Download EACVI Transthoracic Echocardiography (TTE) Online Exam and more Exams Technology in PDF only on Docsity!
Question 1. What is the primary advantage of transthoracic echocardiography (TTE) over transesophageal echocardiography (TEE)? A) Better visualization of posterior cardiac structures B) Non-invasive nature and ease of access C) Superior image resolution in all cases D) Ability to visualize the esophageal and thoracic structures directly Answer: B Explanation: TTE is non-invasive and easily accessible, making it suitable for initial evaluation, whereas TEE provides superior images of posterior structures but is invasive. Question 2. In the evolution of transthoracic echocardiography, which technological advancement significantly improved real-time imaging? A) The introduction of contrast agents B) The development of digital ultrasound systems C) Use of 3D imaging technology D) The invention of Doppler ultrasound Answer: B Explanation: The shift to digital ultrasound systems allowed real-time, high-quality imaging, improving diagnostic capabilities in TTE. Question 3. Which is a key role of TTE in clinical cardiology? A) Definitive assessment of coronary artery patency B) Initial evaluation of cardiac structure and function C) Screening for pulmonary embolism D) Surgical planning for intracardiac tumors Answer: B Explanation: TTE is primarily used for initial assessment of cardiac anatomy, function, and hemodynamics, guiding further management. Question 4. How does TTE compare with cardiac MRI in the assessment of ventricular function?
A) TTE provides more detailed tissue characterization B) MRI offers higher spatial resolution and tissue contrast C) TTE is more accurate in detecting myocardial scars D) Both are equivalent in all aspects of ventricular assessment Answer: B Explanation: MRI provides superior tissue contrast and spatial resolution, especially for myocardial tissue characterization, while TTE is more accessible and quicker. Question 5. Which physical property of sound waves affects the resolution of echocardiography images? A) Frequency of the ultrasound wave B) Speed of sound in tissue C) Wavelength of the sound wave D) Both A and C Answer: D Explanation: Higher frequency ultrasound waves have shorter wavelengths, which improve resolution but reduce penetration depth. Question 6. The Doppler effect in echocardiography is used to assess which of the following? A) Cardiac chamber size B) Blood flow velocity and direction C) Wall motion abnormalities D) Valve morphology Answer: B Explanation: Doppler ultrasound measures blood flow velocity and direction, helping evaluate valvular function and intracardiac flow. Question 7. Which transducer type is most suitable for high-resolution imaging of superficial cardiac structures? A) Phased array transducer
D) Pulmonary valve Answer: B Explanation: The mitral valve separates the left atrium and left ventricle. Question 11. During the cardiac cycle, which phase corresponds to ventricular systole? A) Isovolumetric relaxation B) Ventricular filling C) Ejection phase D) Atrial contraction Answer: C Explanation: During ventricular systole, the ventricles contract, ejecting blood into the aorta and pulmonary artery. Question 12. The main purpose of standard parasternal echocardiographic views is to assess? A) Posterior cardiac structures only B) Anterior and lateral heart structures, including ventricles and valves C) The esophagus and descending aorta D) Coronary artery flow directly Answer: B Explanation: Parasternal views provide detailed images of anterior and lateral heart structures, including ventricles and valves. Question 13. Which imaging modality is best suited for detailed assessment of complex congenital heart defects during TTE? A) 2D echocardiography alone B) Transesophageal echocardiography (TEE) and 3D echocardiography C) MRI only D) Chest X-ray Answer: B
Explanation: TEE combined with 3D imaging provides detailed visualization of complex congenital anomalies. Question 14. M-mode echocardiography primarily provides information about? A) Blood flow velocities B) Rapid, precise measurements of cardiac structures and motion over time C) Tissue characterization D) Coronary flow reserve Answer: B Explanation: M-mode captures motion of cardiac structures along a single line over time, allowing precise measurements. Question 15. Which of the following is a key advantage of 3D echocardiography? A) Better tissue penetration than 2D B) Real-time volumetric assessment of cardiac chambers and valves C) Less operator dependency D) No requirement for specialized equipment Answer: B Explanation: 3D echocardiography allows real-time volumetric and spatial assessment of structures, improving diagnostic accuracy. Question 16. Which Doppler modality is used to assess high-velocity blood flow, such as in valvular stenosis? A) Pulsed wave Doppler B) Spectral Doppler C) Continuous wave Doppler D) Color Doppler Answer: C Explanation: Continuous wave Doppler measures high velocities without aliasing, suitable for stenosis evaluation.
A) Left ventricular systolic dysfunction B) Right ventricular systolic dysfunction C) Normal right ventricular function D) Valvular stenosis Answer: B Explanation: TAPSE measures right ventricular longitudinal contraction; reduced values suggest right systolic dysfunction. Question 21. Pulmonary artery pressure can be estimated in echocardiography by measuring: A) The size of the right atrium B) The tricuspid regurgitation velocity C) The left ventricular wall thickness D) The mitral inflow pattern Answer: B Explanation: The peak velocity of tricuspid regurgitant jet allows estimation of pulmonary artery systolic pressure. Question 22. Which of the following is a common feature of mitral stenosis on echocardiography? A) Increased mitral valve area and high transmitral flow B) Thickened leaflets with restricted opening and a decreased mitral valve area C) Echo-free space around the mitral valve D) Absence of commissural fusion Answer: B Explanation: Mitral stenosis involves thickened, fused leaflets leading to restricted opening and reduced valve area. Question 23. Bicuspid aortic valve is associated with which of the following? A) Increased risk of aortic stenosis and regurgitation B) Exclusive presence in the pulmonary valve
C) A normal variant with no clinical significance D) Increased risk of mitral valve prolapse only Answer: A Explanation: Bicuspid aortic valves are prone to early stenosis, regurgitation, and aortic dilation. Question 24. Vegetations in infective endocarditis are best visualized using which echocardiographic technique? A) Color Doppler only B) 2D TTE with or without transesophageal echocardiography (TEE) C) Spectral Doppler D) M-mode alone Answer: B Explanation: 2D echocardiography, especially TEE, is most sensitive for detecting vegetations. Question 25. Pericardial effusion appears on echocardiography as: A) A bright echo mass within the myocardium B) An echo-free space surrounding the heart C) Thickening of the pericardium with no fluid collection D) A shadow behind the heart with no fluid Answer: B Explanation: Pericardial effusion appears as an anechoic (echo-free) space around the heart. Question 26. Cardiac tamponade is characterized by: A) Large pericardial effusion with signs of compromised cardiac filling and hemodynamic instability B) Small effusion with no clinical significance C) Thickened pericardium without fluid accumulation D) Normal pericardial appearance Answer: A
A) Differential blood pressure in upper and lower limbs and post-stenotic dilation B) Isolated left atrial enlargement C) Isolated mitral regurgitation D) Absence of aortic arch Answer: A Explanation: Coarctation causes upper limb hypertension and post-stenotic dilation seen in imaging. Question 31. Which echocardiographic feature suggests Eisenmenger syndrome? A) Large VSD with bidirectional shunt and pulmonary hypertension B) Isolated atrial septal defect with normal pulmonary pressures C) Isolated mitral stenosis with normal pulmonary pressures D) Bicuspid aortic valve with no pulmonary hypertension Answer: A Explanation: Eisenmenger results from longstanding shunt with pulmonary hypertension leading to bidirectional or right-to-left flow. Question 32. In ischemic heart disease, wall motion abnormalities are best detected by: A) M-mode echocardiography alone B) 2D echocardiography with visual assessment of regional wall motion C) Spectral Doppler alone D) Transesophageal echocardiography only Answer: B Explanation: 2D imaging allows visualization of regional wall motion abnormalities characteristic of ischemia. Question 33. A typical feature of hypertrophic cardiomyopathy (HCM) on echocardiography is: A) Diffuse dilation of all chambers B) Asymmetric septal hypertrophy with preserved systolic function C) Thin ventricular walls with diastolic dysfunction
D) Presence of large ventricular septal defect Answer: B Explanation: HCM is characterized by asymmetric septal hypertrophy and preserved systolic function. Question 34. In dilated cardiomyopathy, echocardiography typically reveals: A) Thickened ventricular walls and normal chamber size B) Dilated ventricles with reduced systolic function C) Hypertrophic ventricles with hyperdynamic motion D) Normal ventricular size with restrictive filling pattern Answer: B Explanation: DCM presents with ventricular dilation and decreased systolic function. Question 35. Which of the following is a sign of restrictive cardiomyopathy on echocardiography? A) Dilated ventricles with poor wall motion B) Biatrial enlargement and abnormal diastolic filling patterns with preserved systolic function C) Asymmetric septal hypertrophy D) Large ventricular septal defects Answer: B Explanation: Restrictive cardiomyopathy shows biatrial enlargement and abnormal diastolic flow with preserved systolic function. Question 36. Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by: A) Fibrofatty replacement of right ventricular myocardium leading to dilation and arrhythmias B) Left ventricular hypertrophy with no arrhythmias C) Isolated left atrial enlargement D) Atrial septal defect and pulmonary hypertension Answer: A
Question 40. Cardiac tumors that are most likely to be attached to the interatrial septum are: A) Myxomas B) Lipomas C) Fibromas D) Sarcomas Answer: A Explanation: Myxomas commonly originate from the interatrial septum, especially in the left atrium. Question 41. Which feature suggests a thrombus rather than a tumor on echocardiography? A) Homogeneous echogenicity and attached to atrial septum B) Mobile with irregular borders and associated with atrial dilation C) Highly vascularized and infiltrative D) Large size with cystic components Answer: B Explanation: Thrombi are often mobile, irregular, and occur in dilated chambers, especially with atrial fibrillation. Question 42. In critically ill patients, point-of-care echocardiography is primarily used to assess: A) Coronary artery anatomy B) Hemodynamic status and ventricular function C) Detailed valvular morphology D) Myocardial perfusion Answer: B Explanation: Point-of-care TTE helps rapidly assess cardiac function and volume status in ICU settings. Question 43. Which of the following is an echocardiographic sign indicative of cardiac tamponade? A) Collapse of the right atrium and right ventricle during diastole
B) Large pericardial effusion with no chamber collapse C) Thickened pericardium without fluid D) Elevated pulmonary artery pressures without effusion Answer: A Explanation: Chamber collapse during diastole is a hallmark of tamponade physiology. Question 44. Vegetations in infective endocarditis are most often located on: A) Valve leaflets, especially on the line of closure B) The aortic arch C) The interventricular septum D) The pericardium Answer: A Explanation: Vegetations are usually attached to valve leaflets, particularly on the closure line. Question 45. Which echocardiographic feature is critical for evaluating prosthetic valve function? A) Valve leaflet mobility and regurgitation jet assessment B) Coronary flow velocity C) Pulmonary venous flow pattern only D) Myocardial strain rate Answer: A Explanation: Valve leaflet motion and regurgitation are key for assessing prosthetic valve function. Question 46. The primary purpose of stress echocardiography is to evaluate: A) Coronary artery anatomy directly B) Myocardial ischemia during increased workload C) Valve morphology at rest only D) Pericardial thickness
Question 50. The hallmark of arrhythmogenic right ventricular cardiomyopathy (ARVC) on echocardiography is: A) Right ventricular dilation, wall thinning, and regional akinesia or dyskinesia B) Left atrial enlargement only C) Bicuspid aortic valve D) Thickened interventricular septum Answer: A Explanation: ARVC presents with right ventricular dilation, regional wall motion abnormalities, and fibrofatty infiltration. Question 51. Non-compaction cardiomyopathy is diagnosed on echocardiography by: A) Presence of a thin, compacted myocardial layer B) Prominent trabeculations with deep intertrabecular recesses in the left ventricle C) Diffuse myocardial fibrosis D) Large septal defects Answer: B Explanation: It is characterized by excessive trabeculation and deep recesses in the myocardium, primarily in the left ventricle. Question 52. The term "heart failure with preserved ejection fraction" (HFpEF) refers to: A) Reduced systolic function with normal diastolic filling B) Normal systolic function but impaired relaxation and increased filling pressures C) Reduced chamber size and contractility D) Isolated right-sided failure only Answer: B Explanation: HFpEF involves normal EF but diastolic dysfunction with elevated filling pressures. Question 53. An echocardiographic feature indicating systolic heart failure is: A) Ejection fraction less than 40%
B) Normal chamber size with diastolic dysfunction C) Increased mitral E/A ratio only D) Biatrial enlargement without ventricular dilation Answer: A Explanation: Reduced EF (<40%) signifies impaired systolic function characteristic of systolic heart failure. Question 54. Cardiac myxomas are most commonly located in the: A) Left atrium, attached to the interatrial septum B) Right ventricle free wall C) Pulmonary artery D) Right atrium, attached to the superior vena cava Answer: A Explanation: Myxomas are predominantly found in the left atrium attached to the interatrial septum. Question 55. Differentiating a thrombus from a tumor on echocardiography often involves assessing: A) Mobility, shape, and attachment site B) Presence of calcification only C) Response to diuretics D) Echo density of the mass only Answer: A Explanation: Thrombi are often mobile and irregular, typically in areas of stasis, whereas tumors may be more homogeneous and attached to the endocardium. Question 56. In critical care echocardiography, assessment of fluid responsiveness often includes: A) Inferior vena cava (IVC) diameter and collapsibility B) Coronary artery flow velocities
Answer: A Explanation: Restricted leaflet motion and abnormal regurgitant jets indicate prosthetic valve malfunction. Question 60. Stress echocardiography is particularly useful for: A) Detecting inducible myocardial ischemia B) Assessing valvular morphology at rest C) Visualizing coronary arteries directly D) Detecting intracardiac tumors Answer: A Explanation: It evaluates for ischemia by assessing for new or worsening wall motion abnormalities under stress. Question 61. Asymmetric septal hypertrophy in hypertrophic cardiomyopathy often results in: A) Systolic anterior motion (SAM) of the mitral valve and dynamic outflow obstruction B) Fixed obstruction due to valvular stenosis C) Dilated ventricles with thin walls D) No effect on outflow tract dynamics Answer: A Explanation: Asymmetric septal hypertrophy causes SAM and dynamic obstruction during systole. Question 62. In dilated cardiomyopathy, the typical pattern of wall motion is: A) Uniform hypokinesia of all segments B) Normal systolic motion with diastolic dysfunction C) Asymmetric hypertrophy D) Hypercontractility of the apex only Answer: A Explanation: DCM generally shows global hypokinesia due to weakened myocardium.
Question 63. Biatrial enlargement on echocardiography is most characteristic of: A) Restrictive cardiomyopathy and longstanding atrial fibrillation B) Isolated ventricular septal defect C) Bicuspid aortic valve D) Pulmonary embolism Answer: A Explanation: Elevated filling pressures and atrial dilation are seen in restrictive cardiomyopathy and atrial fibrillation. Question 64. The hallmark feature of arrhythmogenic right ventricular cardiomyopathy (ARVC) on echocardiography includes: A) Right ventricular dilation, regional akinesia/dyskinesia, and fibrofatty infiltration B) Left ventricular hypertrophy with normal right ventricle C) Large atrial septal defect with no right ventricular changes D) Isolated left atrial enlargement Answer: A Explanation: ARVC involves fibrofatty replacement leading to right ventricular dilation and wall motion abnormalities. Question 65. The diagnosis of non-compaction cardiomyopathy often relies on: A) The ratio of non-compacted to compacted myocardial layers >2:1 during end-systole B) Presence of hypertrophied septum only C) Diffuse myocardial calcification D) Large pericardial effusion Answer: A Explanation: A non-compacted to compacted myocardium ratio >2:1 in systole is diagnostic. Question 66. Heart failure with preserved ejection fraction (HFpEF) is distinguished from systolic heart failure by: A) Normal or near-normal EF and abnormal diastolic parameters
