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ECHO URR 2026 EXAM COMPLETE (259)
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ECHO URR
Prepare for your ECHO URR Exam with this focused and comprehensive study guide. It covers echocardiography principles, ultrasound physics, cardiac anatomy, and image interpretation. Perfect for reinforcing key concepts and boosting exam confidence. Suitable for cardiac sonographers, echocardiography students, and cardiovascular healthcare professionals. Measure the peak velocity across the PFO, calculate the peak pressure gradient across the defect and add the RAP. ✓ ✓ …… ANSWER …… You identify a PFO on an echo and the cardiologist asks you to calculate the LAP. How will you perform this calculation? C) 2.5cm^2 MVA = 759 / deceleration time ✓ ✓ …… ANSWER …… The mitral deceleration time is 300msec. What is the valve area? A) 1.3cm^2 B) 2.8cm^2 C) 2.5cm^2 D) 1.5cm^ M-mode. M-mode is used to doc the MOTION of ball/disk in a mechanical valve. Doppler is used to assess the FLOW of the valve. ✓ ✓ …… ANSWER …… Which of the following is preferred to document motion of the disk in a St. Jude valve?
B) consult the physician for permission to perform contrast imaging; Suboptimal imaging of the LV wall motion on a 2D exam is an indication for contrast administration. A physician order for the contrast must be given, prior to performing the contrast exam. ✓ ✓ …… ANSWER …… A patient presents for an echo to rule out WMA. The TTE 2D exam is suboptimal. What should you do next? A) cancel the order and dismiss the patient B) consult the physician for permission to perform contrast imaging C) cancel the order and schedule the patient for a TEE D) contact the ordering physician to recommend that an MRI exam is ordered instead mean pressure gradient ✓ ✓ …… ANSWER …… Which Doppler measurement of flow through a stenotic AV best correlated w/ the same value obtained during heart catheterization? A) decreased LV function; The continuity equation compensates for the changes in LV function when calculating AVA. CW Doppler is used to assess flow across the AV. Because CW Doppler has no range resolution, it cannot determine the location of the elevated velocity. HOCM and supravalvular stenosis will cause an improper AVA calculation b/c the stenosis is not at the valve. A transcatheter AV replacement relies on the pressure gradients and the velocity ratio to assess stenosis. ✓ ✓ ……
B) mean pulmonary artery pressure; MPAP =4 x (peak velocity of PI)^2 The peak velocity of PI is peak diastolic velocity so it cannot be used to assess systolic pressure. The end diastolic velocity of PI can be used to assess the end diastolic pressure in the PA. ✓ ✓ …… ANSWER …… The peak velocity of PI can be used to assess: A) Peak systolic pulmonary artery pressure B) mean pulmonary artery pressure C) pulmonary artery end diastolic pressure D) severity of pulmonary stenosis D) the AVA will be underestimated by continuity equation; If the Doppler cursor is placed too far from the AV, the LVOT peak velocity will be reduced from what it would be at the correct location. This will cause the calculation of a smaller or underestimated AVA or overestimated level of stenosis. The peak aortic velocity and pressure gradient will not match the level of stenosis indicated by AVA. ✓ ✓ …… ANSWER …… If the LVOT Doppler tracing is obtained from a location that is too far from the AV: A) the SV will be overestimated B) the AVA will be overestimated by the continuity equation C) the LVOT velocity will be overestimated D) the AVA will be underestimated by continuity equation
C) end diastolic velocity of PI; PA end diastolic pressure = 4 (end diastolic pressure velocity of PI)^2 + RA pressure; normal PAEDP + 4 - 12mmhg ✓ ✓ …… ANSWER …… What Doppler measurement is necessary to calculate the end diastolic pressure in the pulmonary artery? A) peak pressure gradient of PI B) peak pressure of TR C) end diastolic velocity of PI D) peak systolic velocity of PI C) PS; The PA pressure is used to assess the pressure in the lungs. If the PV is stenotic, the flow velocity and resistance increase the pressures within the RV, TR is then related to the increased pressure at the valve instead of the lungs. ✓ ✓ …… ANSWER …… If is present, the RVSP calculation from the TR gradient is inaccurate as the measurement of the PAP. A) CHF B) PI C) PS D) PHTN C) ✓ ✓ …… ANSWER …… Which of the following correctly describes how AS is evaluated by catheterization?
A) ✓ ✓ …… ANSWER …… Which of the following correctly describes how to measure the acceleration time of the PV waveform? A) measure the time from onset of sys to the systolic peak B) trace the waveform from start to finish C) measure the slope of the line from the onset of systole to the systolic peak D) measure the distance from the onset of sys to the systolic peak C) bc the supine exercise bike is normally used for valvular assessment, imaging is performed at peak exercise to obtain the peak velocity ✓ ✓ …… ANSWER …… When is imaging performed during a stress echo using a supine exercise bike? A) within 30 sec after the cessation of exercise B) within 60 sec after the cessation of exercise C) during peak exercise D) when the HR increases by 50% from the rest D) ✓ ✓ …… ANSWER …… A patient presents for a 6 month follow up echo for a reported AVA of 1.0cm^2. On today's exam, the continuity equation demonstrates an AVA of 1.6cm^2. Which of the following could explain the variation in measurements?
A) improved EF% from the last exam B) overestimated aortic velocity on current exam C) overestimated LVOT diameter on prior exam D) overestimated LVOT diameter on current exam D) ✓ ✓ …… ANSWER …… Which of the following can be used to differentiate subvalvular from valvular AS? A) CW Doppler B) TDI of aortic annulus C) M-mode of the LV D) M-mode of the aortic cusps B) if the aortic root is dilated, the ascending, arch and descending aorta should be evaluated. This is the best accomplished by using the suprasternal view. The 2C can also provide the additional views of the descending thoracic aorta. ✓ ✓ …… ANSWER …… While performing the PLAX views of the heart, you notice dilation of the aortic root. Which 2D echo view will help best evaluate the extent of this aortic abnormality? A) 5C B) suprasternal long axis C) subcostal short axis
bioprosthetic valve is composed of less dense material and produce less artifact to obstruct flow visualization in the standard preferred apical view from MV assessment. ✓ ✓ …… ANSWER …… Which sonographic view best demonstrates the LV inflow across a bioprosthetic MV? A) subcostal B) PLAX C) PSAX D) apical B) less than 10% ✓ ✓ …… ANSWER …… The difference in LV length measuremens obtained in the 4C and 2C should be: A) less than 20% B) less than 10% C) less than 5mm D) less than 1 cm A) Infusion endpoints: Primary - when HR reaches 85% of maximum calculated HR. Maximum allowable dose of dobutamine received. WMA in 2 or more adjacent segments. Systolic BP greater than 200mmHg or less than 100mmHg, Diastolic BP >120mmHg ✓ ✓ …… ANSWER …… The dobutamine infusion for a stress
echo is typically stopped when the HR reaches 85% of the calculated maximum HR. Which of the following is a secondary reason the infusion will be stopped? A) systolic BP below 100mmHg B) diastolic BP below 100 mmHg C) systolic BP above 140mmHg D) motion abnormality in at least 1 wall segment D) LVEDP = diastolic BP - end diastolic pressure gradient of AI Ex: BP 120/66mmHg, end diastolic velocity of AI 3m/s 4(3)^2 = 36mmHg end diastolic pressure of the AI 66 - 36 = 30mmHg LVEDP ✓ ✓ …… ANSWER …… Which of the following measurements are required to calculate end diastolic pressure of the LV? A) systolic BP and end diastolic velocity of AI B) systolic BP and peak diastolic velocity of AI C) diastolic BP and peak diastolic velocity of AI D) diastolic BP and end diastolic velocity of AI A) when evaluating a pt for LVDD, you must know if the EF% is normal and there is no evidence of myocardial disease. ✓ ✓ …… ANSWER …… What is the first parameter to consider when assessing a pt for diastolic
Mitral decel time, IVRT time and E velocity ✓ ✓ …… ANSWER …… What Doppler measurements are normally used to evaluate a cardiac transplant for rejection? A ✓ ✓ …… ANSWER …… The American Society of Echo recommends that, whenever possible, all 2D and 3D measurements of the LV be take at the interface between: A) compacted and non compacted myocardium B) endocardial lining and blood C) blood and myocardium D) epicardial lining and blood D) the avg LVOT diameter is 2 - 2.3 ✓ ✓ …… ANSWER …… Which of the following correctly describes how to measure the LVOT diameter? A) leading to leading at mid systole B) inner to inner at mid diastole C) at the level of the AV insertion points D) 3 - 10 mm from the AV insertion points A) >40 is abnormal ✓ ✓ …… ANSWER …… A patient presents with a biventricular pacemaker. How do you assess the patient for myocardial dyssynchrony? A) PW Doppler of the LVOT and RVOT are performed toe
evaluate IVCT B) use m-mode to document the anterior and inferior wall motion C) PW Doppler of the LVOT and RVOT are performed to evaluate IVRT D) compare the AP diameters of the left and right atrium A) ✓ ✓ …… ANSWER …… Which of the following describes how to visualize all 3 hepatic veins on the same image? A) subcostal transverse view, angled toward the pt's right shoulder B) subcostal sagittal view, just to the right of the midline C) subcostal sagittal view, just to the left of the midline D) subcostal transverse view, angled towards the pt's left shoulder C) perimembranouse VSDs are associated with septal aneurysm formation. Doppler is normally used to evaluate flow across a VSD but not in the apical view. M-mode could be helpful in demonstrating abnormal motion of the aneurysmal segment and it is best evaluated in the parasternal or subcostal view. ✓ ✓ …… ANSWER …… A pt presents for an echo for pre-op evaluation for an upcoming knee surgery. He has no cardiac complaints. While performing the 5C, you notice a small, thinned aneurysmal portion of the IVS at the basal level. The chamber sizes are
D)
continuity - AVA bernoulli - pressure gradient dp/dt - assess LV systolic function ✓ ✓ …… ANSWER …… is used to estimate. A) continuity equation, peak pressure gradient at the AV B) bernoulli equation, RAP C) dp/dt, diastolic function of the LV D) simpson rule, LV EF% B) Nl pulmonary vasculature is low resistance and results in slower acceleration with the maximum velocity occurring later in the ejection cycle than the AV. The duration of the pulmonary flow is longer than the LV ejection time. The velocity curve is more rounded than the AV. If pulmonary vascular resistance increases, the pulmonary waveform looks more like the AV with a sharper velocity curve and earlier peak velocity. ✓ ✓ …… ANSWER …… Which of the following describes a difference in the normal Doppler tracings obtained at the AV and PV? A) the pulmonary acceleration time is much shorter than the aortic acceleration time B) the maximum velocity of the PV occurs later in the ejection cycle than the AV C) the aortic velocity curve is more rounded than the PV
D) the maximum velocity of the PV occurs earlier in the ejection cycle than the AV C) ✓ ✓ …… ANSWER …… Which of the following procedures can be performed during a left heart catheterization? A) pulmonary capillary wedge pressure assessment B) pulmonary angiography C) ventriculogram D) RVSP assessment B) surface rendering - convert the vol data into a list of polygons which represents the anatomical surface of interest; helpful for evaluation for chamber vol, EF, valves and atrial septum. Volume rendering - besides the anatomical surface, the details beneath the surface can also be visualized; helpful for evaluating LV segmental wall motion and cardiac masses. ✓ ✓ …… ANSWER …… 3D surface rendering is preferred for evaluating , while 3D volume rendering is preferred for. A) adults patients, pediatric patients B) valve characteristics, segmental wall motion C) the AV, the MV D) segmental wall motion,
A) peak E velocity of the TV B) E/A ratio C) LA vol index D) MR peak velocity Doppler evaluation of mitral inflow velocities during normal respiration. ✓ ✓ …… ANSWER …… What is the most reliable method for diagnosing cardiac tamponade? PSAX shows the origins of the coronary arteries from the aorta (coronary ostia) ✓ ✓ …… ANSWER …… Which view would best demonstrate the left and right coronary ostia? MR velocity and systolic BP ✓ ✓ …… ANSWER …… What measurements are necessary to calculate the LAP? A) LA; metastatic tumor formation usually affects the RA bc the blood form the primary cancer is drained by veins that connect to the IVC. The blood in the lungs drains in the pulmonary veins. Blood from the cancerous tumor(s) in the lungs will be emptied into the LA which can lead to metastatic tumor formation ✓ ✓ …… ANSWER …… a pt presents for an echo after a recent diagnosis of untreatable stage IV lung cancer. The order states "evaluate heart for signs of metastasis"? which cardiac structure should you evaluate first for signs of metastatic tumor formation? A) LA
B) aortic root C) RA D) RV D) the lv ejection time is measured from when the AV opens until it closes. LVET increases with increasing AS while an increase in HR can decrease LVET ✓ ✓ …… ANSWER …… Left ventricular ejection time is measured on the m-mode tracing of the. A) LV at the mid ventricle B) MV C) LV at the basal level D) AV C) decreasing the wall filter will allow for lower velocity flow to be more easily displayed. The sweep speed should be increased to spread out the flow properties of the venous flow. This allows the proper visualization of the S and D velocities along with the pea a-wave and duration. ✓ ✓ …… ANSWER …… Which of the following correctly describes how to perform a Doppler evaluation of the pulmonary venosus flow? A) decrease the wall filter and the sweep speed B) increase the wall filter and the sweep speed
