy? ANSW✅✅Left
ventricular hypertrophy (symmetric or asymmetric), small left ventricular cavity, systolic anterior
motion (SAM) of the mitral valve
Name five causes of dilated cardiomyopathy. ANSW✅✅Idiopathic, infection (viral, bacterial,
fungal or parasitic), ischemia, toxic toxicity resulting from (alcohol abuse, lead poisoning, aids, or
drugs), peripartum state.
What are six classical findings associated with dilated cardiomyopathy? ANSW✅✅Dilated left
ventricle, increased EPSS, hypo contractile left ventricular wall motion, be notch on the mitral valve,
double diamond mitral valve( when the valve closes mid- diastole), decreased aortic root motion.
What are four causes of restrictive cardiomyopathy? ANSW✅✅Amloidosis, sarcoidosis,
hemochromatosis, glycogen storage disorders.
Amlyoidosis is the most common cause
The disease is restrictive with respect to physiology but the disease process is infiltrative because it
involves amyloid or sarcoid deposits within the myocardium.
The atria enlarge to greater extent that any type of cardiomyopathy.
Why does myocardium appear so bright in patients with restrictive cardiomyopathy?
ANSW✅✅High reflectivity (groundglass appearance) of the myocardium results from amyloid
deposits in amyloidosis or iron deposits in hemochromatosis. Although this "groundglass
appearance" is classic for infiltrative cardiomyopathies and should be included on any exam question
,with today's improve transducers and equipment Many easy to image patients will have very bright
myocardium.
Describe the appearance of restrictive cardiomyopathy as documented by 2 D echo imaging
What Doppler findings are associated with restrictive cardiomyopathy? ANSW✅✅Left ventricular
hypertrophy, a bright reflective myocardium, ventricular cavity that is normal or near normal in size,
atrial enlargement, small to moderate pericardial effusion (tamponade is rare)
Mitral and/or TR which is usually mild and abnormal mitral inflow patterns. The classic Doppler
pattern consists of a tall E wave, with rapid Decel, and a small A wave.
What would you do to prevent "ghosting"? ANSW✅✅Increase wall filter
PHYSICS**
Which of the following has the MOST impact on color Doppler jet size?
a. TGC
B. gain
C. frame rate
D. system volume control ANSW✅✅B. gain
Which of the following choices would NOT be used correct for pulsed wave Doppler aliasing?
A. shift the baseline
B. use continuous wave
C. use a higher frequency probe
D. decrease sample volume depth ANSW✅✅C. use a higher frequency probe
Scatters
Spectular reflectors ANSW✅✅RBC, smaller than the beam iregular
Smooth Diaphragm
,To improve the axial resolution of a transducer a manufacturer must do what to the pulse
ANSW✅✅shorten it
If the distance to the reflector doubles, the time between pulse transmission and echo detection at
the transducer will ANSW✅✅Double
The 2D image of a phased array echo is produced by ANSW✅✅Sequentially activating a series of
adjacent crystals to angulate the US beam
External focusing of the transducer is done with what? ANSW✅✅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? ANSW✅✅1/2
Contrast can be used to _____ the Doppler signal in order to obtain an adequate display
ANSW✅✅Highlight
When using a contrast media the sonographer must _____ acoustic power ANSW✅✅Decrease.
Higher power will burst the bubbles of contrast
Type of artifact caused by the regular periodic spacing of elements within the array.
ANSW✅✅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
A way of describing the extent to which a signal can vary yet still be accurately processed.
ANSW✅✅Measured in decibels (dB).Dynamic range
T/F, Doppler shift is directly related to transducer frequency ANSW✅✅True
The optimal Doppler angle for echo is degrees ANSW✅✅0-20 degrees
, What is the relationship of the sample depth and PRF? ANSW✅✅Inversely Proportional
What generates sound pulses that excites the transducers piezoelectric crystals and create sound
beams? ANSW✅✅Pulser
What determines amplitude, PRP, PRF? ANSW✅✅Pulser
T/F, the sonographer can adjust the electrical voltage spike of the Pulser ANSW✅✅True
A narrow dynamic range will do what to the gray shades, and contrast? ANSW✅✅Fewer shades
of gray and higher contrast
This artifact is created when sound reflects off a strong reflector and is redirected toward a second
structure ANSW✅✅Mirror image, the redirection causes a replica, second copy
This artifact is the result of width and length mode vibrations, immediate reverberations at crystal-
tissue interface and interference phenomena ANSW✅✅Side lobes
Side lobes are produced by ________ crystal transducers ANSW✅✅Single
A technique called ______ lower side lobes intensity for electronic arrays ANSW✅✅Apodization
T/F, moving the color box region of interest can change the frame rate ANSW✅✅True, if the ROI
is lower in the section it will decrease the frame rate.
T/F, changing the PRF will change the frame rate ANSW✅✅True increase PRF increase FR.
Decreasing image depth
Color Doppler can display ____ frequency shifts, the _____ of BF, and the _______ of flow
ANSW✅✅mean, direction, quality ( such as laminar or turbulent)
CORRECT ANSWERS
How does the administration of amyl nitrate or the Valsalva maneuver effect hypertrophic
obstructive cardiomyopathy's murmur ANSW✅✅The murmur associated with hypertrophic
obstructive cardiomyopathy is a harsh, systolic, Cresendo - decrescendo type. It is best heard cardiac
apex and left sternal border. It increases with the Valsalva maneuver and amyl nitrate
What are tge M-mode appearance of hypertrophic obstructive cardiomyopathy? ANSW✅✅Left
ventricular hypertrophy (symmetric or asymmetric), small left ventricular cavity, systolic anterior
motion (SAM) of the mitral valve
Name five causes of dilated cardiomyopathy. ANSW✅✅Idiopathic, infection (viral, bacterial,
fungal or parasitic), ischemia, toxic toxicity resulting from (alcohol abuse, lead poisoning, aids, or
drugs), peripartum state.
What are six classical findings associated with dilated cardiomyopathy? ANSW✅✅Dilated left
ventricle, increased EPSS, hypo contractile left ventricular wall motion, be notch on the mitral valve,
double diamond mitral valve( when the valve closes mid- diastole), decreased aortic root motion.
What are four causes of restrictive cardiomyopathy? ANSW✅✅Amloidosis, sarcoidosis,
hemochromatosis, glycogen storage disorders.
Amlyoidosis is the most common cause
The disease is restrictive with respect to physiology but the disease process is infiltrative because it
involves amyloid or sarcoid deposits within the myocardium.
The atria enlarge to greater extent that any type of cardiomyopathy.
Why does myocardium appear so bright in patients with restrictive cardiomyopathy?
ANSW✅✅High reflectivity (groundglass appearance) of the myocardium results from amyloid
deposits in amyloidosis or iron deposits in hemochromatosis. Although this "groundglass
appearance" is classic for infiltrative cardiomyopathies and should be included on any exam question
,with today's improve transducers and equipment Many easy to image patients will have very bright
myocardium.
Describe the appearance of restrictive cardiomyopathy as documented by 2 D echo imaging
What Doppler findings are associated with restrictive cardiomyopathy? ANSW✅✅Left ventricular
hypertrophy, a bright reflective myocardium, ventricular cavity that is normal or near normal in size,
atrial enlargement, small to moderate pericardial effusion (tamponade is rare)
Mitral and/or TR which is usually mild and abnormal mitral inflow patterns. The classic Doppler
pattern consists of a tall E wave, with rapid Decel, and a small A wave.
What would you do to prevent "ghosting"? ANSW✅✅Increase wall filter
PHYSICS**
Which of the following has the MOST impact on color Doppler jet size?
a. TGC
B. gain
C. frame rate
D. system volume control ANSW✅✅B. gain
Which of the following choices would NOT be used correct for pulsed wave Doppler aliasing?
A. shift the baseline
B. use continuous wave
C. use a higher frequency probe
D. decrease sample volume depth ANSW✅✅C. use a higher frequency probe
Scatters
Spectular reflectors ANSW✅✅RBC, smaller than the beam iregular
Smooth Diaphragm
,To improve the axial resolution of a transducer a manufacturer must do what to the pulse
ANSW✅✅shorten it
If the distance to the reflector doubles, the time between pulse transmission and echo detection at
the transducer will ANSW✅✅Double
The 2D image of a phased array echo is produced by ANSW✅✅Sequentially activating a series of
adjacent crystals to angulate the US beam
External focusing of the transducer is done with what? ANSW✅✅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? ANSW✅✅1/2
Contrast can be used to _____ the Doppler signal in order to obtain an adequate display
ANSW✅✅Highlight
When using a contrast media the sonographer must _____ acoustic power ANSW✅✅Decrease.
Higher power will burst the bubbles of contrast
Type of artifact caused by the regular periodic spacing of elements within the array.
ANSW✅✅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
A way of describing the extent to which a signal can vary yet still be accurately processed.
ANSW✅✅Measured in decibels (dB).Dynamic range
T/F, Doppler shift is directly related to transducer frequency ANSW✅✅True
The optimal Doppler angle for echo is degrees ANSW✅✅0-20 degrees
, What is the relationship of the sample depth and PRF? ANSW✅✅Inversely Proportional
What generates sound pulses that excites the transducers piezoelectric crystals and create sound
beams? ANSW✅✅Pulser
What determines amplitude, PRP, PRF? ANSW✅✅Pulser
T/F, the sonographer can adjust the electrical voltage spike of the Pulser ANSW✅✅True
A narrow dynamic range will do what to the gray shades, and contrast? ANSW✅✅Fewer shades
of gray and higher contrast
This artifact is created when sound reflects off a strong reflector and is redirected toward a second
structure ANSW✅✅Mirror image, the redirection causes a replica, second copy
This artifact is the result of width and length mode vibrations, immediate reverberations at crystal-
tissue interface and interference phenomena ANSW✅✅Side lobes
Side lobes are produced by ________ crystal transducers ANSW✅✅Single
A technique called ______ lower side lobes intensity for electronic arrays ANSW✅✅Apodization
T/F, moving the color box region of interest can change the frame rate ANSW✅✅True, if the ROI
is lower in the section it will decrease the frame rate.
T/F, changing the PRF will change the frame rate ANSW✅✅True increase PRF increase FR.
Decreasing image depth
Color Doppler can display ____ frequency shifts, the _____ of BF, and the _______ of flow
ANSW✅✅mean, direction, quality ( such as laminar or turbulent)
