Download ARDMS Echo RDCS Board Exam: Practice Questions and more Exams Advanced Education in PDF only on Docsity!
ARDMS Echo RDCS Board Registry
Practice Test Questions and Answers
Which is the following is the typical treatment for advanced pericarditis? a. thoracentesis b. stent placement c. heart transplant d. pericardectomy - ANS-d When recording flow velocity on the LVOT, the: a. PW Doppler cursor should be placed distal to the aortic valve closure b. CW doppler should be placed parallel to the aortic valve closure c. CW doppler should be placed perpendicular to the aortic valve closure d. PW Doppler cursor should be placed proximal to the aortic valve closure - ANS-d The ultrasound system relies on the ____________________ for accurate recording of motion clips on an echo a. R wave and T wave on the EKG b. system timer to be set at 5 seconds c. QRS on the EKG d. system timer to be set at 3 seconds - ANS-a Which of the following describes how to differentiate a ruptured chordae attached to a flail anterior mitral leaflet from a vegetation attached to the anterior mitral leaflet? a. Flail leaflets usually cause regurgitation and vegetations normally cause stenosis. b. Mitral vegetations normally form on the atrial side of the valve and the ruptured chordae related to a flail leaflet will be identified on the ventricular side of the valve. c. Vegetations are much more hypoechoic than the chordae tendinae. d. A flail mitral leaflet demonstrates a distinct appearance on m-mode that is easily differentiated from the m-mode appearance of vegetation on the valve. - ANS-b Which of the following decreases as aortic stenosis increases in severity? A: time velocity interval B: mean pressure gradient C: peak pressure gradient D: valve area - ANS-d Which of the following would be part of the standard patient history that should be obtained for every transesophageal echo but not for a
transthoracic echo?
shorter than normal deceleration time. Which of the following will cause this finding? A: grade 1 diastolic dysfunction B: restrictive cardiomyopathy C: pulmonary HTN D: mitral stenosis - ANS-b Which of the following right ventricular wall segments is seen on the apical 4 chamber view? A: Inferior B: Lateral C: Medial D: Anterior - ANS-b How do you measure the strain rate for a specific segment of the left ventricular wall? A: Measure the wall thickness in systole and diastole B: use m-mode to demonstrate the velocity of the segment of interest and the adjacent normal segments C: Take 2-3 tissue Doppler samples from the area of interest D: Take 2-3 PW Doppler samples from the area of interest - ANS-c If there is a weak signal and significant fluctuation in the vertical position of the EKG tracing across the screen: A: the skin contact with the electrodes is poor B: the EKG should be increased to a maximum level C: the alcohol used to clean the skin is causing artifact D: a cell phone or other nearby electrical device is causing interference - ANS-a A patient currently undergoing chemotherapy for breast cancer is referred for an echo. A small mass is noted within the right ventricular wall and a mild pericardial effusion. There is debris and fibrous strands throughout the effusion. The mass is in the right ventricle is most likely A: primary cardiac malignancy B: rhabdomyoma C: secondary cardiac malignancy D: myxoma - ANS-c Global longitudinal strain is measured from: A: parasternal views B: subcostal views C: apical views D: more than one of the above - ANS-c
Which of the following is the most common cause of tricuspid regurgitation? A: pulmonary HTN B: atherosclerosis C: prolapse D: rheumatic fever complication - ANS-a When measuring the left ventricular end systolic volume, you should use the cine function to: A: find the frame just after the MV closes B: find the frame just before the MV opens C: find the frame just before the AV opens D: find the frame at the peak of the R wave - ANS-b Which of the following statements is correct regarding tricuspid valve prolapse(TVP)? A: TVP rarely leads to significant tricuspid regurgitation. B: TVP most commonly occurs as an isolated finding. C: TVP refers to abnormal diastolic displacement of the valve leaflet into the RA. D: The anterior and septal leaflets are most commonly involved. - ANS-d Dobutamine is used to assess suspected hibernating myocardium. If the affected wall motion improves at low doses but declines at higher doses, A: the myocardium has irreversible damage and reperfusion would not be recommended B: the patient will be scheduled for a transesophageal echo to better evaluate the endocardium C: the patient will be scheduled for a reperfusion procedure D: the patient will be scheduled for a treadmill stress echo - ANS-c The echocardiogram demonstrates akinesis of the left ventricular apex. Which coronary artery is most likely affected by coronary artery disease? A: obtuse artery B: right coronary artery C: left anterior descending artery D: left circumflex artery - ANS-c Aortic and pulmonic insufficiency will cause A: a mid-diastolic murmur B: a crescendo-decrescendo murmur C: an early diastolic murmur D: an early systolic murmur - ANS-c
D: 25mmHg - ANS-a Severe dilatation of the aortic root is diagnosed at _____ or greater A: 5.0cm B: 6.0cm C: 4.5cm D. 3.8cm - ANS-a A Sonographer should instruct the patient on the use of the Borg Scale during: A: a stress echo B: a saline contrast exam C: a transesophageal echo D: a microbubble contrast exam - ANS-a Diastolic flow reversal in the hepatic veins and a mitral E/A ratio of 1.9 correlates with which of the following? A: constrictive pericarditis B: right upper and lower pulmonary vein stenosis C: moderate mitral stenosis D: 2mm perimembranous VSD - ANS-a The early heart tube normally: A: loops medially then laterally B: loops laterally then anterior C: loops anterior and to the right D: loops anterior and to the left - ANS-c Severe aortic regurgitation demonstrates A: a flat slope B: a very faint waveform pattern due to turbulence C: a peak velocity =5m/s D: a significant difference between the peak velocity at the onset and the end of the regurgitation - ANS-d What classic characteristic of hypertrophic cardiomyopathy is not identified in patients with focal mid-cavity hypertrophy? A: dagger shaped waveform at the narrowed area of the ventricle B: systolic crescendo-decrescendo murmur C: systolic anterior motion of the mitral valve D: turbulent flow at the area of narrowing in the ventricle - ANS-c Which pulmonary vein is able to be evaluated by PW Doppler in the apical 4 chamber view in most
patients? A: left upper B: right lower C: left lower D: right upper - ANS-d Leaflet redundancy and myxomatous degeneration are common signs of: A: subvalvular aortic stenosis B: mitral valve prolapse C: carcinoid disease D: supravalvular aortic stenosis - ANS-b You are performing an apical view during a microbubble contrast echo on a patient with suspected wall motion abnormalities in the basal anterolateral left ventricular segment. You notice significant swirling of the contrast in the area of the apex. How can you adjust the controls to reduce this artifactual swirling? A: move the focal zone to the apex B: inject contrast at a faster rate C: turn off harmonic imaging D: decrease the mechanical index setting - ANS-d Which of the following is true regarding an Austin Flint murmur? A: It is associated with significant mitral regurgitation causing mitral valve fluttering seen on the m-mode tracing. B: It is associated with a large VSD causing paradoxical interventricular septal motion seen on the m-mode. C It is associated with severe aortic regurgitation causing compression/vibration of the anterior mitral valve leaflet in diastole
C: E to A reversal D: dagger shaped waveform - ANS-a Renal cell carcinoma most commonly metastasizes to the heart through the A: IVC B: portal venous system C: lymphatic system D: aorta - ANS-a Which type of cardiomyopathy is related to fatty and fibrous tissue replacement of the myocardium of the right ventricle? A: right ventricular hemochromatosis B: lipomatous septal hypertrophy C: arrhythmogenic right ventricular cardiomyopathy D: endomyocardial fibrosis - ANS-c The pattern of wall hypertrophy in hypertensive heart disease is ______________, and in hypertrophic cardiomyopathy the pattern is usually ______________ A: symmetric, the same B: symmetric, asymmetric C: asymmetric, symmetric D: focal, diffuse - ANS-b A 22yr old patient presents for an echo and you identify biventricular wall thickening, mild pericardial effusion and thickening of the leaflets of all four valves. Which of the following is the most likely cause for these findings? A: amyloidosis B: hypertrophic cardiomyopathy C: carcinoid disease D: rheumatic fever - ANS-a A patient presents for an echo due to a recent stroke. The order states that they are looking for an embolic source for the stroke. She has been admitted to the hospital and is currently on her second day of Heparin treatment due to a recent diagnosis of DVT in her left leg. A recent VQ scan was normal with no evidence of pulmonary embolism. Which of the following is a potential reason for why the study was ordered? A: to evaluate the patient for CHF
B: to evaluate the patient for a possible vegetation on the tricuspid valve C: to evaluate the patient for a possible patent foramen ovale D: to evaluate the patient for a possible VSD - ANS-c Which of the following is a normal response seen
D: PW Doppler sample volume positioned in the center of the left atrial appendage - ANS-c Systole is defined as: A: from the end of the isovolumic contraction period to the start of the isovolumic relaxation period B: from mitral valve closure to aortic valve closure C: from the end of the isovolumic relaxation period to the start of the isovolumic contraction period D: from the opening of the aortic valve to aortic valve closure - ANS-b If the heart rate is 80bpm and the stroke volume is 50mL, what is the cardiac output? A: 4000mL B: 400 L/min C: 4 mL/min D: 4 L/min - ANS-d Which of the following should be suspected on the echo in the presence of a diastolic murmur? A: aortic stenosis B: MVP C: ASD D: mitral stenosis - ANS-d Which of the following adjustments should be made to the Doppler settings when evaluating left ventricular inflow in a patient with constrictive pericarditis? A: Decrease the PRF to demonstrate the expected low velocity peaks of the mitral waveform B: Decrease the sweep speed C: Increase the PRF to demonstrate the expected E peak velocities greater than 2.0m/s D: Increase the sweep speed - ANS-b The motion of which of the following wall segments can be evaluated on the apical four chamber view? A: basal anteroseptal wall B: mid anteroseptal wall C: lateral right ventricular wall D: basal inferolateral wall - ANS-c Which of the following is the most common type of infiltrative cardiomyopathy to develop restrictive cardiomyopathy? A: endomyocardial fibrosis
B: amyloidosis C: sarcoidosis D: Fabry disease - ANS-b Which of the following lab tests should be performed regularly for a patient with a Starr- Edwards valve? A: staphylococcus aureus levels B: prothrombin time C: white blood cell count D: eosinophil count - ANS-b Which of the following is the most likely EF% on a patient with dilated cardiomyopathy? A: 45% B: 85% C: 15% D: 60% - ANS-c A patient presents for a follow up scan due to a history of moderate aortic insufficiency noted on an exam 2 years ago. Which of the following would be an expected finding on the exam? A: hypercontractile left ventricle B: hypertrophic left ventricle C: atrophied left ventricle D: pulmonary artery dilatation - ANS-a A patient with a history of Marfan syndrome presents for his annual echo. What measurement is most important for you to obtain during today's exam? A: dp/dt B: peak velocity across the pulmonic valve C: LV wall thickness in diastole D: aortic root diameter - ANS-d What is the difference between an aortic dissection and an intramural hematoma? A: An intramural hematoma has no intimal flap or false lumen like a dissection does B: An intramural hematoma only affects the abdominal aorta and a dissection only affects the ascending segment
=65% suggests severe regurgitation All the following are caused by tricuspid regurgitation, except? A: IVC dilatation B: pulmonary HTN C: increased right atrial pressures D: right heart volume overload - ANS-b Where is the oblique sinus? A: at the LV apex B: posterior to the left atrium C: between the aortic root and left pulmonary artery D: between the aortic root and right pulmonary artery - ANS-b A 20yr old male presents for an echo with visible distension of the jugular veins. Which of the following is the least likely cause for this symptom? A: Aortic coarctation B: Pulmonary HTN C: Tricuspid stenosis D: Constrictive pericarditis - ANS-a
- Which the following is commonly demonstrated with right ventricular infarction? A: hypertrophied right ventricle B: dilated pulmonary artery C: dilated right ventricle D: high velocity tricuspid regurgitation - ANS-c A thin layer of muscle provides support for the atrial walls. A: pectinate B: precordial C: pectoralis D: papillary - ANS-a The McConnell sign refers to hyperdynamic motion of the apex of the right ventricle with akinesis of the free wall that is usually seen with: A: cortriatriatum B: congenital pulmonary stenosis C: acute pulmonary embolism D: chronic pulmonary HTN - ANS-c A peak emptying velocity of 15cm/s in the left atrial
appendage indicates: A: normal flow B: the presence of an ASD C: increased risk of thrombus formation D: stenosis of the outlet - ANS-c Average emptying flow velocity of the LAA is around 40cm/s. Flow moving <20cm/s indicates an increased risk of thrombus formation. The peak velocity of aortic regurgitation indicates the maximum pressure gradient between: A: the aorta and the left ventricular in systole B: the left ventricular and the left atrium in diastole C: the aorta and the left ventricular in diastole D: the left ventricle and the left atrium in diastole - ANS-c At what point in the cardiac cycle is the left ventricle at its greatest dimension? A: mid systole B: early diastole C: end diastole D: end systole - ANS-c Pectus excavatum is most commonly associated with what cardiac abnormality? A: Tetralogy of Fallot B: mitral stenosis C: MVP D: VSD - ANS-c The Doppler tracing is consistent with which of the following cardiac abnormalities?
Placing the transducer at the 5th intercostal space on the patient's chest can lead to A: an oval appearance of the left ventricle in short axis. B: a decreased angle between the interventricular septum and the aortic root in long axis. C: improved visualization of mitral valve prolapse. D: better visualization of the pulmonary artery. - ANS-a If a patient had a prior repair of an aortic dissection, what are the expected findings on the echo? A: thick linear reflection extending from the sinuses to the arch that inhibits all color Doppler evaluation B: it is not possible to repair an aortic dissection C: echodense, cylindrical structure with a uniform diameter attached to native sinuses D: multiple areas of increased echogenicity where the donor aorta was attached to the ventricle - ANS-c Which of the following is a characteristic of chronic systemic HTN identified on Doppler evaluation? A: E/A ratio=1. B: Left ventricular hypertrophy C: Tricuspid regurgitation D: E to A reversal - ANS-d A patient presents for an echo due to a recent stroke. Considering there is a normal septum, which of the following could be a potential cause? A: aortic valve stenosis B: right atrial rhabdomyoma C: dissection of the descending thoracic aorta D: tricuspid valve vegetation - ANS-a A patient presents for an echo and the order does not list an indication for the exam. You review the chart for the patient history to locate an appropriate indication for the echo. Which of the following is an appropriate indication to perform an echo? A: onset of systemic HTN 6 months ago B: lab work that demonstrates the presence of staphylococcus aureus
C: history of coumadin therapy D: suspected abdominal aortic aneurysm - ANS-b Which of the following views is preferred for measurement of the vena contracta of moderate aortic insufficiency? A: Parasternal short axis B: Apical 5 C: Parasternal long axis D: Apical 3 - ANS-c Which orthogonal plane is most commonly used to obtain a planimetry measurement of the mitral valve area? A: long axis B: short axis C: apical D: subcostal - ANS-b What is the major advantage of using color Doppler in transesophageal echo (TEE) evaluation of a prosthetic valve over color Doppler evaluation of the same valve on a transthoracic echo (TTE) exam? A: TEE Can identify paravalvular Ieakage which is usually very limited on a TTE. B: TEE can use color Doppler to assess the PISA radius of MR which is usually limited by valve masking on TTE. C: TEE can identify turbulence caused by valvular stenosis which cannot successfully be diagnosed on TTE. D: TEE can identify valvular dehiscence while TTE usually cannot diagnose this abnormality with color Doppler. - ANS-a The tricuspid valve opens _________ the mitral valve opens and closes __________ the mitral valve closes. A: after, before B: after, after C: before, after D: simultaneously with, 60ms before - ANS-c You are performing a bubble study to evaluate a patient with a possible pulmonary arteriovenous malformation(AVM). The standard echo demonstrates no shunt flow across the septum. Which of the following correctly describes what a positive study would demonstrate?
