A Quiz On Cardiomyopathy For Pros

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A Quiz On Cardiomyopathy For Pros - Quiz

Cardiomyopathy is a disease of the heart muscle that makes it harder for your heart to pump blood to the rest of the body. There might be no signs or symptoms in the early stages of cardiomyopathy but as the disease advances symptoms become clearer. Take the quiz on cardiomyopathy for pros and gauge your knowledge.


Questions and Answers
  • 1. 

    All of the following are etiologies for congestive (dilated) cardiomyopathies except:

    • A.

      Metabolic

    • B.

      Viral

    • C.

      Peripartum

    • D.

      Ischemic

    • E.

      Hemochromatosis

    Correct Answer
    D. Ischemic
    Explanation
    Ischemic cardiomyopathy is specifically related to heart damage caused by myocardial ischemia, typically from coronary artery disease and heart attacks, leading to the heart muscle becoming weakened and dilated. This is different from congestive (dilated) cardiomyopathy, which can have various etiologies such as viral infections, metabolic disorders, hemochromatosis (iron overload), and it can occur peripartum (around the time of childbirth).

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  • 2. 

    Amyloid is what type of Cardiomyopathy?

    • A.

      Infiltrative

    • B.

      Restrictive

    • C.

      Congestive

    • D.

      Dilated

    • E.

      Hypertrophic

    Correct Answer
    B. Restrictive
    Explanation
    Amyloid cardiomyopathy is a type of restrictive cardiomyopathy. It is characterized by the deposition of abnormal proteins called amyloids in the heart muscle, which can lead to stiffening of the heart walls and impaired heart function.

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  • 3. 

    In patients with asymmetric septal hypertrophy what is the septal to posterior wall ratio?

    • A.

      1:5:1

    • B.

      1:3:1

    • C.

      1:1:3

    • D.

      1:1:5

    • E.

      Any ratio greater than 1:1

    Correct Answer
    B. 1:3:1
    Explanation
    In patients with asymmetric septal hypertrophy, the septal to posterior wall ratio is 1:3:1. This means that the thickness of the septum is 1 unit, while the thickness of the posterior wall is 3 units. This ratio indicates an abnormal thickening of the septum compared to the posterior wall, which is characteristic of asymmetric septal hypertrophy.

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  • 4. 

    Hemochromatosis is most commonly associated with which of the following cardiomyopathies?

    • A.

      Infiltrative

    • B.

      Dilated

    • C.

      Congestive

    • D.

      Hypertrophic

    Correct Answer
    A. Infiltrative
    Explanation
    Hemochromatosis is most commonly associated with infiltrative cardiomyopathy. Infiltrative cardiomyopathy refers to a condition where abnormal substances, such as iron in the case of hemochromatosis, accumulate in the heart muscle, causing damage and impairing its function. This can lead to symptoms such as fatigue, shortness of breath, and heart failure. Infiltrative cardiomyopathy is different from other types of cardiomyopathies like dilated, congestive, and hypertrophic, which have different underlying causes and characteristics.

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  • 5. 

    When amyl nitrite is administered to a patient who has hypertrophic obstructive cardiomyopathy it is likely to:

    • A.

      Decrease systolic flow velocity in the LVOT

    • B.

      Decrease septal thickening

    • C.

      Increases the systolic anterior motion of the MV

    • D.

      Increase pulmonary venous return

    Correct Answer
    C. Increases the systolic anterior motion of the MV
    Explanation
    Amyl nitrite is a vasodilator that relaxes smooth muscles, including the muscles in the walls of blood vessels. When administered to a patient with hypertrophic obstructive cardiomyopathy, it can cause a decrease in systemic vascular resistance, leading to a decrease in left ventricular outflow tract (LVOT) obstruction. This decrease in obstruction can result in an increase in the systolic anterior motion (SAM) of the mitral valve (MV). SAM occurs when the anterior leaflet of the MV is pushed towards the LVOT during systole, potentially causing further obstruction and worsening symptoms. Therefore, the administration of amyl nitrite can increase the SAM of the MV in patients with hypertrophic obstructive cardiomyopathy.

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  • 6. 

    The ratio of early transmitral (E) to atrial (A) Doppler filling velocities are influenced by all of the following factors except:

    • A.

      Patients age

    • B.

      Transducer freq

    • C.

      Left ventricular preload

    • D.

      Delayed left ventricular relaxation

    Correct Answer
    B. Transducer freq
    Explanation
    The ratio of early transmitral (E) to atrial (A) Doppler filling velocities is influenced by patient's age, left ventricular preload, and delayed left ventricular relaxation. However, the transducer frequency does not have an impact on this ratio. The transducer frequency determines the depth and resolution of the ultrasound image, but it does not affect the E/A ratio.

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  • 7. 

    Which of the following is a common echo finding in patients with a restrictive cardiomyopathy?

    • A.

      Left ventricular dilation

    • B.

      Asymmetric septal hypertrophy

    • C.

      Pericardial effusion

    • D.

      Right ventricular dilation

    • E.

      Normal left atrial size

    Correct Answer
    C. Pericardial effusion
    Explanation
    Pericardial effusion is a common echo finding in patients with restrictive cardiomyopathy. Restrictive cardiomyopathy is characterized by impaired filling of the ventricles due to stiffening of the heart muscle. Pericardial effusion refers to the accumulation of fluid in the pericardial sac surrounding the heart. This can be seen on an echocardiogram as an abnormal collection of fluid around the heart. The other options, such as left ventricular dilation, asymmetric septal hypertrophy, right ventricular dilation, and normal left atrial size, are not typically associated with restrictive cardiomyopathy.

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  • 8. 

    If your patient has right heart failure, what classic signs and symptoms would you expect to see?

    • A.

      Lower extremity edema

    • B.

      Hymoptysis

    • C.

      Atrial fib

    • D.

      TS

    Correct Answer
    A. Lower extremity edema
    Explanation
    In right heart failure, the right side of the heart is unable to effectively pump blood, leading to a buildup of fluid in the body. Lower extremity edema is a classic sign of right heart failure because the fluid tends to accumulate in the legs and ankles due to gravity. This can cause swelling and discomfort in the lower limbs. The other options, such as hemoptysis (coughing up blood), atrial fibrillation, and TS (which is not defined in the question), are not typically associated with right heart failure.

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  • 9. 

    Which of the following is a common Doppler finding in patients with a restrictive cardiomyopathy?

    • A.

      Mitral inflow Doppler not valid

    • B.

      E-greater than A on mitral inflow

    • C.

      Equal E to A on mitral inflow

    • D.

      A greater than E ratio on mitral inflow

    • E.

      Aortic outflow gradient

    Correct Answer
    B. E-greater than A on mitral inflow
    Explanation
    In patients with restrictive cardiomyopathy, the correct Doppler finding is E-greater than A on mitral inflow. This means that the early diastolic filling velocity (E) is greater than the late diastolic filling velocity (A) on the mitral inflow waveform. This finding is characteristic of restrictive cardiomyopathy and is due to impaired ventricular relaxation and increased stiffness of the ventricular walls, leading to decreased compliance of the ventricles.

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  • 10. 

    A cardiomyopathy is a disease that diffusely affects the____, resulting in enlargement and/or ventricular dysfunction

    • A.

      Heart valves

    • B.

      Epicardium

    • C.

      Myocardium

    • D.

      Endocardium

    Correct Answer
    C. Myocardium
    Explanation
    A cardiomyopathy is a disease that diffusely affects the myocardium, resulting in enlargement and/or ventricular dysfunction. The myocardium is the middle layer of the heart wall and is responsible for the contraction of the heart muscle. When the myocardium is affected by a cardiomyopathy, it can lead to the enlargement of the heart chambers and impair the heart's ability to pump blood effectively. Therefore, the correct answer is myocardium.

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  • 11. 

    M-mode findings in a patient with IHSS might include all the following except:

    • A.

      Asymmetric septal hypertrophy

    • B.

      MV prolapse

    • C.

      Systolic anterior motion of the MV

    • D.

      Mid-systolic closure of the AV

    Correct Answer
    B. MV prolapse
    Explanation
    In a patient with IHSS (idiopathic hypertrophic subaortic stenosis), M-mode findings may include asymmetric septal hypertrophy, systolic anterior motion of the MV (mitral valve), and mid-systolic closure of the AV (aortic valve). However, MV prolapse is not typically seen in IHSS.

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  • 12. 

    If a patient with IHSS has a resting outflow velocity of 3 m/sec what is the peak gradient?

    • A.

      9 mmHg

    • B.

      36 mmHg

    • C.

      100 mmHg

    • D.

      64 mmHg

    Correct Answer
    B. 36 mmHg
    Explanation
    The peak gradient in Hypertrophic Obstructive Cardiomyopathy (HOCM) is calculated using the simplified Bernoulli equation, which states that the pressure difference across a stenotic valve is equal to 4 times the square of the velocity of blood flow. In this case, the resting outflow velocity is given as 3 m/sec. Plugging this value into the equation, we get (4 * 3^2) = 36 mmHg. Therefore, the peak gradient is 36 mmHg.

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  • 13. 

    Patients with IHSS and a high resting outflow gradient may be offered which of the following treatments?

    • A.

      Contrast septal ablation

    • B.

      Lipitor medical therapy

    • C.

      Sublingual nitroglycerin

    • D.

      Surgical septal myectomy

    Correct Answer
    D. Surgical septal myectomy
    Explanation
    Patients with IHSS (idiopathic hypertrophic subaortic stenosis) and a high resting outflow gradient may be offered surgical septal myectomy as a treatment option. This procedure involves the surgical removal of a portion of the thickened septum in the heart, which helps to relieve the obstruction of blood flow and improve symptoms. Other treatment options such as contrast septal ablation, Lipitor medical therapy, and sublingual nitroglycerin may not be as effective in reducing the outflow gradient and improving symptoms in these patients.

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  • 14. 

    Patients with a restrictive cardiomyopathy typically have a Doppler finding of:

    • A.

      Prolonged isovolumic relaxation time interval

    • B.

      Respiratory variation in the early diastolic E wave

    • C.

      Large early E wave with short deceleration time and a small A wave

    • D.

      Small early E wave with a short decal time and a large A wave

    Correct Answer
    C. Large early E wave with short deceleration time and a small A wave
    Explanation
    In patients with restrictive cardiomyopathy, there is impaired relaxation and filling of the ventricles. This leads to a large early E wave on Doppler echocardiography, indicating rapid early filling. However, due to the impaired relaxation, there is a short deceleration time of the E wave, meaning that it quickly decelerates after reaching its peak. Additionally, there is a small A wave, which represents atrial contraction, because the impaired relaxation limits the amount of blood that can be ejected from the atria into the ventricles.

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  • 15. 

    All of the following are echo findings in patients with hypertrophic obstructive cardiomyopahty except:

    • A.

      Decreased EF

    • B.

      Midsystolic closure of the aortic valve

    • C.

      LVH

    • D.

      SAM of the MV

    • E.

      Small left ventricular cavity size

    Correct Answer
    A. Decreased EF
    Explanation
    Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by the thickening of the heart muscle, particularly the left ventricle. Common echo findings in HOCM include left ventricular hypertrophy (LVH), systolic anterior motion of the mitral valve (SAM), midsystolic closure of the aortic valve, and a small left ventricular cavity size. However, decreased ejection fraction (EF) is not typically seen in HOCM. EF is a measure of how well the heart is pumping blood and is usually reduced in conditions such as heart failure, but it is not a characteristic finding in HOCM.

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  • 16. 

    All of the following might be a physical symptom in patients with congestive dilated cardio except:

    • A.

      Sinus tachycardia

    • B.

      Edema

    • C.

      Systemic hypertension

    • D.

      Fatigue

    • E.

      Dyspnea

    Correct Answer
    C. Systemic hypertension
    Explanation
    Congestive dilated cardio refers to a condition where the heart becomes enlarged and weakened, leading to poor blood circulation. Sinus tachycardia, edema, fatigue, and dyspnea are all physical symptoms commonly seen in patients with congestive dilated cardio. However, systemic hypertension, which is high blood pressure, is not typically associated with this condition. In fact, congestive dilated cardio often leads to low blood pressure rather than high blood pressure.

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  • 17. 

    Patients with hypertrophic obstructive cardio will often have “bright” myocardial appearance by echo due to:

    • A.

      Amyloid deposits

    • B.

      Using too high a gain setting

    • C.

      Myocardial fiber disarray

    • D.

      LVH

    • E.

      Small cavity size

    Correct Answer
    C. Myocardial fiber disarray
    Explanation
    Patients with hypertrophic obstructive cardiomyopathy (HOCM) often have a "bright" myocardial appearance by echo due to myocardial fiber disarray. In HOCM, the myocardial fibers are disorganized and arranged in a haphazard manner, leading to abnormal thickening of the left ventricle. This results in increased echogenicity or brightness on the echocardiogram. The other options, such as amyloid deposits, using too high a gain setting, LVH (left ventricular hypertrophy), or small cavity size, are not the primary reasons for the bright myocardial appearance in HOCM.

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  • 18. 

    Patients with Chagas Disease might develop which type of cardio?

    • A.

      Infiltrative

    • B.

      Ischemic

    • C.

      Restrictive

    • D.

      Congestive

    • E.

      Hypertrophic

    Correct Answer
    D. Congestive
    Explanation
    Patients with Chagas Disease might develop congestive cardio because Chagas Disease is a parasitic infection caused by the Trypanosoma cruzi parasite. This infection can lead to inflammation and damage to the heart muscle, resulting in congestive heart failure. Congestive heart failure occurs when the heart is unable to pump enough blood to meet the body's needs, leading to symptoms such as fluid retention, shortness of breath, and fatigue. Therefore, congestive cardio is a possible complication of Chagas Disease.

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  • 19. 

    All of the following are echo finding in patients with congestive (dilated) cardio except:

    • A.

      Reduced MV excursion

    • B.

      Global hypokinesis

    • C.

      Dilated LV

    • D.

      LV hypertrophy

    • E.

      Increased aortic root excursion

    Correct Answer
    E. Increased aortic root excursion
    Explanation
    Increased aortic root excursion is not typically associated with echo findings in patients with congestive (dilated) cardio. Echo findings commonly seen in these patients include reduced mitral valve excursion, global hypokinesis, dilated left ventricle, and left ventricular hypertrophy. Increased aortic root excursion is not a typical finding in this condition.

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  • 20. 

    Patients with advanced symptoms from having a dilated cardio might benefit from all of the following except:

    • A.

      MV replacement

    • B.

      Intra-aortic balloon pump

    • C.

      LV assist device

    • D.

      Heart transplant

    Correct Answer
    A. MV replacement
    Explanation
    Patients with advanced symptoms from having a dilated cardio may benefit from interventions such as intra-aortic balloon pump, LV assist device, and heart transplant. However, mitral valve (MV) replacement may not be beneficial in this case. MV replacement involves replacing the damaged mitral valve with a prosthetic valve, which may not directly address the symptoms caused by dilated cardio. Other interventions mentioned are more suitable for managing the advanced symptoms and improving the patient's condition.

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  • 21. 

    What is the proper technique for Dopplering the Mitral inflow looking for diastolic dysfunction:

    • A.

      Apical 4 ch, pulsed Doppler, at mitral annulus

    • B.

      Apical 2ch, pulsed Doppler, at mitral tips

    • C.

      Apical 2ch, pulsed Doppler, at mitral annulus

    • D.

      Apical 4ch, color Doppler, at mitral tips

    • E.

      Apical 4ch, pulsed Doppler, at mitral tips

    Correct Answer
    E. Apical 4ch, pulsed Doppler, at mitral tips
    Explanation
    The proper technique for Dopplering the Mitral inflow looking for diastolic dysfunction is to use Apical 4ch view, pulsed Doppler, at mitral tips. This allows for the evaluation of the flow pattern across the mitral valve during diastole, which is important in assessing diastolic function. The Apical 4ch view provides a clear visualization of the mitral valve and the pulsed Doppler allows for the measurement of the E and A wave velocities, which are indicators of diastolic dysfunction. Dopplering at the mitral tips ensures accurate measurement of the flow across the valve.

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  • 22. 

    Which echo findings are typically associated with IHSS

    • A.

      LVH and decrease left ventricular contractility

    • B.

      Left ventricular enlargement and abnormal septal thinning

    • C.

      SAM of the MV and asymmetric septal hypertrophy

    • D.

      Redundant MV leaflets and RV enlargement

    Correct Answer
    C. SAM of the MV and asymmetric septal hypertrophy
    Explanation
    SAM (systolic anterior motion) of the MV (mitral valve) and asymmetric septal hypertrophy are typically associated with IHSS (idiopathic hypertrophic subaortic stenosis). SAM refers to the abnormal movement of the mitral valve during systole where the valve moves towards the septum, obstructing the left ventricular outflow tract. Asymmetric septal hypertrophy refers to the thickening of the interventricular septum in a non-uniform manner. These findings are characteristic of IHSS, a condition where the left ventricle becomes abnormally thickened, leading to obstruction of blood flow out of the heart.

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  • 23. 

    Patients with a dilated cardio may develop apical thrombi. When looking for them in the LV apex you should use:

    • A.

      Tissue harmonic imaging

    • B.

      Higher freq transducer

    • C.

      Lower freq transducer

    • D.

      Saline contrast

    Correct Answer
    B. Higher freq transducer
    Explanation
    A higher frequency transducer should be used when looking for apical thrombi in the LV apex of patients with a dilated cardio. This is because a higher frequency transducer provides better resolution and allows for clearer imaging of small structures, such as thrombi, in the heart. Using a lower frequency transducer may not provide sufficient resolution to detect these small structures. Tissue harmonic imaging and saline contrast are not specifically mentioned as necessary for detecting apical thrombi in this context.

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  • 24. 

    Which of the following is an echo finding in patients with DCM?

    • A.

      Increased ventricular function

    • B.

      Increased MV excursion

    • C.

      Exaggerated E-point to septal separation

    • D.

      Exaggerated aortic root excursion

    • E.

      B-notch on the M-mode

    Correct Answer
    E. B-notch on the M-mode
    Explanation
    An echo finding in patients with DCM is the presence of a B-notch on the M-mode. This refers to a dip or notch in the systolic descent of the left ventricular posterior wall. It is often seen in dilated cardiomyopathy and is thought to be due to abnormal myocardial relaxation and early closure of the aortic valve. The B-notch is not a normal finding and can be indicative of impaired left ventricular function.

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  • 25. 

    By echo, patients with congestive cardio have LV that are:

    • A.

      Thick and hyperdynamic

    • B.

      Increased shortening fraction and hypertrophy

    • C.

      Dilated and poorly contracting

    • D.

      Hypertrophied with normal chamber size

    Correct Answer
    C. Dilated and poorly contracting
    Explanation
    Patients with congestive cardio have dilated and poorly contracting left ventricles. This means that the left ventricle of the heart is enlarged and not functioning effectively, resulting in reduced pumping ability. This can lead to symptoms such as fatigue, shortness of breath, and fluid retention. The dilation and poor contraction of the left ventricle are characteristic features of congestive cardio, indicating a weakened heart muscle.

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  • 26. 

    All of the following are etiologies for restrictive (infltrative) cardio except:

    • A.

      Sarcoidosis

    • B.

      Endomyocardial fibrosis

    • C.

      Renal failure

    • D.

      Amyloidosis

    • E.

      Hemochromatosis

    Correct Answer
    C. Renal failure
    Explanation
    Restrictive (infiltrative) cardiomyopathy is a condition in which the heart muscle becomes stiff and less able to relax and fill with blood. This can be caused by various diseases that infiltrate the heart muscle, such as sarcoidosis, endomyocardial fibrosis, amyloidosis, and hemochromatosis. However, renal failure is not typically considered an etiology for restrictive cardiomyopathy. Renal failure primarily affects the kidneys and can lead to fluid overload and high blood pressure, but it does not directly infiltrate or stiffen the heart muscle.

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  • 27. 

    All of the following are Doppler findings in patients with hypertrophic obstructive cardio except:

    • A.

      \Subaortic turbulence by color flow

    • B.

      Late peaking systolic spectral trace

    • C.

      Increased a-to-e ratio on mitral inflow

    • D.

      Outflow gradient that decreases with a valsalva maneuver

    • E.

      Outflow gradient that increases with a valsalva maneuver

    Correct Answer
    D. Outflow gradient that decreases with a valsalva maneuver
    Explanation
    In patients with hypertrophic obstructive cardiomyopathy (HOCM), the outflow gradient typically increases with a valsalva maneuver due to increased obstruction. This is known as the "systolic anterior motion" (SAM) phenomenon. Therefore, the correct answer is "Outflow gradient that decreases with a valsalva maneuver" because it is not a Doppler finding seen in HOCM.

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  • 28. 

    Patients with IHSS and a high resting outflow gradient may benefit from a surgical septal myectomy to decrease the gradient. What is a common complication from this procedure

    • A.

      Atrial fib

    • B.

      Mitral regurg

    • C.

      VSD

    • D.

      AI

    Correct Answer
    C. VSD
    Explanation
    A common complication from a surgical septal myectomy procedure is the development of a ventricular septal defect (VSD). This refers to an abnormal hole in the septum, the wall that separates the left and right ventricles of the heart. This can occur due to the surgical manipulation of the septum during the myectomy, leading to a rupture or tear in the tissue. VSD can result in symptoms such as heart murmurs, shortness of breath, and fatigue, and may require additional interventions or surgical repair.

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  • 29. 

    Common echo findings in dilated cardio include all the following except:

    • A.

      Increased LV wall thickness

    • B.

      Diffusely reduced ventricular contractility

    • C.

      Dilated atrial and ventricular cavities

    • D.

      Low Doppler velocitiy in the LVOT

    Correct Answer
    A. Increased LV wall thickness
    Explanation
    The correct answer is "Increased LV wall thickness." In dilated cardio, there is usually a thinning of the LV wall rather than an increase in thickness. Dilated cardio refers to the enlargement of the atrial and ventricular cavities, which is one of the common echo findings. Additionally, there is diffusely reduced ventricular contractility, meaning that the heart muscles are not contracting properly. Low Doppler velocity in the LVOT (left ventricular outflow tract) may also be observed.

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  • 30. 

    Patients with a hypertrophic cardio usually have an EF in the range of

    • A.

      40-55%

    • B.

      70-80%

    • C.

      25-35%

    • D.

      10-20%

    • E.

      50-65%

    Correct Answer
    B. 70-80%
    Explanation
    Patients with hypertrophic cardiomyopathy usually have an EF (ejection fraction) in the range of 70-80%. EF is a measure of how well the heart is pumping blood. In hypertrophic cardiomyopathy, the walls of the heart become thickened, which can affect the heart's ability to pump blood effectively. However, in some cases, the EF may be preserved or even increased due to the increased contractility of the heart muscle. Therefore, a higher EF range of 70-80% is more commonly seen in patients with hypertrophic cardiomyopathy.

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  • 31. 

    Contraindications to amyl nitrite inhalation include all of the following except:

    • A.

      Moderate mitral regurg

    • B.

      Allergies to nitrites

    • C.

      Severe aortic stenosis

    • D.

      Hemodynamic instability

    • E.

      Recent stroke

    Correct Answer
    A. Moderate mitral regurg
    Explanation
    Amyl nitrite inhalation is a medication used to treat angina and cyanide poisoning. It works by relaxing blood vessels and increasing blood flow. Contraindications are conditions or factors that make it unsafe or inappropriate to use a particular treatment. In this case, the contraindications to amyl nitrite inhalation include allergies to nitrites, severe aortic stenosis, hemodynamic instability, and recent stroke. However, moderate mitral regurgitation is not listed as a contraindication, meaning that it is not a reason to avoid using amyl nitrite inhalation.

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  • 32. 

    The restrictive transmitral filling pattern is most consistently associated with which physiological parameters?

    • A.

      Elevated LA pressures, decreased ventrciulatr stiffness

    • B.

      Elevated LA pressures, increased ventricular stiffness

    • C.

      Low LA pressures, decreased ventricular stiffness

    • D.

      Low LA pressures, increased ventricular stiffness

    Correct Answer
    B. Elevated LA pressures, increased ventricular stiffness
    Explanation
    The restrictive transmitral filling pattern is characterized by a rapid early filling phase followed by a reduced late filling phase. This pattern is most commonly seen in conditions with elevated left atrial (LA) pressures and increased ventricular stiffness. Elevated LA pressures can occur due to conditions such as left ventricular hypertrophy, diastolic dysfunction, or mitral valve disease. Increased ventricular stiffness can be caused by conditions such as myocardial fibrosis or infiltrative diseases. Together, these physiological parameters contribute to the restrictive transmitral filling pattern.

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  • 33. 

    The shape of the LV as it remodels in patients with a dilated cardio is:

    • A.

      Elongated

    • B.

      Asymmetric

    • C.

      Rectangular

    • D.

      Spherical

    Correct Answer
    D. Spherical
    Explanation
    The shape of the LV as it remodels in patients with a dilated cardio is spherical. In dilated cardiomyopathy, the left ventricle becomes enlarged and weakened, leading to a spherical shape. This change in shape is due to the stretching and thinning of the ventricular walls. The spherical shape is a characteristic feature of dilated cardiomyopathy and can be visualized through imaging techniques such as echocardiography.

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  • 34. 

    In a patient with IHSS:

    • A.

      SAM of the MV will decrease with a valsalva maneuver

    • B.

      MR is often present

    • C.

      LV posterior wall to septal ratio is usually greater than 1.3

    • D.

      In aortic valve will show mid-diastolic closure

    Correct Answer
    B. MR is often present
    Explanation
    In a patient with IHSS (idiopathic hypertrophic subaortic stenosis), it is commonly observed that mitral regurgitation (MR) is often present. MR refers to the backward flow of blood from the left ventricle into the left atrium due to a faulty mitral valve. This is typically seen in IHSS patients, along with other symptoms such as a decrease in SAM (systolic anterior motion) of the mitral valve with a valsalva maneuver and a left ventricular posterior wall to septal ratio greater than 1.3. Additionally, IHSS does not directly affect the aortic valve, so mid-diastolic closure of the aortic valve is not expected.

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  • 35. 

    By echo measurement asymmetric septal hypertrophy is present when the interventricular septum to posterior wall ratio is:

    • A.

      1:2:1

    • B.

      < 1:3:1

    • C.

      >1:3:1

    • D.

    Correct Answer
    C. >1:3:1
    Explanation
    Asymmetric septal hypertrophy is present when the interventricular septum to posterior wall ratio is greater than 1:3:1. This means that the thickness of the interventricular septum is significantly greater than the thickness of the posterior wall of the heart. This abnormality can be indicative of certain heart conditions, such as hypertrophic cardiomyopathy, where the heart muscle becomes abnormally thick and stiff.

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  • 36. 

    If you obtain a systolic, high velocity and late peaking jet in the LVOT by continuous wave dopper from the apex the likely diagnosis is:

    • A.

      TR

    • B.

      Hypertrophic obstructive cardio

    • C.

      Valvular stenosis

    • D.

      MR

    Correct Answer
    B. Hypertrophic obstructive cardio
    Explanation
    If a systolic, high velocity, and late peaking jet is obtained in the left ventricular outflow tract (LVOT) by continuous wave Doppler from the apex, the likely diagnosis is hypertrophic obstructive cardiomyopathy (HOCM). HOCM is characterized by the thickening of the heart muscle, particularly in the left ventricle, which can lead to obstruction of blood flow out of the heart. This obstruction causes a turbulent blood flow, resulting in the specific Doppler pattern described in the question. TR (tricuspid regurgitation), valvular stenosis, and MR (mitral regurgitation) are not associated with this specific Doppler pattern.

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  • 37. 

    Patients with a dilated cardio may demonstrate which of the following Doppler patterns of mitral inflow?

    • A.

      Abnormal relaxation

    • B.

      Normal inflow pattern

    • C.

      Pseudonormal pattern

    • D.

      Restrictive inflow pattern

    Correct Answer
    A. Abnormal relaxation
    Explanation
    Patients with a dilated cardio may demonstrate an abnormal relaxation Doppler pattern of mitral inflow. This abnormal relaxation pattern is characterized by a decreased early diastolic filling velocity (E wave) and an increased atrial contraction filling velocity (A wave). It is often seen in patients with impaired left ventricular relaxation and is associated with conditions such as diastolic dysfunction and heart failure.

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  • 38. 

    Another echo term for a systolic, high velocity and late peaking jet in the LVOT by CW Doppler from the apex is:

    • A.

      Dagger shaped

    • B.

      Classic shape

    • C.

      Elliptical shape

    • D.

      Rounded shape

    Correct Answer
    A. Dagger shaped
    Explanation
    The correct answer is Dagger shaped. This term is used to describe the shape of a systolic, high velocity, and late peaking jet in the left ventricular outflow tract (LVOT) as observed by continuous wave (CW) Doppler from the apex. The term "Dagger shaped" implies that the jet has a sharp and pointed appearance, resembling the shape of a dagger. This description helps in identifying and characterizing the flow pattern in the LVOT.

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  • 39. 

    Echo features of amyloid heart disease included all of the following except:

    • A.

      Multivalvular regurg

    • B.

      MVP

    • C.

      Increased wall thickness

    • D.

      PE

    Correct Answer
    B. MVP
    Explanation
    The given options list various features of amyloid heart disease. MVP, or mitral valve prolapse, is not typically associated with amyloid heart disease. This condition is characterized by the displacement of the mitral valve into the left atrium during systole, causing regurgitation. However, amyloid heart disease is known to cause multivalvular regurgitation, increased wall thickness, and pulmonary embolism (PE).

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  • 40. 

    Which type of cardio might you see in a patient with AIDS:

    • A.

      Hypertrophic

    • B.

      Infiltrative

    • C.

      Congestive

    • D.

      Restrictive

    • E.

      Obstructive

    Correct Answer
    C. Congestive
    Explanation
    A patient with AIDS might experience congestive cardio, which refers to the condition where the heart is unable to pump enough blood to meet the body's needs. AIDS can lead to weakened immune system and opportunistic infections, such as viral or bacterial infections, which can affect the heart and cause inflammation or damage. This can result in congestive heart failure, where the heart becomes enlarged and weakened, leading to fluid buildup in the lungs and other parts of the body.

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  • 41. 

    Patients with dilated cardiomyopathy frequently experience multiple symptoms, such as:

    • A.

      Hypertension

    • B.

      Increased cardiac output

    • C.

      Dyspnea

    • D.

      WDW

    Correct Answer
    C. Dyspnea
    Explanation
    Dyspnea is a common symptom experienced by patients with dilated cardiomyopathy. It refers to difficulty or discomfort in breathing. This symptom occurs due to the weakened heart's inability to pump blood effectively, leading to fluid accumulation in the lungs. As a result, patients may feel short of breath, especially during physical exertion or when lying flat. Therefore, dyspnea is a characteristic symptom of dilated cardiomyopathy.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Apr 09, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 28, 2012
    Quiz Created by
    Britte9597
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