Valves

62 Questions

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Valve Quizzes & Trivia

Echo


Questions and Answers
  • 1. 
    Complications of rheumatic MS include all of the following except:
    • A. 

      Scarring of the MV apparatus

    • B. 

      Possible pulmonary hypertension

    • C. 

      Dilated LV

    • D. 

      Increased LA pressure

  • 2. 
    Patients with MVP and MR have an increased risk for:
    • A. 

      Pulmonary hypertension

    • B. 

      Systemc hypertension

    • C. 

      Endocarditis

    • D. 

      Developing WPW

  • 3. 
    Which of the following valves is least likely affected in patients with rheumatic heart disease?
    • A. 

      Mitral

    • B. 

      Aortic

    • C. 

      Pulmonic

    • D. 

      Tricuspid

  • 4. 
    Given a tricuspid gradient of 4 m/sec and a RA pressure of 20 mmHg what is the RVSP?
    • A. 

      36 mmHg

    • B. 

      84 mmHg

    • C. 

      51 mmHg

    • D. 

      27 mmHg

  • 5. 
    Acquired valvular heart disease may be due to all of the following except:
    • A. 

      Down syndrome

    • B. 

      Endocarditis

    • C. 

      Age

    • D. 

      Rheumatic fever

  • 6. 
    Given a tricuspid regurg gradient and RA pressure what can you calculate?
    • A. 

      RA pressure

    • B. 

      LV end-diastolic pressure

    • C. 

      LV systolic pressure

    • D. 

      RV systolic pressure

  • 7. 
    High frequency systolic vibrations of the AV on M-mode most likely reflects:
    • A. 

      AV regurg

    • B. 

      A normal finding

    • C. 

      Low cardiac output

    • D. 

      Mitral insufficiency

  • 8. 
    Why follow patients with chronic AR?
    • A. 

      Check the LA size

    • B. 

      Check for pulmonary hypertension

    • C. 

      Check the LV size

    • D. 

      Look for MV preclosure

  • 9. 
    A patient has an RVSP of 60 mmHg. One year later the RVSP is 30 mmHg. What happened to this patient?
    • A. 

      Hypertrophic cardio

    • B. 

      Pulmonary hypertension

    • C. 

      RV infaction

    • D. 

      LV infarttion

  • 10. 
    What would you typically see on the M-mode of an 14 year old with a bicuspid AV?
    • A. 

      Presence of a raphe

    • B. 

      Eccentric closure

    • C. 

      Football shaped opening

    • D. 

      Diastolic doming

  • 11. 
    The classic manifestations of acute rheumatic fever includes all of the following except:
    • A. 

      Abdominal aortic aneurysms

    • B. 

      Subcutaneous nodules

    • C. 

      Carditis

    • D. 

      Arthritis

  • 12. 
    What is the normal aortic valve area?
    • A. 

      6-8 cm2

    • B. 

    • C. 

      2.5-3.5 cm2

    • D. 

      3-5 cm2

  • 13. 
    Patients with a parachute MV usually have which echo findings?
    • A. 

      Single papillary muscle

    • B. 

      RV dilation

    • C. 

      Three papillary muscles

    • D. 

      LA thrombus

    • E. 

      LV dilation

  • 14. 
    All of the following are etiologies for aortic regurg except:
    • A. 

      Aortic type I dissection

    • B. 

      Pulmonary hypertension

    • C. 

      Systemic hypertension

    • D. 

      Marfan syndrome

  • 15. 
    Which of the following is the most common etiology for aortic stenosis?
    • A. 

      Calcific/degenerative

    • B. 

      Supra valvular obstructions

    • C. 

      Rheumatic fever

    • D. 

      Prosthetic valve dysfunction

    • E. 

      Congenital membranes

  • 16. 
    MR in patients with rheumatic MS is most likely due to:
    • A. 

      LA enlargement

    • B. 

      Scarring of the IVS

    • C. 

      LV enlargement

    • D. 

      AV notching

  • 17. 
    Patients with Marfan syndrome are followed by echo to check:
    • A. 

      Changes in aotic root dimensions

    • B. 

      MVP

    • C. 

      AR

    • D. 

      MR

  • 18. 
    With A-fib and MS the Doppler velocity is best performed:
    • A. 

      Averaged over 2 beats

    • B. 

      Averaged over 3-5 beats

    • C. 

      Averaged over 20 beats

    • D. 

      Unable to measure in A-fib

  • 19. 
    Patients with marfan syndrome typically die from which of the following?
    • A. 

      MVP

    • B. 

      Aortic dissection

    • C. 

      Syncope

    • D. 

      Stroke

  • 20. 
    All of the following are etiologies for MR except:
    • A. 

      Ruptured mitral chordate

    • B. 

      Ebsteins anomaly

    • C. 

      Mitral endocarditis

    • D. 

      Cleft MV

  • 21. 
    Which of the following is the most common etiology for TS?
    • A. 

      Prothetic valve dysfunction

    • B. 

      Congenital malformation

    • C. 

      Rheumatic fever

    • D. 

      Acquired stenosis

    • E. 

      Ebsteins anomaly

  • 22. 
    What is another term used to describe flow reversal?
    • A. 

      No reflow

    • B. 

      Retrograde

    • C. 

      Subgrade

    • D. 

      Antegrade

  • 23. 
    Systolic flow reversal in the pulmonary veins can also be described as:
    • A. 

      Retrograde

    • B. 

      Normal

    • C. 

      Antegrade

    • D. 

      No flow

  • 24. 
    Which valve lesion typically has the lowest Doppler peak velocity?
    • A. 

      AR

    • B. 

      PR

    • C. 

      TR

    • D. 

      MR

  • 25. 
    What percent of patients with a bicuspid aortic valve will not have eccentric closure on M-mode?
    • A. 

      15%

    • B. 

      40%

    • C. 

      50%

    • D. 

      25%

  • 26. 
    All of the following are physical findings in patients with AR except:
    • A. 

      Bounding, bifid arterial pulses

    • B. 

      Diastolic blowing murmur

    • C. 

      Systolic blowing murmur

    • D. 

      Wide pulse pressures

  • 27. 
    What is a typical Doppler velocity range for aortic stenosis?
    • A. 

      0.1-1.6 m/sec

    • B. 

      3.0-5.0 m/sec

    • C. 

      2.0-3.0 m/sec

    • D. 

      1.6-2.0 m/sec

  • 28. 
    All of the following syndromes significantly raise the patients risk of aortic dissection except:
    • A. 

      Ehlers-danlos syndrome

    • B. 

      Marfan syndrom’

    • C. 

      Down syndrome

    • D. 

      Turners syndrome

  • 29. 
    All of the following are etiologies for PR except:
    • A. 

      Carcinoid heart disease

    • B. 

      Systemic hypertension

    • C. 

      Pulmonary hypertension

    • D. 

      Pulmonic stenosis

  • 30. 
    What is the best way to determine if severe MR is present?
    • A. 

      MV inflow velocity

    • B. 

      Size of vena contracta

    • C. 

      Size of color Doppler jet

    • D. 

      Pulmonary venous flow

  • 31. 
    MVP is best seen in which echo view?
    • A. 

      Parasternal long axis

    • B. 

      Subcostal 4 chamber

    • C. 

      Apical 4-chamber

    • D. 

      Parasternal short axis

  • 32. 
    Which of the following best describes a sinus of valsalva aneurysm?
    • A. 

      Commonly seen in the left coronary sinus

    • B. 

      Often involves more than one sinus

    • C. 

      Saccular type of dilation

    • D. 

      Often accompanied by subvalvular aortic stenosis

  • 33. 
    Echo where do most aortic aneurysms occur?
    • A. 

      Aortic arch

    • B. 

      Abdominal aorta

    • C. 

      Aortic root

    • D. 

      Aortic isthmus

  • 34. 
    What PHT by CW Doppler would you expect on a patient with mild AI?
    • A. 

      350-500 msec

    • B. 

      < 200 msec

    • C. 

      >500 msec

    • D. 

      16-36 mmHg

  • 35. 
    In echo the use of the continuity equation in patients with AS is based on the premise that:
    • A. 

      The worse the stenosis, the higher the V1

    • B. 

      The worse the stenosis, the lower the V1

    • C. 

      The higher the cardiac output the lower the V2

    • D. 

      Flow below the valve is equal to flow above the valve

  • 36. 
    All of the following are etiologies of valvular AS except:
    • A. 

      Calcific

    • B. 

      Rheumatic

    • C. 

      IHSS

    • D. 

      Congenital

  • 37. 
    All of the following are m-mode findings in rhematic mitral stenosis except:
    • A. 

      Decreased EF slope

    • B. 

      Multiple reverberations

    • C. 

      Posterior leaflet moves anterior

    • D. 

      Increased EF slope

  • 38. 
    What is the MV area cutoff for severe stenosis?
    • A. 

      6-8 cm2

    • B. 

      3-4 cm2

    • C. 

    • D. 

      4-6 cm2

  • 39. 
    One advantage of using the PLAX view to diagnose MVP is?
    • A. 

      The ultrasonic beam is perpendicular to the leaflets in systole

    • B. 

      The relative position of the MV and TV is better visualized

    • C. 

      There is less motion of the mitral annulus

    • D. 

      False prolapsed caused by the annulus shape is avoided

  • 40. 
    Which of the following is an etiology of valvular AS?
    • A. 

      Coarctation of the aorta

    • B. 

      Rheumatic fever

    • C. 

      Systemic hypertension

    • D. 

      IHSS

  • 41. 
    A patient comes to the echo lab with decreased CO, CP, syncope and a possible cerebral infarct. What is the most likely diagnosis?
    • A. 

      MVP

    • B. 

      TS

    • C. 

      AS

    • D. 

      PI

  • 42. 
    Which of the following would most likely cause chronic AI?
    • A. 

      MS

    • B. 

      Trauma

    • C. 

      AS

    • D. 

      Aortic dissection

  • 43. 
    Inhalation of amyl nitrite might be used to demonstrate which of the following?
    • A. 

      Valvular MS

    • B. 

      MVP

    • C. 

      MI

    • D. 

      Valvular AS

  • 44. 
    What causes mitral valve pre-systolic closure?
    • A. 

      Pulmonary hypertension

    • B. 

      Elevated LVEDP ( LV end diastolic pressure)

    • C. 

      Moderate AR

    • D. 

      Low LVEDP

  • 45. 
    Longstanding MS leads to all of the following except:
    • A. 

      LA dilation

    • B. 

      Pulmonary hypertension

    • C. 

      CHF

    • D. 

      LV dilation

  • 46. 
    Which of the following syndromes fits with AR, Ao dilation, Ao dissections, and Ao aneurysms?
    • A. 

      Dressler

    • B. 

      Marfan

    • C. 

      Barlow

    • D. 

      Noonans

  • 47. 
    Given a tricuspid gradient of 3 m/sec and a RA pressure of 15 mmHg what is the RVSP?
    • A. 

      27 mmHg

    • B. 

      51 mmHg

    • C. 

      70 mmHg

    • D. 

      21 mmHg

  • 48. 
    Dynamic LVOT obstruction cause the AV to:
    • A. 

      A) Flutter in systole

    • B. 

      B) Close in mid systole

    • C. 

      C) Close in late systole

    • D. 

      D) Flutter in diastole

  • 49. 
    Given the mitral PHT of 200 msec what would the area be?
    • A. 

      1.1cm2

    • B. 

      0.9 cm2

    • C. 

      1cm2

  • 50. 
    If you measure the LVOT too big how will this affect your measurement for aortic area?
    • A. 

      Area cannot be measure in dilated hearts

    • B. 

      Area does not change

    • C. 

      Area is too large

    • D. 

      Area is too small

  • 51. 
    Severe PR can often result in all the following except:
    • A. 

      Systemic hypertension

    • B. 

      RV failure

    • C. 

      Diastolic murmur

    • D. 

      RV volume overload

  • 52. 
    What is the primary effect of long-stnading AR?
    • A. 

      Dilated LV

    • B. 

      Dilated RV

    • C. 

      MV preclosure

    • D. 

      Decreased EF

  • 53. 
    A common cause for RV volume overload is?
    • A. 

      TR

    • B. 

      Tetralogy of Fallot

    • C. 

      Patent ductus

    • D. 

      Pulmonic stenosis

  • 54. 
    With a MV PHT of 230 msec, what is present:
    • A. 

      Normal MV

    • B. 

      Moderate MS

    • C. 

      Mild MS

    • D. 

      Severe MS

  • 55. 
    An underestimation of the severity of AS by CW Doppler may occur with:
    • A. 

      High Doppler gain settings

    • B. 

      Angle cosine thats of 40 degrees

    • C. 

      High cardiac output

    • D. 

      Severe AR

  • 56. 
    Using saline contrast, systolic appearance of bubbles in the IVC would indicate:
    • A. 

      High RA pressures

    • B. 

      A normal finding

    • C. 

      Cardiac tamponade

    • D. 

      TR

  • 57. 
    Which of the following are common secondary finding in MS?
    • A. 

      LVH and dilation

    • B. 

      LA enlargement and signs of pulmonary hypertension

    • C. 

      LV and LA dilation

    • D. 

      RA enlargement and MR

  • 58. 
    In echo when is a raphe typically seen?
    • A. 

      Cleft aortic valve

    • B. 

      Rheumatic AS

    • C. 

      Bicuspid AV

    • D. 

      Degenerative AS

  • 59. 
    How do you position a patient As for using a PEDOF probe along the right sterna boarder
    • A. 

      Right lateral decubitus

    • B. 

      Left lateral decubitus

    • C. 

      Fowlers

    • D. 

      Trendelenburg

  • 60. 
    Marfan syndrome is best described as:
    • A. 

      Causing MA

    • B. 

      A connective tissue disorder

    • C. 

      A type of cancer

    • D. 

      Seen in short ppl

  • 61. 
     For patients with the combination of AS and a-fib, peak systolic aortic velocity will be:
    • A. 

      Lower following long R-R intercals

    • B. 

      Higher following short R-R intervals

    • C. 

      Unaffected by R-R intervals

    • D. 

      Higher following long R-R internvals

  • 62. 
    Rheumatic MS creates a volume and pressure overload pattern which may result in all of the following except:
    • A. 

      Small D shaped LV

    • B. 

      RV enlargement

    • C. 

      LV enlargement

    • D. 

      LA enlargement