CCI Adult Echo CTL Evaluate Findings Pt 3 Questions and Correct Answers
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CCI Echo
Institution
CCI Echo
The peak systolic velocity of the tricuspid regurgitation is 4m/s. The systolic BP is 120/80mmHg and the 2.7 IVC collapses <50% with respiration. What level of pulmonary HTN is present if any? A: no pulmonary HTN is present B: mild pulmonary HTN C: moderate pulmonary HTN D: severe pulmonary HTN ...
CCI Adult Echo CTL Evaluate Findings
Pt 3 Questions and Correct Answers
The peak systolic velocity of the tricuspid regurgitation is 4m/s. The systolic BP is
120/80mmHg and the 2.7 IVC collapses <50% with respiration. What level of pulmonary
HTN is present if any?
A: no pulmonary HTN is present
B: mild pulmonary HTN
C: moderate pulmonary HTN
D: severe pulmonary HTN ✅D: severe pulmonary HTN
Feedback: RVSP = (V x V) + RAP
RAP is estimated at 15mmHg with reduced respiratory collapse of the dilated IVC.
RVSP= 4(4x4)+15=79mmHg=severe
Ankylosing spondylitis and Loeys- dietz syndrome and ehlers-danlos syndrome are
commonly associated with what echo finding?
A: mitral stenosis
B: dilation of the aortic root and or ascending aorta
C: tricuspid valve dysplasia
D: dilated coronary sinus ✅B: dilation of the aortic root and or ascending aorta
A 60yr old patient presents for an echo and the script states there is a loud S3. Which of
the following could explain the abnormal heart sound?
A: patent ductus arteriosus
B: severe mitral stenosis
C: severe aortic stenosis
D: severe aortic insufficiency ✅D: severe aortic insufficiency
Feedback: caused by the oscillation of blood back and forth between the walls of the
ventricles due to rapid inflow of blood from the atria:
Normal heart sound in a child or young adult
After age 40, a third heart sound is usually abnormal and correlates with dysfunction or
volume overload of the ventricles
Indicates rapid ventricular filling due to pregnancy, anemia, CHF, dilated
cardiomyopathy, severe valvular regurgitation, left to right shunting, and high cardiac
output
The _______ of the signal displayed on CW doppler is directly related to the severity of
regurgitation.
A: size of the spectral window
B: peak velocity
C: intensity
D: peak pressure gradient ✅C: intensity
,Feedback: the intensity of the signal displayed on CW doppler is directly related to the
severity of the regurgitation. The peak velocity of regurgitation is not always directly
related to the severity of the regurgitation. Severe leakage through large openings can
demonstrate low pressure gradients and jet velocity. Depressed cardiac function can
also reduce the velocity of a significant regurgitant jet. The same applies for peak
pressure gradient.
Which of the following is most commonly associated with closure of the aortic valve mid
systole?
A: hypertrophic obstructive cardiomyopathy
B: 3mm VSD
C: severe pulmonic insufficiency
D: severe aortic insufficiency ✅A: hypertrophic obstructive cardiomyopathy
All of the following are abnormal findings in a patient with a left ventricular assist device,
except:
A: increased LV size
B: decreased LV size
C: normal position of the atrial septum
D: changes to frequency of aortic valve opening ✅C: normal position of the atrial
septum
Feedback: Abnormal findings include
changes in LV chamber size:
changes in septal position (septal shift)
changes in AV opening frequency
changes to regurgitation levels
A patient presents with a script for an echo that states "grade 5/6 systolic crescendo-
decrescendo murmur". This clinical finding is the most suggestive of:
A: patent ductus arteriosus
B: ASD
C: aortic stenosis
D: mitral stenosis ✅C: aortic stenosis
M-mode demonstrates diastolic fluttering of the interventricular septum. Which of the
following is the most likely cause for this finding?
A: aortic insufficiency
B: mitral stenosis
C: mitral regurgitation
D: ASD ✅A: aortic insufficiency
Feedback: an eccentric AI jet can cause the IVS and/or anterior MV leaflet to vibrate in
diastole
Dobutamine is used to assess suspected hibernating myocardium. If the affected wall
motion improves at low doses but declines at higher doses,
A: the patient will be scheduled for a reperfusion procedure
,B: the myocardium has irreversible damage and reperfusion would not be
recommended
C: the patient will be scheduled for a transesophageal echo to better evaluate the
endocardium
D: the patient will be scheduled for a treadmill stress echo ✅A: the patient will be
scheduled for a reperfusion procedure
Feedback: dobutamine is used to assess suspected hibernating myocardium. If the
affected wall motion improves at low doses but declines at higher doses, the patient
would benefit from a reperfusion procedure (stent, bypass). If the myocardium shows no
response to the dobutamine, it has suffered irreversible damage.
A 25yr old patient presents for an echo due to a heart murmur. You identify mitral valve
prolapse and a bicuspid aortic valve. What other abnormality is commonly associated
with these findings?
A: pulmonary stenosis
B: membranous subaortic stenosis
C: tricuspid atresia
D: coarctation ✅D: coarctation
Feedback: MVP and a bicuspid aortic valve are also associated with coarctation
A patient presents for an echo after recent diagnosis of Chagas disease. What are you
looking for on the exam?
A: dilated cardiomyopathy and apical aneurysm
B: infiltrative cardiomyopathy
C: supravalvular stenosis and/or coarctation
D: non-compaction of the LV ✅A: dilated cardiomyopathy and apical aneurysm
Feedback: chagas disease is a parasitic infection common in Mexico, Central America,
and South America. The parasite is introduced into the system by an insect bite. Most
patients are asymptomatic. Of those with chronic symptoms, 2/3 have dilated
cardiomyopathy and over half have an apical aneurysm.
Which type of cardiomyopathy is related to fatty and fibrous tissue replacement of the
myocardium of the right ventricle?
A: right ventricular hemochromatosis
B: lipomatous septal hypertrophy
C: endomyocardial fibrosis
D: arrhythmogenic right ventricular cardiomyopathy ✅D: arrhythmogenic right
ventricular cardiomyopathy
Feedback: ARVC is a familial disorder characterized by fatty fibrous tissue replacement
of the myocardium of the right ventricle. These changes lead to a dilated RV with
reduced systolic function and wall motion abnormalities. it is also associated with low
velocity tricuspid regurgitation
Which type of aortic dissection is identified as an isolated finding localized to the
ascending aorta?
A: Debakey I
, B: Debakey II
C: Debakey III
D: Debakey IV ✅B: Debakey II
Feedback:
type 1: dissection extends from proximal ascending aorta into the descending portion
type 2: dissection located at the ascending aorta only
type 3: dissection extends from the descending aorta into the abdominal aorta
What conduction abnormality is commonly seen with chronic mitral stenosis?
A: bundle branch block
B: ventricular tachycardia
C: wolff-parkinson-white
D: atrial fibrillation ✅D: atrial fibrillation
A 50yr old female presents for an echo due to increasing dyspnea. She has regular
physical exams and no history of lung or cardiac disease. You identify pulmonary artery
pressure of 75mmHg on the echo. Which of the following can explain these findings?
A: severe tricuspid regurgitation
B: chronic moderate pulmonary insufficiency
C: pulmonary embolism
D: primary pulmonary HTN ✅D: primary pulmonary HTN
Feedback: pulmonary HTN refers to idiopathic HTN without a related cause from heart
or lung disease. Most patients with primary pulmonary HTN are female.
Which of the following would be the most likely cause of myocardial ischemia?
A: aortic insufficiency with pressure half time of 175ms
B: tricuspid regurgitation with a 25mmHg pressure gradient
C: aortic insufficiency with pressure half time of 775ms
D: mitral regurgitation with a 4mm PISA radius ✅A: aortic insufficiency with pressure
half time of 175ms
Feedback: significant aortic insufficiency will decrease LV outflow to the aorta and its
branches. The coronaries will receive less blood causing myocardial ischemia
Rheumatic disease causes abnormal thickening of the ______, while carcinoid disease
causes abnormal thickening of the ______.
A: right ventricular walls, left ventricular walls
B: entire valve leaflet, tips of the valve leaflets
C: tips of the valve leaflets, entire valve leaflet
D: right ventricular outflow tract, left ventricular outflow tract ✅C: tips of the valve
leaflets, entire valve leaflet
Feedback: valvular stenosis caused by carcinoid disease causes stiffening of the entire
affected leaflet, while rheumatic valvular stenosis causes thickening and tethering of the
leaflet tips
The coronary sinus will dilate with increased _______ pressure.
A: left atrial
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