Download PrepIQ BEC011 Basic Echo Ultimate Exam and more Exams Technology in PDF only on Docsity!
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Question 1. Which physical property of an ultrasound wave determines its ability to resolve small structures? A) Frequency B) Amplitude C) Velocity D) Attenuation Answer: A Explanation: Higher frequency waves have shorter wavelengths, providing better axial resolution for small structures. Question 2. In soft tissue, the speed of sound is approximately: A) 340 m/s B) 1540 m/s C) 3000 m/s D) 5000 m/s Answer: B Explanation: The average speed of sound in most soft tissues is about 1540 m/s, a value used by ultrasound machines for distance calculations. Question 3. The piezoelectric crystal in a transducer converts: A) Electrical energy into magnetic fields B) Mechanical pressure into electrical voltage C) Light into sound D) Heat into mechanical motion Answer: B Explanation: Piezoelectric crystals generate an electrical signal when compressed and vibrate to produce sound when an electrical voltage is applied. Question 4. When imaging a neonate, the preferred transducer frequency is: A) 1–2 MHz B) 2–3 MHz C) 5–7 MHz D) 10–12 MHz
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Answer: C Explanation: Higher frequencies (5–7 MHz) provide better resolution for the small structures of neonates, while still penetrating adequately. Question 5. Time Gain Compensation (TGC) is used to: A) Increase frame rate B) Adjust gain at specific depths C) Change the field of view D) Reduce side-lobes Answer: B Explanation: TGC allows independent gain adjustments at multiple depth zones to compensate for attenuation of the ultrasound beam. Question 6. Which knob controls overall brightness of the image? A) Depth B) Focus C) Gain D) Dynamic range Answer: C Explanation: The gain knob amplifies all returning echoes, affecting overall image brightness. Question 7. A narrow sector width primarily improves: A) Frame rate B) Lateral resolution C) Depth penetration D) Temporal resolution Answer: B Explanation: Reducing sector width narrows the beam, decreasing lateral beam width and thus improving lateral resolution. Question 8. Acoustic shadowing is most commonly caused by: A) Highly reflective surfaces
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Question 12. Which valve prevents backflow from the left ventricle to the left atrium? A) Tricuspid valve B) Pulmonary valve C) Mitral valve D) Aortic valve Answer: C Explanation: The mitral (bicuspid) valve closes during left ventricular systole to stop regurgitation into the left atrium. Question 13. During isovolumic relaxation, which of the following is true? A) The mitral valve is open B) All valves are closed and ventricular pressure falls C) The aortic valve is open D) Blood is ejected into the aorta Answer: B Explanation: Isovolumic relaxation occurs after aortic valve closure and before mitral valve opening; ventricular volume remains constant while pressure drops. Question 14. The QRS complex on the ECG corresponds to: A) Atrial depolarization B) Ventricular depolarization C) Ventricular repolarization D) Atrial repolarization Answer: B Explanation: The QRS complex represents the rapid depolarization of the ventricles, which precedes mechanical contraction. Question 15. The normal pressure gradient between the left atrium and left ventricle during early diastole is approximately: A) 0 mmHg B) 2–5 mmHg
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C) 10–15 mmHg D) 30–40 mmHg Answer: B Explanation: Early diastolic filling is driven by a modest pressure difference (≈2– 5 mmHg) between LA and LV. Question 16. In the parasternal long-axis (PLAX) view, the aortic root is best visualized at which level? A) Mid-ventricular level B) At the mitral valve annulus C) At the level of the aortic valve cusps D) At the apex Answer: C Explanation: The PLAX view includes the aortic valve and proximal aortic root, allowing assessment of cusp morphology and root diameter. Question 17. The “Mercedes-Benz” sign is seen in which echocardiographic view? A) Parasternal long axis B) Parasternal short axis at the papillary muscle level C) Apical four-chamber D) Subcostal inferior vena cava view Answer: B Explanation: In the PSAX view at the level of the aortic valve, the three leaflets form a Mercedes-Benz-like pattern. Question 18. Which apical view allows direct measurement of the left ventricular outflow tract (LVOT) diameter? A) Apical two-chamber B) Apical three-chamber (A3C) C) Apical five-chamber (A5C) D) Apical four-chamber Answer: C
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A) 3–5 mm B) 6–11 mm C) 12–15 mm D) >15 mm Answer: B Explanation: A posterior wall thickness of 6–11 mm is considered normal for adult females and males. Question 23. The Simpson’s biplane method calculates ejection fraction by: A) Measuring Doppler velocity time integral B) Tracing end-diastolic and end-systolic areas in two orthogonal planes C) Using M-Mode linear dimensions only D) Applying the Bernoulli equation to LVOT flow Answer: B Explanation: Simpson’s rule sums the volumes of a series of disks derived from traced areas in the apical four- and two-chamber views. Question 24. “Eyeball” EF estimation is considered acceptable when the EF is: A) Exactly 55% B) Between 30% and 40% C) Clearly normal (>55%) or severely reduced (<35%) D) Between 45% and 50% Answer: C Explanation: Visual estimation is reliable when EF is distinctly normal or severely depressed; intermediate values require quantitative methods. Question 25. In color Doppler, the “BART” acronym stands for: A) Blue = Away, Red = Toward B) Baseline, Amplitude, Rhythm, Timing C) Brightness, Attenuation, Resolution, Transparency D) None of the above Answer: A
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Explanation: BART is a mnemonic to remember that blue indicates flow away from the transducer and red indicates flow toward it. Question 26. Pulse-wave (PW) Doppler is best suited for measuring: A) High-velocity jets across stenotic valves B) Low-velocity flow in peripheral arteries C) Velocity at a specific sample volume, such as mitral inflow D) Continuous flow across the aortic valve Answer: C Explanation: PW Doppler samples a single location, making it ideal for mitral inflow, LVOT, or carotid velocities. Question 27. Continuous-wave (CW) Doppler is necessary when evaluating: A) Mitral valve E-wave velocity only B) Low-velocity flow in the hepatic vein C) Severe aortic stenosis with high velocities (>4 m/s) D) Tissue motion (TDI) Answer: C Explanation: CW Doppler can record unlimited velocities without aliasing, essential for high-velocity jet assessment in severe stenosis. Question 28. Tissue Doppler imaging (TDI) primarily measures: A) Blood flow velocity B) Myocardial wall motion velocity (e’) C) Valve opening times D) Cardiac output Answer: B Explanation: TDI quantifies low-velocity, high-amplitude myocardial motion, providing e’ (early diastolic) and a’ (atrial contraction) velocities. Question 29. According to the simplified Bernoulli equation, a jet velocity of 3 m/s corresponds to a pressure gradient of: A) 9 mmHg
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Explanation: Tamponade typically causes hypotension, not hypertension; the other findings are classic. Question 33. In dilated cardiomyopathy, the left ventricular end-diastolic dimension (LVEDD) is usually: A) <45 mm B) 45–55 mm C) >55 mm D) >70 mm only in children Answer: C Explanation: Dilated cardiomyopathy features LV enlargement; LVEDD >55 mm in adults is a diagnostic criterion. Question 34. Hypertrophic cardiomyopathy (HCM) most often demonstrates: A) Global hypokinesis B) Asymmetric septal hypertrophy >15 mm C) Dilated atria with normal wall thickness D) Reduced LV outflow tract velocity Answer: B Explanation: HCM is characterized by disproportionate septal thickening, often >15 mm, leading to dynamic LVOT obstruction. Question 35. Which of the following is a contraindication to performing a transthoracic echo? A) Recent myocardial infarction B) Severe COPD with hyperinflated lungs C) Atrial fibrillation D) Mild hypertension Answer: B Explanation: Hyperinflated lungs attenuate the ultrasound beam, making image acquisition difficult; it is a relative contraindication. Question 36. The term “gain” on an ultrasound machine is synonymous with:
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A) Amplification of received echo signals B) Frequency selection C) Depth adjustment D) Frame rate control Answer: A Explanation: Gain amplifies the returning echo amplitudes, affecting overall image brightness. Question 37. Which of the following adjustments will improve lateral resolution without affecting axial resolution? A) Increase frequency B) Narrow sector width C) Increase overall gain D) Decrease depth Answer: B Explanation: A narrower sector reduces beam width laterally, enhancing lateral resolution while axial resolution (determined by frequency) remains unchanged. Question 38. The term “acoustic impedance” is defined as: A) The speed of sound in a medium B) Density × speed of sound of the medium C) The attenuation coefficient of tissue D) The frequency-dependent scattering factor Answer: B Explanation: Acoustic impedance (Z) equals tissue density (ρ) multiplied by sound speed (c); mismatches cause reflection. Question 39. When the ultrasound beam encounters a fluid-filled cyst, the typical artifact observed is: A) Shadowing B) Enhancement (posterior acoustic) C) Reverberation D) Mirror image
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Question 43. In a healthy adult, the normal right ventricular (RV) systolic pressure estimated by CW Doppler of the tricuspid regurgitant jet is: A) <20 mmHg B) 25–30 mmHg C) 35–45 mmHg D) >50 mmHg Answer: C Explanation: Using the simplified Bernoulli equation, a TR jet velocity of 2.5– 3.0 m/s yields an RV systolic pressure of ~35–45 mmHg, approximating normal. Question 44. Which view provides the most accurate measurement of the left atrial volume? A) Parasternal long axis B) Apical four-chamber (A4C) alone C) Biplane method using apical four- and two-chamber views D) Subcostal view Answer: C Explanation: The biplane Simpson’s method (A4C + A2C) gives a more precise LA volume than a single plane. Question 45. The presence of a “smoke” pattern in the left atrium on echo most likely indicates: A) Normal blood flow turbulence B) Atrial fibrillation with stasis, suggesting thrombus risk C) Mitral valve prolapse D) Pulmonary hypertension Answer: B Explanation: Spontaneous echo contrast (“smoke”) reflects low-velocity, stagnant blood, commonly seen in atrial fibrillation and increases thromboembolic risk. Question 46. Aortic regurgitation severity on color Doppler is primarily assessed by: A) Peak velocity of the regurgitant jet
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B) Width of the jet at the valve annulus (vena contracta) C) Presence of diastolic flow reversal in the abdominal aorta D) Both B and C Answer: D Explanation: Both vena contracta width and diastolic flow reversal in the descending aorta are key quantitative parameters for AR severity. Question 47. In mitral stenosis, the “pressure half-time” (PHT) is measured to estimate: A) Mitral valve area B) Peak gradient across the valve C) Left atrial pressure D) Aortic valve area Answer: A Explanation: PHT (time for the pressure gradient to halve) inversely correlates with mitral valve area; a longer PHT indicates a smaller valve area. Question 48. Which of the following is the most sensitive echocardiographic sign of early right-ventricular dysfunction? A) Decreased TAPSE (tricuspid annular plane systolic excursion) B) Increased RV end-diastolic area C) Reduced RV fractional area change (FAC) D) Elevated RV systolic pressure Answer: A Explanation: TAPSE is an easy, reproducible measure of RV longitudinal function; a reduction is an early indicator of RV systolic impairment. Question 49. The “M-mode” tracing of the mitral valve leaflets is commonly used to assess: A) Mitral regurgitation severity B) Mitral valve opening and closing times (E-point to septal separation) C) Aortic valve area D) Pulmonary artery pressure
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Question 53. In a patient with atrial fibrillation, the mitral inflow pattern typically shows: A) A distinct E-wave and A-wave B) Only an E-wave with absent A-wave C) Only an A-wave with absent E-wave D) No measurable flow Answer: B Explanation: In AF, atrial contraction is absent, eliminating the A-wave; only the early diastolic E-wave remains. Question 54. The “IVRT” (isovolumic relaxation time) is measured between: A) Aortic valve closure and mitral valve opening B) Mitral valve closure and aortic valve opening C) Systolic peak and diastolic trough in PW Doppler D) End-systolic and end-diastolic volumes Answer: A Explanation: IVRT is the interval from aortic valve closure to mitral valve opening, reflecting relaxation properties. Question 55. Which of the following best describes “Tissue harmonics” in ultrasound imaging? A) Use of higher-order frequencies generated by tissue to improve resolution B) Filtering out low-frequency noise C) Increasing the depth of penetration D) Reducing frame rate to improve image quality Answer: A Explanation: Tissue harmonic imaging utilizes the second-order harmonic frequencies produced by nonlinear propagation, reducing artifacts and enhancing resolution. Question 56. The term “dynamic range” on an ultrasound machine refers to: A) The range between the lowest and highest detectable echo amplitudes B) The frequency spectrum of the transducer
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C) The depth of field D) The number of frames per second Answer: A Explanation: Dynamic range controls the contrast; a wider range displays both weak and strong echoes, affecting image brightness and noise. Question 57. In the parasternal short-axis view at the level of the papillary muscles, the normal LV wall thickness is approximately: A) 2–4 mm B) 6–10 mm C) 12–15 mm D) >15 mm Answer: B Explanation: At the papillary muscle level, normal LV wall thickness (septum and posterior wall) is about 6–10 mm. Question 58. The “L-VOT” (left ventricular outflow tract) velocity-time integral (VTI) is used to calculate: A) Cardiac output when multiplied by LVOT area B) Mitral valve area C) Pulmonary artery pressure D) Right atrial pressure Answer: A Explanation: Stroke volume = LVOT area × VTI; multiplying by heart rate yields cardiac output. Question 59. Which of the following is NOT a typical feature of restrictive cardiomyopathy on echo? A) Bi-atrial enlargement B) Normal or mildly reduced LV size with thickened walls C) Marked pericardial effusion D) Elevated E/e’ ratio Answer: C
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A. Parasternal long axis B. Apical four-chamber with color Doppler C. Subcostal four-chamber D. Suprasternal notch Answer: C Explanation: The subcostal four-chamber view aligns the probe parallel to the septum, facilitating detection of ASDs and shunt flow. Question 64. The “vena contracta” measurement is taken at: A) The narrowest portion of a regurgitant jet just distal to the valve orifice B) The point where the jet first appears on color Doppler C) The center of the jet at the level of the valve leaflets D) The proximal aorta for aortic regurgitation Answer: A Explanation: Vena contracta width reflects the effective orifice area and is a reliable quantitative metric for regurgitation severity. Question 65. In a patient with severe mitral regurgitation, the left atrial volume is expected to be: A) Decreased due to low preload B) Normal because the LA compensates C) Increased due to chronic volume overload D) Unchanged regardless of severity Answer: C Explanation: Chronic MR leads to LA dilation from volume overload. Question 66. The “Friedrich’s sign” refers to: A) Aortic valve opening delay B) Early systolic flow reversal in the pulmonary artery in severe tricuspid regurgitation C) Color Doppler “blooming” artifact in high-gain settings D) None of the above Answer: B
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Explanation: Friedrich’s sign is the early systolic flow reversal seen in the pulmonary artery on CW Doppler in severe TR. Question 67. Which of the following best describes “frame rate” in echocardiography? A) Number of scan lines per sector B) Number of images displayed per second C) The frequency of the ultrasound wave D) The depth of the image field Answer: B Explanation: Frame rate (frames per second) determines temporal resolution; higher rates capture rapid cardiac motion more accurately. Question 68. The “systolic time interval” measured from the aortic valve opening to closure is called: A) Ejection time (ET) B) Pre-ejection period (PEP) C) Isovolumic contraction time (IVCT) D) Diastolic filling time (DFT) Answer: A Explanation: Ejection time is the duration of forward blood flow across the aortic valve during systole. Question 69. In the assessment of pulmonary hypertension, which echocardiographic parameter is most commonly used? A) Tricuspid regurgitant jet velocity B) Mitral valve E-wave velocity C) Aortic valve peak gradient D) LVOT VTI Answer: A Explanation: TR jet velocity, converted via Bernoulli, estimates right-systolic pressure, a surrogate for pulmonary artery pressure. Question 70. The “white-out” artifact on color Doppler is caused by:
