Adult Echocardiography Test! Hardest Trivia Questions Quiz

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Adult Echocardiography Test! Hardest Trivia Questions Quiz - Quiz

Welcome to the Ultimate Adult Echocardiography Quiz! Designed for echocardiographers, cardiologists, and medical professionals, this quiz aims to test and enhance your understanding of adult echocardiography. This quiz features a range of questions from basic to advanced levels, focusing on anatomy, physiology, pathological conditions, and the latest diagnostic techniques in the field. Each question has been developed by experts to provide comprehensive insights into echocardiographic interpretation and clinical application.

Participants will navigate through multiple-choice questions that not only measure their technical knowledge but also their practical understanding. Feedback is provided instantly for each question, helping you learn and understand the Read morerationale behind correct and incorrect answers.

Ideal for both self-assessment and educational group activities, this Adult Echocardiography Quiz serves as a valuable resource for anyone involved in the care of patients with cardiovascular conditions. Engage with our quiz today and elevate your echocardiographic proficiency to the next level!


Adult Echocardiography Questions and Answers

  • 1. 

    Which of the following supplies blood to the arterial system after contraction?

    • A.

      Left ventricle

    • B.

      Left atrium

    • C.

      Right atrium

    • D.

      Right ventricle

    Correct Answer
    A. Left ventricle
    Explanation
    The left ventricle is responsible for pumping oxygenated blood to the rest of the body through the arterial system. After the contraction of the left ventricle, blood is forced out of the heart and into the aorta, which is the main artery that distributes blood to the rest of the body. Therefore, the left ventricle is the correct answer as it supplies blood to the arterial system after contraction.

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  • 2. 

    The sensitivity switch controls the:

    • A.

      Heat

    • B.

      Speed

    • C.

      Amplification

    • D.

      ECG position

    Correct Answer
    C. Amplification
    Explanation
    The sensitivity switch controls the amplification. Amplification refers to the process of increasing the strength or magnitude of a signal. In the context of the sensitivity switch, it likely refers to adjusting the level of amplification for a particular device or instrument. By adjusting the sensitivity switch, the user can increase or decrease the amplification of the signal being processed, allowing for more precise control and measurement.

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  • 3. 

    The little "spark" that makes the heart beat, originates in the:

    • A.

      AV node

    • B.

      Purkinje fibers

    • C.

      Bundle branches

    • D.

      SA node

    Correct Answer
    D. SA node
    Explanation
    The SA node, also known as the sinoatrial node, is responsible for generating electrical impulses that initiate the heartbeat. It is located in the right atrium of the heart. These impulses spread throughout the heart, causing the atria to contract and then travel to the AV node, bundle branches, and Purkinje fibers, which further coordinate the contraction of the ventricles. Therefore, the SA node is the correct answer as it is the initial source of the electrical signal that triggers the heartbeat.

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  • 4. 

    Which of the following is a poor conductor of electric current?

    • A.

      Metal

    • B.

      Blood

    • C.

      Dry skin

    • D.

      Body fluids

    Correct Answer
    C. Dry skin
    Explanation
    Dry skin is a poor conductor of electric current because it lacks moisture. Moisture in the form of body fluids or sweat helps in the conduction of electricity. Dry skin, on the other hand, has a high resistance to the flow of electric current due to the absence of moisture. This makes it a poor conductor compared to metals or body fluids like blood.

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  • 5. 

    In which of the following patients would enteric isolation technique be used?

    • A.

      Influenza

    • B.

      Draining wounds

    • C.

      Respiratory disease

    • D.

      Diseases spread by fecal contamination

    Correct Answer
    D. Diseases spread by fecal contamination
    Explanation
    The enteric isolation technique would be used in patients with diseases spread by fecal contamination. This technique involves isolating and implementing strict infection control measures to prevent the spread of enteric pathogens, which are typically transmitted through fecal-oral route. This includes diseases such as cholera, typhoid fever, and norovirus infections. By implementing enteric isolation techniques, healthcare providers can effectively prevent the transmission of these diseases and protect both the patient and others from infection.

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  • 6. 

    While performing two-dimensional echocardiography on Ms. Heinz, you discover what appears to be a large thrombus in the left ventricle. Ms. Heinz states that she just can’t wait to talk with her doctor and that any information you could supply concerning what you see would be a big relief to her. You should inform Ms. Heinz that:

    • A.

      Her nurse is the only person qualified to discuss the results of her test

    • B.

      There is a large thrombus in the main pumping chamber of her heart and surgery is definitely necessary

    • C.

      You do see a small abnormality in her Echocardiogram, but it is not something she should concern herself with

    • D.

      You cannot interpret her Echocardiogram, but assure her that her doctor will be reviewing it as soon as possible

    Correct Answer
    D. You cannot interpret her Echocardiogram, but assure her that her doctor will be reviewing it as soon as possible
  • 7. 

    Mr. Smith is a 90-year-old male scheduled for a Transesophageal Echocardiogram. As a preoperative measure, his doctor has given him 25 mg of Demerol. Upon entry to the laboratory, his breathing is shallow and he is unresponsive. After notifying the physician, which of the following medications would be MOST useful for counteracting the effects of the narcotic given?

    • A.

      Versed

    • B.

      Narcan

    • C.

      Oxygen

    • D.

      Valium

    Correct Answer
    B. Narcan
    Explanation
    Narcan is the most useful medication for counteracting the effects of the narcotic given to Mr. Smith. Narcan, also known as naloxone, is an opioid receptor antagonist that can quickly reverse the effects of opioids such as Demoral. It works by binding to the opioid receptors in the brain and blocking the effects of the opioid, thereby reversing respiratory depression and sedation. Given Mr. Smith's shallow breathing and unresponsiveness, which are signs of opioid overdose, administering Narcan would be the most appropriate and effective intervention to reverse the effects of the narcotic and restore his breathing and consciousness.

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  • 8. 

    Splitting of S2 is best heard at the?

    • A.

      Third left intercostal space

    • B.

      Apex

    • C.

      Fourth left intercostal space

    • D.

      Second right intercostal space

    Correct Answer
    A. Third left intercostal space
    Explanation
    The splitting of S2 refers to the splitting of the second heart sound, which is caused by the closure of the aortic and pulmonary valves. This splitting is best heard at the third left intercostal space. The third left intercostal space is located close to the aortic and pulmonary areas of the heart, where the sounds of these valves are most audible. Therefore, this is the most likely location to hear the splitting of S2.

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  • 9. 

    During the holding phase of the Valsalva Maneuver, which of the following occurs?

    • A.

      Increased cardiac output

    • B.

      Decreased intrathoracic pressure

    • C.

      Increased venous return to the heart

    • D.

      Decreased venous return to the heart

    Correct Answer
    D. Decreased venous return to the heart
    Explanation
    During the holding phase of the Valsalva Maneuver, there is increased pressure in the chest cavity due to the forced expiration against a closed airway. This increased pressure compresses the veins, reducing their ability to return blood to the heart, resulting in decreased venous return to the heart. This decrease in venous return can lead to decreased cardiac output.

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  • 10. 

    Mr. Kline reported to the non-invasive laboratory for an exercise stress test. While preparing Mr. Kline for his examination, he complains of chest pain radiating down his left arm. The resting 12 lead ECG indicates ST segment elevation is present in leads V1 through V6, and the T wave is inverted. Before the physician can be notified, Mr. Kline converts to ventricular tachycardia, lapses to an unconscious state, and has no palpable pulse. According to ACLS guidelines, the technologist should:

    • A.

      Begin CPR

    • B.

      Administer intracardiac epinephrine

    • C.

      Defibrillate the patient at 360 watts/second

    • D.

      Prepare an external pacemaker for immediate use

    Correct Answer
    A. Begin CPR
    Explanation
    The correct answer is to begin CPR. Mr. Kline's symptoms and ECG findings suggest that he is experiencing a myocardial infarction (heart attack) with ST segment elevation, which can progress to ventricular tachycardia and cardiac arrest. According to ACLS guidelines, the first step in managing a cardiac arrest is to initiate CPR to provide circulation and oxygenation to the heart and brain. This should be done before notifying the physician or considering other interventions such as administering medications or using a defibrillator.

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  • 11. 

    Sound travels through tissue at approximately:

    • A.

      154.0 m/sec

    • B.

      1,540.0 m/sec

    • C.

      15,400 m/sec

    • D.

      154,000 m/sec

    Correct Answer
    B. 1,540.0 m/sec
    Explanation
    Sound travels through tissue at approximately 1,540.0 m/sec. This is the correct answer because sound waves travel faster through denser materials, and tissue is a relatively dense material compared to air. The speed of sound in tissue is higher than in air, but lower than in some other materials like water or steel. Therefore, 1,540.0 m/sec is a reasonable speed for sound to travel through tissue.

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  • 12. 

    Which of the following is most influenced by distance from the face of the transducer?

    • A.

      Frequency

    • B.

      Wavelength

    • C.

      Axial resolution

    • D.

      Lateral resolution

    Correct Answer
    D. Lateral resolution
    Explanation
    Lateral resolution is the measure of the ability of an imaging system to distinguish between two closely spaced objects that are perpendicular to the direction of the ultrasound beam. The distance from the face of the transducer plays a significant role in determining the lateral resolution. As the distance increases, the lateral resolution deteriorates, meaning that the system becomes less capable of distinguishing between closely spaced objects. Therefore, the lateral resolution is most influenced by the distance from the face of the transducer.

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  • 13. 

    If the relative output of an ultrasound instrument is calibrated in decibels and the technologist increases the output by 50 dB, how many times will the beam intensity increase?

    • A.

      2

    • B.

      100

    • C.

      100,000

    • D.

      1,000,000

    Correct Answer
    C. 100,000
    Explanation
    When the output of an ultrasound instrument is calibrated in decibels, a 10 dB increase represents a 10-fold increase in intensity. Therefore, a 50 dB increase would represent a 50-fold increase in intensity. Since the question asks how many times the beam intensity will increase, the answer would be 50 times 10, which equals 500. So, the beam intensity will increase 500 times, which is equivalent to 100,000.

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  • 14. 

    A ventricular wall motion abnormality that is reversible with nitroglycerine is associated with:

    • A.

      Pericarditis

    • B.

      Myocardial fibrosis

    • C.

      Myocardial ischemia

    • D.

      Myocardial infarction

    Correct Answer
    C. Myocardial ischemia
    Explanation
    A ventricular wall motion abnormality that is reversible with nitroglycerine suggests that there is a temporary decrease in blood flow to the heart muscle, known as myocardial ischemia. Nitroglycerine is a vasodilator that helps to relax and widen the blood vessels, improving blood flow to the heart. This is commonly used as a treatment for angina, which is caused by inadequate blood supply to the heart. Pericarditis, myocardial fibrosis, and myocardial infarction are not typically reversible with nitroglycerine and are associated with different pathologies.

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  • 15. 

    Difficulty in determining echocardiographic signs of tamponade may occur in the presence of:

    • A.

      Right pleural effusion

    • B.

      Systemic hypertension

    • C.

      Left ventricular dysfunction

    • D.

      Right ventricular hypertrophy

    Correct Answer
    D. Right ventricular hypertrophy
    Explanation
    Difficulty in determining echocardiographic signs of tamponade may occur in the presence of right ventricular hypertrophy. This is because right ventricular hypertrophy can lead to changes in the anatomy and function of the heart, making it more challenging to identify specific signs of tamponade on echocardiography.

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  • 16. 

    While performing a 2-D Echocardiogram on Ms. Cane for assessment of her left ventricular function, you discover regional wall motion abnormalities and a dilated hypokinetic left ventricle. The pericardium contains no fluid, valvular pathology, and function are normal. The patient's chart indicates a history of rheumatic heart fever, and a recent history of fever, fatigue, and precordial pain. Her 12 lead EKG exhibits an LBBB and nonspecific ST-T wave changes and a prolonged QT interval. Pulmonary congestion and a moderate cardiomegaly are evidenced by chest X-ray. Correlating these data you would suspect a diagnosis of:

    • A.

      Myocarditis

    • B.

      Cardiac tamponade

    • C.

      Pericardial effusion

    • D.

      Congestive heart failure

    Correct Answer
    A. Myocarditis
    Explanation
    Based on the given information, the patient has regional wall motion abnormalities, a dilated hypokinetic left ventricle, a history of rheumatic heart fever, and recent symptoms such as fever, fatigue, and precordial pain. Additionally, the patient's EKG shows a LBBB and nonspecific ST-T wave changes, and the chest X-ray reveals pulmonary congestion and moderate cardiomegaly. These findings suggest myocarditis, which is an inflammation of the myocardium (the heart muscle) often caused by viral or bacterial infections.

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  • 17. 

    According to the American Society of Echocardiography, the left ventricle should be measured at the region of the:

    • A.

      Papillary muscles

    • B.

      Chordae tendineae above the papillary muscles

    • C.

      Mitral valve where only the anterior leaflet is seen

    • D.

      Mitral valve where both the anterior and posterior leaflets are visualized

    Correct Answer
    B. Chordae tendineae above the papillary muscles
    Explanation
    The correct answer is "Chordae tendineae above the papillary muscles." According to the American Society of Echocardiography, the left ventricle should be measured at this region because it provides a more accurate assessment of the ventricle's size and function. The papillary muscles and chordae tendineae are anatomical structures within the left ventricle, and measuring above the papillary muscles allows for a consistent and standardized measurement. The other options mentioned, such as the mitral valve leaflets, are not the recommended regions for measuring the left ventricle.

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  • 18. 

    Your patient’s history shows recent cardiac catheterization data indicating elevated right heart pressures and an IV end-diastolic pressure less then the left atrial mean pressure. The EKG demonstrates atrial fibrillation. A holosystolic murmur can be auscultated. Which of the following imaging methods would be useful during two dimensional echocardiography of this patient?

    • A.

      Continuous wave Doppler and m-mode echocardiography

    • B.

      Two-dimensional echocardiography for the measurement of aortic valve orifice size

    • C.

      Two-dimensional echocardiography in combination with Doppler for the measurement and determination of the mitral orifice size

    • D.

      Color flow imaging in combination with two-dimensional echocardiography for the evaluation of flow disturbance across the aortic valve

    Correct Answer
    C. Two-dimensional echocardiography in combination with Doppler for the measurement and determination of the mitral orifice size
    Explanation
    The patient's history suggests that there may be a problem with the mitral valve, as indicated by the elevated right heart pressures and the IV end-diastolic pressure being less than the left atrial mean pressure. The presence of atrial fibrillation and a holosystolic murmur further support this possibility. Therefore, using two-dimensional echocardiography in combination with Doppler would be useful in measuring and determining the size of the mitral orifice, allowing for a more comprehensive evaluation of the mitral valve function.

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  • 19. 

    In the performance of echocardiography, which of the following methods requires invasive introduction of the transducer?

    • A.

      Stress echocardiography

    • B.

      Contrast echocardiography

    • C.

      Assisted pericardiocentesis

    • D.

      Transesophageal echocardiography

    Correct Answer
    D. Transesophageal echocardiography
    Explanation
    Transesophageal echocardiography requires invasive introduction of the transducer. This method involves inserting a specialized transducer into the patient's esophagus to obtain clearer images of the heart. It allows for a closer and more detailed view of the heart structures compared to traditional echocardiography, which uses a transducer placed on the outside of the chest. The invasive nature of transesophageal echocardiography makes it a more invasive procedure compared to other methods mentioned in the question, such as stress echocardiography, contrast echocardiography, and assisted pericardiocentesis.

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  • 20. 

    Which of the following conditions would be a contraindication to the performance of contrast Echocardiography?

    • A.

      VaIvular regurgitation

    • B.

      Left ventricular dysfunction

    • C.

      Complex congenital heart disease

    • D.

      A large right-to-left intracardiac shunt

    Correct Answer
    B. Left ventricular dysfunction
    Explanation
    Left ventricular dysfunction would be a contraindication to the performance of contrast echocardiography because it could potentially worsen the condition. Contrast echocardiography involves the injection of a contrast agent to enhance the visualization of the heart structures. In patients with left ventricular dysfunction, the heart is already compromised and may not be able to handle the additional stress of the contrast agent. This could lead to further deterioration of the heart function and potentially cause harm to the patient. Therefore, it is important to avoid performing contrast echocardiography in patients with left ventricular dysfunction.

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  • 21. 

    How many colors can be displayed in a single pixel of color flow image?

    • A.

      1

    • B.

      2

    • C.

      3

    • D.

      4

    Correct Answer
    A. 1
    Explanation
    In a single pixel of a color flow image, only one color can be displayed. A pixel is the smallest unit of an image, and it can only represent a single color at a time. Therefore, the correct answer is 1.

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  • 22. 

    Which of the following Doppler frequencies would result in the shallowest penetration depth?

    • A.

      2 MHz

    • B.

      8 MHz

    • C.

      10 MHz

    • D.

      20 MHz

    Correct Answer
    D. 20 MHz
    Explanation
    Higher frequency ultrasound waves have shorter wavelengths and are absorbed more quickly by tissue, resulting in shallow penetration depth. Since 20 MHz has the highest frequency among the given options, it would result in the shallowest penetration depth.

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  • 23. 

    Which of the following frequency shifts would produce aliasing, when using a 5 MHz pulsed Doppler transducer, with a pulse repetition frequency of 15 kHz?

    • A.

      3 kHz

    • B.

      5 kHz

    • C.

      6 kHz

    • D.

      8 kHz

    Correct Answer
    D. 8 kHz
    Explanation
    Using a 5 MHz pulsed Doppler transducer with a pulse repetition frequency of 15 kHz, the Nyquist limit can be calculated as half of the pulse repetition frequency, which is 7.5 kHz. Any frequency shift that exceeds the Nyquist limit will result in aliasing. In this case, a frequency shift of 8 kHz exceeds the Nyquist limit, therefore it would produce aliasing.

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  • 24. 

    Why are patients requested to record the time of bowel movements when wearing a Holter monitor?

    • A.

      Valsalva Maneuver will cause a heart rate change

    • B.

      To correlate the motion artifact on the recording

    • C.

      For the systematic recording of all patient activity

    • D.

      Breathing rate will delay conduction through AV node

    Correct Answer
    A. Valsalva Maneuver will cause a heart rate change
    Explanation
    Patients are requested to record the time of bowel movements when wearing a Holter monitor because the Valsalva Maneuver, which is commonly performed during bowel movements, can cause a change in heart rate. This information is important for healthcare professionals to analyze and interpret the data from the Holter monitor accurately. By recording the time of bowel movements, any heart rate changes associated with the Valsalva Maneuver can be identified and taken into consideration when evaluating the patient's heart health.

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  • 25. 

    Dr. Hager has ordered an echocardiogram of Mr. Finney for evaluation of left ventricular function. The patient’s history indicates that the left ventricle is enlarged. When reviewing the 12 lead ECG, you observe that the T wave is inverted in leads 1, AVL, V5 and V6. The ST segment is depressed. You realize that this finding is MOST consistent with: 

    • A.

      Pericarditis

    • B.

      An old myocardial infarction

    • C.

      Left ventricular hypertrophy

    • D.

      Right ventricular hypertrophy

    Correct Answer
    C. Left ventricular hypertrophy
    Explanation
    The T wave inversion in leads 1, AVL, V5, and V6, along with the depressed ST segment, is a common finding in left ventricular hypertrophy (LVH). LVH is a condition where the muscle of the left ventricle becomes thickened, usually due to chronic high blood pressure. This thickening can cause changes in the electrical conduction of the heart, leading to T wave inversion and ST segment depression. Pericarditis and old myocardial infarction may also cause changes in the ECG, but the specific pattern described is most consistent with LVH. Right ventricular hypertrophy would typically present with different ECG findings.

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  • 26. 

    Which of the following is NOT an effect of exercise in the patient with a healthy heart? Increased:

    • A.

      Stroke volume

    • B.

      Ejection fraction

    • C.

      End-systolic volume

    • D.

      End-diastolic volume

    Correct Answer
    C. End-systolic volume
    Explanation
    Exercise typically leads to an increase in stroke volume, ejection fraction, and end-diastolic volume. These changes occur because exercise causes the heart to pump more blood with each beat, resulting in a higher volume of blood being ejected from the heart and a greater amount of blood being present in the heart during diastole. However, exercise does not typically lead to an increase in end-systolic volume. End-systolic volume refers to the amount of blood remaining in the heart at the end of systole, or contraction. During exercise, the heart contracts more forcefully, resulting in a decrease in end-systolic volume rather than an increase.

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  • 27. 

    Which of the following is NOT considered an indicator of coronary artery disease, during the performance of exercise stress testing?

    • A.

      Sinus tachycardia

    • B.

      ST segment elevation

    • C.

      ST segment depression

    • D.

      Increased in R wave amplitude

    Correct Answer
    A. Sinus tachycardia
    Explanation
    Sinus tachycardia is not considered an indicator of coronary artery disease during exercise stress testing. Sinus tachycardia refers to an increased heart rate, which can occur due to various reasons such as exercise, stress, or medications. While coronary artery disease may cause ST segment elevation, ST segment depression, and increased R wave amplitude, sinus tachycardia is not directly associated with coronary artery disease. It is important to note that other symptoms and indicators should be considered in conjunction with exercise stress testing to diagnose coronary artery disease accurately.

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  • 28. 

    The first heart sound is associated with:

    • A.

      Preload

    • B.

      Afterload

    • C.

      Semilunar valve closure

    • D.

      Atrioventricular valve closure

    Correct Answer
    D. Atrioventricular valve closure
    Explanation
    The first heart sound, also known as S1, is the sound produced by the closure of the atrioventricular valves (mitral and tricuspid valves) during ventricular contraction. This closure marks the beginning of systole, the phase where the ventricles contract and pump blood out of the heart. Preload refers to the volume of blood in the ventricles before contraction, afterload refers to the pressure against which the ventricles pump, and semilunar valve closure occurs during the second heart sound (S2) when the aortic and pulmonary valves close.

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  • 29. 

    The patient’s ECG indicates the presence of atrioventricular dissociation, without heart block. This condition may cause a significant drop in blood pressure and cardiac output. Which of the following would be the MOST effective treatment choice to control and increase heart rate?

    • A.

      Atropine sulfate intravenously

    • B.

      Temporary atrial or ventricular pacing

    • C.

      Administration of approximately 500cc of normal saline

    • D.

      Implantation of a permanent atrioventricular pacemaker

    Correct Answer
    B. Temporary atrial or ventricular pacing
    Explanation
    Temporary atrial or ventricular pacing would be the most effective treatment choice to control and increase heart rate in a patient with atrioventricular disassociation. This condition disrupts the normal electrical conduction between the atria and ventricles, leading to a drop in blood pressure and cardiac output. Temporary pacing involves the use of external or internal pacemaker leads to stimulate the heart and restore a coordinated rhythm. Atropine sulfate intravenously may be used in certain cases, but it is not as effective in this scenario. Administration of normal saline and implantation of a permanent pacemaker are not appropriate treatments for increasing heart rate in this situation.

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  • 30. 

    Which of the following terms identifies the abnormal collection of clotted or partially clotted blood within an organ or soft tissue space?

    • A.

      Stroke or heart attack

    • B.

      Hematoma

    • C.

      Hematomato

    • D.

      Thrombosis

    • E.

      Embolus

    Correct Answer
    B. Hematoma
    Explanation
    A hematoma refers to the abnormal collection of clotted or partially clotted blood within an organ or soft tissue space. It is a localized swelling that occurs due to the rupture of blood vessels, leading to the accumulation of blood in the surrounding area. This condition can be caused by trauma, surgery, or underlying medical conditions. Hematomas can vary in size and severity, and may require medical intervention depending on their location and impact on surrounding structures.

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  • 31. 

    Which of these terms is best described by the following “ the sum of a list of values, divided by the total number of values in the list"

    • A.

      Median

    • B.

      Range

    • C.

      Sum

    • D.

      Mode

    • E.

      Average

    Correct Answer
    E. Average
    Explanation
    The term "average" is best described as the sum of a list of values divided by the total number of values in the list. It is a measure of central tendency that represents the typical value in a dataset. The average is calculated by adding up all the values in the list and then dividing the sum by the total number of values. It provides a balanced representation of the data and is commonly used in statistics and everyday life to summarize information.

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  • 32. 

    Which of the following terms identifies the formation or presence of a blood clot within a blood vessel?

    • A.

      Hematoma

    • B.

      Thrombosis

    • C.

      Stroke or heart attack

    • D.

      Embolus

    Correct Answer
    B. Thrombosis
    Explanation
    Thrombosis refers to the formation or presence of a blood clot within a blood vessel. A hematoma is a collection of blood outside of blood vessels, usually caused by an injury. Stroke or heart attack refers to the blockage of blood flow to the brain or heart respectively. An embolus is a blood clot that has traveled from its original site and is now blocking a blood vessel.

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  • 33. 

    What is the purpose of measuring cardiac enzymes?

    • A.

      To measure the mass of the heart muscle

    • B.

      To measure cardiac performance

    • C.

      To measure the flow of blood through the heart

    • D.

      To measure heart muscle damage after a heart attack

    Correct Answer
    D. To measure heart muscle damage after a heart attack
    Explanation
    Cardiac enzymes are measured to assess heart muscle damage after a heart attack. When a heart attack occurs, the blood flow to a part of the heart muscle is blocked, leading to tissue damage. Cardiac enzymes, such as troponin and creatine kinase, are released into the bloodstream as a result of this damage. By measuring the levels of these enzymes, healthcare professionals can determine the extent of heart muscle damage and monitor the progress of the patient's recovery.

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  • 34. 

    What might be the first indication of metastatic cardiac disease?

    • A.

      Pleural effusion

    • B.

      Pericardial effusion

    • C.

      Right atrial mass

    • D.

      Left atrial mass

    • E.

      Myxoma

    Correct Answer
    B. Pericardial effusion
    Explanation
    Pericardial effusion is the accumulation of fluid in the pericardial sac surrounding the heart. It can be an early sign of metastatic cardiac disease, as cancer cells can spread to the pericardium and cause inflammation and fluid buildup. This can lead to symptoms such as chest pain, shortness of breath, and fluid retention. Pleural effusion, on the other hand, refers to fluid accumulation in the pleural space around the lungs and is not specific to cardiac disease. Right atrial and left atrial masses, as well as myxoma, are not typically associated with metastatic cardiac disease.

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  • 35. 

    This spectral Doppler pattern might be seen in which cardiac disease?

    • A.

      Dilated cardiomyopathy

    • B.

      Abnormal relaxation

    • C.

      Constrictive pericarditis

    • D.

      Pericardial tamponade

    • E.

      Ischemic cardiomyopathy

    Correct Answer
    C. Constrictive pericarditis
    Explanation
    This spectral Doppler pattern might be seen in constrictive pericarditis. Constrictive pericarditis is a condition where the pericardium, the sac surrounding the heart, becomes thick and rigid, impairing the heart's ability to fill properly. This can lead to a characteristic Doppler pattern on echocardiography, showing a rapid early diastolic filling followed by a sudden cessation or plateau in filling. This pattern is distinct from other cardiac diseases such as dilated cardiomyopathy, abnormal relaxation, ischemic cardiomyopathy, and pericardial tamponade.

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  • 36. 

    Inhalation of amyl nitrite be used to demonstrate which of the following?

    • A.

      Mitral valve prolapse

    • B.

      Aortic stenosis

    • C.

      Mitral stenosis

    • D.

      Aortic insufficiency

    • E.

      Mitral insufficiency

    Correct Answer
    A. Mitral valve prolapse
    Explanation
    Inhalation of amyl nitrite can be used to demonstrate Mitral valve prolapse. Amyl nitrite is a vasodilator that relaxes smooth muscles, including the muscles of the blood vessels. When inhaled, it causes a rapid and intense dilation of the blood vessels, leading to a drop in blood pressure. In patients with Mitral valve prolapse, the valve between the left atrium and the left ventricle does not close properly, causing blood to leak back into the atrium during ventricular contraction. Inhalation of amyl nitrite can exacerbate this regurgitation, leading to a characteristic systolic click and murmur, which helps in diagnosing Mitral valve prolapse.

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  • 37. 

    Which of the following diseases is represented by the diastolic flow on this Doppler spectral trace?

    • A.

      PDA

    • B.

      MS

    • C.

      TS

    • D.

      PI

    • E.

      AI

    Correct Answer
    E. AI
    Explanation
    The correct answer is AI, which stands for Aortic Insufficiency. Aortic Insufficiency is a condition where the aortic valve does not close properly, causing blood to flow back into the left ventricle during diastole. This results in a diastolic flow pattern on a Doppler spectral trace, which is represented by the diastolic flow seen in this case.

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  • 38. 

    This mitral valve M-mode demonstrates what pathology?

    • A.

      Mitral valve endocarditis

    • B.

      Diastolic dysfunction

    • C.

      Ruptured chordae

    • D.

      Atrial fibrillation

    • E.

      Aortic regurg

    Correct Answer
    E. Aortic regurg
    Explanation
    This M-mode of the mitral valve does not show any signs of endocarditis, diastolic dysfunction, ruptured chordae, or atrial fibrillation. However, it does show signs of aortic regurgitation, which is the backflow of blood from the aorta into the left ventricle during diastole. This can be seen as a thickened and elongated mitral valve in the M-mode image.

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  • 39. 

    The patient with this M-mode would have which of the following murmurs on physical exam:

    • A.

      Continuous

    • B.

      Diastolic blow

    • C.

      Late systolic

    • D.

      Holosytolic

    • E.

      Diastolic rumble

    Correct Answer
    B. Diastolic blow
    Explanation
    A diastolic blow murmur refers to a murmur that occurs during diastole, the relaxation phase of the cardiac cycle. This type of murmur is typically heard in conditions such as aortic regurgitation, where blood flows back into the left ventricle from the aorta during diastole. The term "blow" is used to describe the sound of the murmur, which is often described as a high-pitched, blowing noise. Therefore, if a patient has a diastolic blow murmur, it suggests the presence of aortic regurgitation.

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  • 40. 

    Thickened tricuspid leaflets which are fixed in the open position might mean that the patient has which of the following problems?

    • A.

      Ebstein's anomaly

    • B.

      Sarcoidosis

    • C.

      Tricuspid endocarditis

    • D.

      Hemochromatosis

    • E.

      Carcinoid heart disease

    Correct Answer
    E. Carcinoid heart disease
    Explanation
    Thickened tricuspid leaflets that are fixed in the open position are a characteristic finding in carcinoid heart disease. Carcinoid heart disease is a condition that occurs as a result of metastatic neuroendocrine tumors, called carcinoid tumors. These tumors release substances, such as serotonin, that cause fibrosis and thickening of the heart valves, including the tricuspid valve. This thickening and fixation of the tricuspid leaflets in the open position can lead to regurgitation of blood back into the right atrium, causing symptoms such as fatigue, edema, and heart failure.

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  • 41. 

    Longstanding MS leads to all of the following except:

    • A.

      CHF

    • B.

      RV dilation

    • C.

      LA dilation

    • D.

      Pulmonary hypertension

    • E.

      LV dilation

    Correct Answer
    E. LV dilation
    Explanation
    Longstanding MS leads to various cardiac changes, including RV dilation, LA dilation, pulmonary hypertension, and CHF. However, LV dilation is not typically associated with MS. The left ventricle does not typically undergo significant dilation in response to the increased pressure and volume overload caused by mitral stenosis. Instead, the left atrium and right ventricle are more commonly affected due to the backflow of blood caused by the narrowed mitral valve.

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  • 42. 

    All of the following are echo findings in patients with dilated cardiomyopathy except:

    • A.

      Exaggerated aortic root excursion

    • B.

      Reduced mitral valve excursion

    • C.

      B-notch on the M-mode

    • D.

      Exaggerated E-point to septal separation

    • E.

      Decreased ventricular function

    Correct Answer
    A. Exaggerated aortic root excursion
    Explanation
    In patients with dilated cardiomyopathy, there are several echo findings that can be observed. These include reduced mitral valve excursion, B-notch on the M-mode, exaggerated E-point to septal separation, and decreased ventricular function. However, an exaggerated aortic root excursion is not typically seen in patients with dilated cardiomyopathy. This finding is more commonly associated with conditions such as aortic regurgitation or aortic root dilation.

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  • 43. 

    This parasternal long-axis view demonstrates what type of prosthetic aortic valve?

    • A.

      Caged ball

    • B.

      Starr-Edwards

    • C.

      Bioprosthetic

    • D.

      Bjork-Shirley

    • E.

      Bileaflet

    Correct Answer
    C. Bioprosthetic
    Explanation
    This parasternal long-axis view demonstrates a bioprosthetic aortic valve. Bioprosthetic valves are made from animal tissue, such as porcine or bovine valves, and are used to replace a diseased or malfunctioning aortic valve. They are preferred for older patients or those who cannot take blood thinners, as they do not require long-term anticoagulation therapy. Bioprosthetic valves have a limited lifespan and may need to be replaced after 10-15 years.

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  • 44. 

    Where should saline contrast be injected in order to diagnose a persistent left superior vena cava?

    • A.

      Subclavian artery

    • B.

      Left arm

    • C.

      Right arm

    • D.

      Subclavian vein

    • E.

      Femoral vein

    Correct Answer
    B. Left arm
    Explanation
    Saline contrast should be injected in the left arm in order to diagnose a persistent left superior vena cava. This is because the left arm is connected to the left superior vena cava, which is the vein that drains blood from the upper body into the heart. By injecting the contrast in the left arm, it can flow through the left superior vena cava and help visualize any abnormalities or blockages in this vein.

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  • 45. 

    Pericardial effusions are commonly seen in patients with:

    • A.

      Renal failure

    • B.

      Atrial flutter

    • C.

      Left atrial myxoma

    • D.

      Pulmonary hypertension

    • E.

      Aortic stenosis

    Correct Answer
    A. Renal failure
    Explanation
    Pericardial effusions are commonly seen in patients with renal failure. Renal failure can lead to fluid retention in the body, including the pericardial sac surrounding the heart. This fluid accumulation can cause the pericardial effusion. It is important to monitor and manage fluid balance in patients with renal failure to prevent complications such as pericardial effusion.

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  • 46. 

    Which is the best echo view for assessing the anterior wall of the LV?

    • A.

      Apical 2 chamber

    • B.

      Apical long axis

    • C.

      Parasternal long axis

    • D.

      Parasternal short axis

    • E.

      Apical 4 chamber

    Correct Answer
    A. Apical 2 chamber
    Explanation
    The best echo view for assessing the anterior wall of the LV is the Apical 2 chamber view. This view provides a clear visualization of the anterior wall of the left ventricle, allowing for accurate assessment of its function and any abnormalities.

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  • 47. 

    What type of valve is a St. Jude?

    • A.

      One leaflet

    • B.

      Pericardial

    • C.

      Ball and Cage

    • D.

      Bioprothetic

    • E.

      Bi-disk

    Correct Answer
    E. Bi-disk
    Explanation
    A St. Jude valve is a type of bi-disk valve. This means that it consists of two discs that open and close to control the flow of blood. The design of the bi-disk valve allows for efficient and smooth blood flow, making it a commonly used valve in heart surgeries.

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  • 48. 

    This mitral inflow Doppler spectral trace demonstrates which of the following problems?

    • A.

      Pericardial tamponade

    • B.

      Restrictive cardiomyopathy

    • C.

      Dilated cardiomyopathy

    • D.

      Hypertrophic cardiomyopathy

    • E.

      Normal age related changes

    Correct Answer
    B. Restrictive cardiomyopathy
    Explanation
    The mitral inflow Doppler spectral trace is used to assess the flow of blood through the mitral valve during diastole. In restrictive cardiomyopathy, the ventricles become stiff and have reduced compliance, leading to impaired filling during diastole. This is reflected in the mitral inflow Doppler trace, which typically shows a rapid early filing (E wave) followed by a reduced late filling (A wave) and an elevated E/A ratio. Therefore, the given correct answer of restrictive cardiomyopathy is consistent with the findings on the mitral inflow Doppler spectral trace.

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  • 49. 

    Myxomas are commonly attached to which of the following?

    • A.

      Left atrial free wall

    • B.

      Fossa ovalis

    • C.

      Mitral valve leaflets

    • D.

      Pulmonary artery

    • E.

      Left ventricular apex

    Correct Answer
    B. Fossa ovalis
    Explanation
    Myxomas are commonly attached to the fossa ovalis. The fossa ovalis is a depression in the interatrial septum of the heart, which is a remnant of the fetal foramen ovale. Myxomas are the most common primary cardiac tumors and are typically found in the left atrium. They can cause symptoms such as dyspnea, fatigue, and embolic events. Surgical removal is the treatment of choice for myxomas.

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  • 50. 

    If a large PDA is not corrected what might develop?

    • A.

      Pulmonary hypertension

    • B.

      Pericardial effusion

    • C.

      Eisenmenger syndrome

    • D.

      Nothing

    • E.

      Pulmonary edema

    Correct Answer
    C. Eisenmenger syndrome
    Explanation
    If a large PDA is not corrected, it can lead to the development of Eisenmenger syndrome. Eisenmenger syndrome is a condition where a large PDA causes increased blood flow from the left side of the heart to the right side. This leads to increased pressure in the lungs, which can eventually cause irreversible damage to the blood vessels in the lungs. As a result, the direction of blood flow is reversed, causing oxygen-poor blood to be pumped out to the body. This condition can lead to cyanosis, heart failure, and other complications.

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Farah Naz |MBBS, Medicine |
Medical Expert
Farah holds a Bachelor of Medicine and Bachelor of Surgery (MBBS) from Dow University of Health Sciences. She gained valuable experience through internships in Radiology, Cardiology, and Neurosurgery, and has contributed to two research publications in medical journals. Passionate about healthcare education, Farah excels in crafting medical content, including articles, literature reviews, and e-learning courses. Leveraging her expertise, she meticulously reviews medical science quizzes, ensuring accuracy and educational value for aspiring healthcare professionals.

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  • Current Version
  • Apr 25, 2024
    Quiz Edited by
    ProProfs Editorial Team

    Expert Reviewed by
    Farah Naz
  • Nov 28, 2012
    Quiz Created by
    Britte9597
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