Which of these is NOT an Absolute Contraindication for performing a TEE?

Esophageal Varices, tumors, stenosis

TEE - Image Anatomy & Procedure

1.

The left coronary artery feeds which Aortic Valve cusp?

Explanation
The left coronary artery feeds the left cusp of the aortic valve.

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2.

Which views are LA appendages seen in? (check 2)
- A.
  
  ME 2 Chamber
- B.
  
  TG LAX
- C.
  
  TG 2 Chamber
Correct Answer(s)
A. ME 2 Chamber
C. TG 2 Chamber

Explanation
The LA appendages are seen in the ME 2 Chamber and TG 2 Chamber views.

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3.

Which view is the RA appendage seen in?

Correct Answer(s)
ME Bicaval

Explanation
The RA appendage is seen in the ME Bicaval view. This view is obtained by placing the ultrasound probe at the subxiphoid position and angling it towards the patient's right shoulder. In this view, both the superior and inferior vena cava can be visualized, along with the right atrium and the RA appendage.

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4.

What are the 3 areas of common thrombus/emboli detection?
- A.
  
  Apex
- B.
  
  Appendages
- C.
  
  Posterior leaflets
- D.
  
  Intra-atrial septum
Correct Answer(s)
A. Apex
B. Appendages
D. Intra-atrial septum

Explanation
The three areas of common thrombus/emboli detection are the apex, appendages, and intra-atrial septum. Thrombus or emboli can often be found in these areas during medical examinations or imaging tests.

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5.

In the ME AV SAX view, what is the order of AV cusps?
- A.
  
  Right, left, non
- B.
  
  Left, non, right
- C.
  
  Non, left, right
- D.
  
  Non, right, left
Correct Answer
C. Non, left, right

Explanation
The correct order of AV cusps in the ME AV SAX view is non, left, right.

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6.

The _________________ of the AV is always on the side of the Intra-atrial septum.
- A.
  
  Left coronary cusp
- B.
  
  Non coronary cusp
- C.
  
  AV Groove
- D.
  
  Coaptation
Correct Answer
B. Non coronary cusp

Explanation
The non coronary cusp of the AV (aortic valve) is always on the side of the Intra-atrial septum.

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7.

The _________ of the MV is always on the side of the non- coronary cusp of the AV.
- A.
  
  Posterior leaflet
- B.
  
  Excursion
- C.
  
  Scallop
- D.
  
  Anterior leaflet
Correct Answer
D. Anterior leaflet

Explanation
The correct answer is anterior leaflet. The statement implies that the anterior leaflet of the mitral valve is always located on the side of the non-coronary cusp of the aortic valve. This information helps in understanding the anatomical positioning and relationship between these two valves in the heart.

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8.

The Coronary Sinus shows up on which myocardial walls in the ME 2 Chamber & ME 4 Chamber? (choose 2)
- A.
  
  Lateral
- B.
  
  Inferior
- C.
  
  Anterior
Correct Answer(s)
A. Lateral
B. Inferior

Explanation
The Coronary Sinus shows up on the lateral and inferior myocardial walls in both the ME 2 Chamber and ME 4 Chamber views.

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9.

The Coronary Sinus is located next to which MV leaflet?

Correct Answer(s)
posterior

Explanation
The Coronary Sinus is located next to the posterior mitral valve (MV) leaflet. This means that it is positioned towards the back of the MV leaflet.

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10.

The LAA is on the same side of the __________MV leaflet and ___________ wall of myocardium.
- A.
  
  Anterior; anterior
- B.
  
  Anterior; lateral
- C.
  
  Posterior; anterior
- D.
  
  Posterior; inferior
Correct Answer
A. Anterior; anterior

Explanation
The LAA (Left Atrial Appendage) is located on the same side as the anterior MV (Mitral Valve) leaflet and the anterior wall of the myocardium.

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11.

The Eustacian Valve is seen in the ME Bicaval view with the _____________ being on the left side of it.
- A.
  
  IVC
- B.
  
  SVC
- C.
  
  Coronary sinus
Correct Answer
A. IVC

Explanation
The Eustachian valve is seen in the ME Bicaval view with the IVC being on the left side of it. This means that when the ME Bicaval view is obtained, the inferior vena cava (IVC) is visualized to the left of the Eustachian valve. The Eustachian valve is a fold of tissue within the right atrium of the heart, and its position in relation to the IVC can be identified using this specific view.

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12.

The TG Mid SAX show the ___________muscle to be on the top.

Correct Answer
posterior medial papillary

Explanation
The TG Mid SAX view is a cardiac imaging technique that allows visualization of the posterior medial papillary muscle. This muscle is located at the top portion of the heart, which is why it is shown to be on the top in the TG Mid SAX view.

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13.

A patient must be ________ for ______ hours prior to the TEE exam, to reduce vomiting. (choose 2)
- A.
  
  NPO - fasting
- B.
  
  DOE
- C.
  
  4
Correct Answer(s)
A. NPO - fasting
C. 4

Explanation
To reduce the risk of vomiting during a TEE (Transesophageal Echocardiogram) exam, the patient must refrain from eating or drinking for a certain number of hours before the procedure. This is known as NPO (Nil Per Os) or fasting. Additionally, the patient must fast for a period of 4 hours prior to the exam. By abstaining from food and drink, the stomach is empty, reducing the likelihood of regurgitation or aspiration during the procedure.

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14.

What solution is used to clean/disinfect the probe once the exam is finished?
- A.
  
  Cidex
- B.
  
  Lidocaine
- C.
  
  Windex
- D.
  
  Lisol
Correct Answer
A. Cidex

Explanation
Cidex is the correct answer because it is a solution commonly used to clean and disinfect medical instruments, including probes, after use. It is an effective disinfectant that kills a wide range of microorganisms, including bacteria, viruses, and fungi. Cidex is often used in healthcare settings to ensure proper hygiene and prevent the spread of infections.

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15.

The probe must not be in the cleaning solution for longer than 20 minutes because it is an acid.
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
The probe must not be in the cleaning solution for longer than 20 minutes because it is an acid. This suggests that the cleaning solution is acidic in nature and prolonged exposure to the probe can cause damage or corrosion. Therefore, it is important to limit the time the probe spends in the cleaning solution to prevent any potential harm.

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16.

Which of these is NOT an Absolute Contraindication for performing a TEE?
- A.
  
  Inability to swallow
- B.
  
  Radiation therapy
- C.
  
  Esophageal Varices, tumors, stenosis
- D.
  
  Gastrointestinal bleeding
Correct Answer
B. Radiation therapy

Explanation
Radiation therapy is not an absolute contraindication for performing a transesophageal echocardiogram (TEE). TEE is a procedure that involves inserting a probe into the esophagus to obtain detailed images of the heart. While conditions such as inability to swallow, esophageal varices, tumors, and stenosis, and gastrointestinal bleeding may hinder the safe performance of TEE, radiation therapy does not directly interfere with the procedure. However, it is important to consider the potential risks and benefits of TEE in patients who have undergone radiation therapy, as there may be increased sensitivity or damage to the esophagus due to the treatment.

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17.

It a patient is ROP (Routine OUt Patient), they should be able to drive home themselves without any difficulties...After all, if they had Versed, they shouldn't have issues since they can't remember anything anyway.
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
ROP patients MUST have a ride home. This is not a laughing matter. :)

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TEE - Image Anatomy & Procedure

The left coronary artery feeds which Aortic Valve cusp?

Which views are LA appendages seen in? (check 2)

Which view is the RA appendage seen in?

What are the 3 areas of common thrombus/emboli detection?

In the ME AV SAX view, what is the order of AV cusps?

The _________________ of the AV is always on the side of the Intra-atrial septum.

The _________ of the MV is always on the side of the non- coronary cusp of the AV.

The Coronary Sinus shows up on which myocardial walls in the ME 2 Chamber & ME 4 Chamber? (choose 2)

The Coronary Sinus is located next to which MV leaflet?

The LAA is on the same side of the MV leaflet and _ wall of myocardium.

The Eustacian Valve is seen in the ME Bicaval view with the _____________ being on the left side of it.

The TG Mid SAX show the ___________muscle to be on the top.

A patient must be __ for hours prior to the TEE exam, to reduce vomiting. (choose 2)

What solution is used to clean/disinfect the probe once the exam is finished?

The probe must not be in the cleaning solution for longer than 20 minutes because it is an acid.

Which of these is NOT an Absolute Contraindication for performing a TEE?

It a patient is ROP (Routine OUt Patient), they should be able to drive home themselves without any difficulties...After all, if they had Versed, they shouldn't have issues since they can't remember anything anyway.

TEE - Image Anatomy & Procedure

The left coronary artery feeds which Aortic Valve cusp?

Which views are LA appendages seen in? (check 2)

Which view is the RA appendage seen in?

What are the 3 areas of common thrombus/emboli detection?

In the ME AV SAX view, what is the order of AV cusps?

The _________________ of the AV is always on the side of the Intra-atrial septum.

The _________ of the MV is always on the side of the non- coronary cusp of the AV.

The Coronary Sinus shows up on which myocardial walls in the ME 2 Chamber & ME 4 Chamber? (choose 2)

The Coronary Sinus is located next to which MV leaflet?

The LAA is on the same side of the __________MV leaflet and ___________ wall of myocardium.

The Eustacian Valve is seen in the ME Bicaval view with the _____________ being on the left side of it.

The TG Mid SAX show the ___________muscle to be on the top.

A patient must be ________ for ______ hours prior to the TEE exam, to reduce vomiting. (choose 2)

What solution is used to clean/disinfect the probe once the exam is finished?

The probe must not be in the cleaning solution for longer than 20 minutes because it is an acid.

Which of these is NOT an Absolute Contraindication for performing a TEE?

It a patient is ROP (Routine OUt Patient), they should be able to drive home themselves without any difficulties...After all, if they had Versed, they shouldn't have issues since they can't remember anything anyway.

The LAA is on the same side of the MV leaflet and _ wall of myocardium.

A patient must be __ for hours prior to the TEE exam, to reduce vomiting. (choose 2)