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ARDMS ACTUAL EXAM NEWEST 202 5/
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ARDMS EXAM
A patient is sent to the echo lab with a diagnosis of Marfan's Syndrome. Which of the following are you most likey to find? a. aortic rupture b. cleft mitral valve c. dilated aortic root d. pericardial effusion - CORRECT ANSWER>>c. dilated aortic root A young patient is sent to the echo lab with a diagnosis of Kawasaki's disease. Which of the following would you look for? a. ASD b. right atrial myxoma c. MVP d. regional wall motion abnormalities - CORRECT ANSWER>>d. regional wall motion abnormalities Normally pericardial fluid drains into the: a. pleural space b. coronary sinus c. peritoneal space d. lymphatic system - CORRECT ANSWER>>d. lympathic system A patient who has a higher blood pressure in the right arm than the left may have:
a. aortic stenosis b. hypoplastic left heart c. coarctation of the aorta d. patent ductus arteriosis - CORRECT ANSWER>>c. coarctation of the aorta Premature closure of the aortic valve on M-mode is most consistent with:
In normal patients why does the peak velocity of flow in the pulmonary artery occurs later than the peak velocity in the aorta? a. flow volume is lower b. flow volume is higher c. vascular resistance is lower d. vascular resistance is higher - CORRECT ANSWER>>c. vascular resistance is lower The beginning of systole is accompained by which heart sound:
3 | P a g e a. S b. S c. S d. S4 - CORRECT ANSWER>>a. S Of the following conditions, which is NOT a cause of increased left ventricular mass? a. aortic stenosis b. systemic hypertension c. MVP d. aortic insuff - CORRECT ANSWER>>c. MVP Which of the following terms refers to increased LV wall motion: a. dyskinesis b. hyperkinesis c. hypokinesis d. akinesis - CORRECT ANSWER>>b. hyperkinesis 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 - CORRECT 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 - CORRECT ANSWER>>B. Subcostal
4 | P a g e 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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
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 - CORRECT ANSWER>>b. apical four chamber
6 | P a g e 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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
7 | P a g e d. rheumatic mitral stenosis - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER>>c. echo the patient in the standing position
c. posterior left atrial free wall d. fossa ovalis region of the atrial septum - CORRECT 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
9 | P a g e d. parasternal long axis and apical two chamber views - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER>>b. aliasing
10 | P a g e Doppler ultrasound may show retrograde flow velocites within the ascending aorta during diastole in the presence of: a. aortic regurg b. patient ductus arterosis c. aorticpulmonary window d. aorticsubclavian shunts - CORRECT ANSWER>>a. aortic regurg A patient with a recent myocardial infarction is dianosised with Dressler's syndrome. Special care in performing a 2 - D study should be followed to rule out: a. RV infarction b. left atrial thrombi c. pericardial effusion d. aortic root dissection - CORRECT ANSWER>>c. pericardial effusion In a patient with mitral stenosis, a continuous wave Doppler study shows a peak diastole velocity of 2m/s. What is the peak pressure gradient across the mitral valve? a. 8 mm Hg b. 16 mm Hg c. 32 mm Hg d. 90 mm Hg - CORRECT ANSWER>>b. 16 mm Hg In patients with tricuspid atresia, blood flow will shunt from the right atrium to the left atrium through a: a. ostium primum defect b. patent foramen ovale c. coronary sinus defect d. patent ductus arteriosus - CORRECT ANSWER>>b. patent foramen ovale A 22 year old patient with Down Syndrome is referred to the echo lab. The most common lesion associated with these patients is: a. tetralogy of Fallot
b. bicuspid aortic valve c. AV septal defect d. transposition of the great arteries - CORRECT ANSWER>>c. AV septal defect What is the standard echo view for contrast study for an ASD? a. RVIT view b. RVOT view
