Cardiac Evaluation Methods

S1 is caused by:

mitral and tricuspid valve opening
mitral and tricuspid valve closing
aortic and pulmonic valve opening
aortic and pulmonic valve closing

S2 is caused by:

mitral and tricuspid valve opening
mitral and tricuspid valve closing
aortic and pulmonic valve opening
aortic and pulmonic valve closing

For cardiac auscultation, the mitral area is considered to be the:

lower left sternal border
cardiac apex
right upper sternal border
left upper sternal border

For cardiac auscultation, the tricuspid area is considered to be the:

lower left sternal border
cardiac apex
right upper sternal border
left upper sternal border

For cardiac auscultation, the aortic area is considered to be the:

lower left sternal border
cardiac apex
right upper sternal border
left upper sternal border

For cardiac auscultation, the pulmonic area is considered to be the:

lower left sternal border
cardiac apex
right upper sternal border
left upper sternal border

With inspiration, the interval between the two components of S2, aortic and pulmonic valve closure is:

increased
decreased
unchange
cannot be predicted

The S3 occurs in:

ventricular systole
early ventricular diastole
late ventricular diastole
atrial systole

Another term used ot describe the S3 is:

presystolic gallop
atrial gallop
protodiastolic gallop
summation gallop

All of the following pathologies are assoicated with an S3 EXCEPT:

aortic regurgitation
mitral stenosis
atrial septal defect
anemia

The S4 occurs in response to:

early ventricular diastole
atrial systole
ventricular diastasis
ventricular systole

The S4 indicates:

increased early diastolic filling
increased ventricular contraction
decreased ventricular compliance
decreased atrial contraction

A loud S1 may indicate the presence of:

aortic regurgitation
mitral stenosis
decreased ventricular compliance
increased early diastolic filling

An opening snap is associate with:

atrioventricular valve stenosis
pulmonary regurgitation
decreased ventricular compliance
increased early diastolic filling

An ejection sound or click is associated with:

mitral stenosis
pulmonary regurgitation
semilunar valve stenosis
decreased ventricular compliance

The midsystolic click may indicate the presense of mitral valve:

stenosis
prolapse
flail
endocarditis

Fixed split S2 is associated with:

atrial septal defect
ventricular septal defect
patent ductus arteriosus
bicuspid aortic valve

Which of the following heard sounds is associated with pericarditis?

loud S1
soft S2
pericardial friction rub
pericardial knock

Which of the following heart sounds is associated with constrictive pericarditis?

ejection sound
midsystolic click
pericardial friction rub
pericardial knock

Which of the following is incorrect when decribing the auscultation areas for the cardiac valves?

aortic: right upper sternal border
pulmonic: left upper sternal border
mitral: lower left sternal border
tricuspid: xyphoic area

A grade I murmur is a murmur that is:

loud
moderately loud
faintly heard
barely heard

A grade II murmur is a murmur that is:

loud
moderately loud
faintly heard
barely heard

A grade III murmur is a murmur that is:

loud
moderately loud
faintly heard
barely heard

A grade IV murmur is a murmur that is:

loud
moderately loud
faintly heard
barely heard

A grade V murmur is a murmur that is:

moderately loud
loud
very loud
loud with a thrill

A grade VI murmur is a murmur that is:

moderately loud
loud
very loud
loud with a thrill

____________ murmur is one that begins softly and becomes louder.

crescendo
decresendo
crescendo-decrescendo
decrescendo-crescendo

____________ murmur is one that begins loud and becomes softer.

crescendo
decresendo
crescendo-decrescendo
decrescendo-crescendo

____________ murmur is one that begins softly, becomes louder and then decreases in loudness.

crescendo
decresendo
crescendo-decrescendo
decrescendo-crescendo

____________ murmur that begins loud, becomes softer and  the increases in loudness.

crescendo
decresendo
crescendo-decrescendo
decrescendo-crescendo

A low pitched murmur is best heard with the stethescope's:

bell
diaphragm
both bell and diaphragm
varies

A medium pitched murmur is best heard with the stethescope's:

bell
diaphragm
both bell and diaphragm
varies

A high pitched murmur is best heard with the stethescope's:

bell
diaphragm
both bell and diaphragm
varies

Which of the following murmurs begin with the first heart sound and end in midsystole?

early systolic
systolic ejection
holosystolic
late systolic

Which of the following murmurs begin after the semilunar valves open?

early systolic
systolic ejection
holosystolic
late systolic

Which of the following murmurs start well after ejection?

early systolic
systolic ejection
holosystolic
late systolic

Which of the following murmurs is present when there is flow between two chambers that have widely different pressures throughout systole?

early systolic
systolic ejection
pansystolic
late systolic

All of the following are possible causes of early systolic murmurs except:

valvular arotic stenosis
small ventricular septal defect
large ventricular septal defect with pulmonary hypertension
severe acute mitral /tricuspid regurgitation

All of the following are associated with a systolic ejection murmur EXCEPT:

valvular aortic/pulmonic stenosis
aortic/pulmonic dilatation
anemia
ventricular septal defect

All of the following are considered to be associated with a pansystolic murmur EXCEPT:

mitral/tricuspid regurgitation
ventricular septal defect
aortopulmonary shuts
mitral valve prolapse

All of the following are associated with a late systolic murmur except:

papillary muscle dysfunction
myocardial ischemia/infraction
valvular pulmonic stenosis
mitral valve prolapse

Which of the following murmurs begins immediately after the second heart sound?

early diastolic
mid-diastolic
late diastolic
continuous

Which of the following is mostl likely to cause an early diastolic murmur?

aortic valve regurgitation
mitral valve prolapse
patent ductus arteriosus
ventricular septal defect

Which of the following murmurs is caused by foward flow across an atrioventriclar valve?

early diastolic
mid-diastolic
continous
early systolic

All of the following are assoicated with a mid-diastolic or late diastolic murmur EXCEPT:

mitral/tricuspid stenosis
left atrial myxoma
mitral/tricuspid regurgitation
aortic regurgitation

Which of the following murmurs may result from blood flow constantly moving from a high pressure to a low pressure area?

early diastolic
mid-diastolic
late diastolic
continous

All of the following are associated with a continuous murmur EXCEPT:

patent ductus arteriosus
systemic arteriovenous fistula
severe mitral regurgitation
coronary artery from the pulmonary artery

Which effect will the strain phase of the Valsalva maneuver have on the venous return?

increase
decrease
varies
cannot be predicted

All of the following murmurs will decrease in intensity during the strain phase of the Valsalva of maneuver EXCEPT:

valvular aortic stenosis
mitral stenosis
hypertrophic obsturctive cardiomyopathy
tricuspid regurgitation

What effect will the isometric handgrip have on mitral regurgitation?

increase
decrease
varies
cannot be predicted

What effect will the isometric handgrip have on valvualr arotic stenosis?

increase
decrease
varies
cannot be predicted

What effect will the inhalation of amly nitrite have on a ventricular septal defect murmur?

increase
decrease
varies
cannot be predicted

What effect will the inhalation of amyl nitrite have on left heart regurgitation murmurs?

increase
decrease
varies
cannot be predicted

What effect will the inhalation of amyl nitrite have on the murmur of hypertrophic obstructive cardiomyopathy?

increase
decrease
varies
cannot be predicted

What effect will the inhalation of amyl nitrite have on mitral valve prolapse?

increase
decrease
varies
cannot be predicted

Which of the following is used to eveluate the cardiovascular response to excercise?

exercise stress test
EKG
Echo
auscultation

All of the following are indications for an exercise stress test EXCEPT:

chest pain
arryhthmias
valvular aortic stenosis
assessment of cardiovascular fitness

Which of the following is the most reliable indicater of myocardial ischemia during a exercise stress test examination?

ST segment depression
hypotension
decrease in R wave voltage
arryhthmias

Which of the following is a postitive inotrope and postive chronotrope?

dipyridamole
Persantine
adenosine
dobutamine

All ofo the following may induce myocardial ischemia via dilatation of the coronary arteries EXCEPT:

dipyridamole
Persantine
adenosine
dobutamine

Which of the following examinations is an invasive procedure used to vizualize cardiac chambers and the coronary arterial system?

echocardiography
electrocardiography
electroencephalogram
cardiac catheterization

All of the following may be assessed during a cardiac catheterization EXCEPT:

intracardiac pressures
oxygen saturation
ventricular function
pericardial thickness

All ofo the following may be catheterized during a right heart catheterization EXCEPT:

vena cava
pulmonary veins
right atrium
pulmonary artery

All of the following pressures may be measured during a right heart catheterization EXCEPT:

right atrium
right ventricle
main pulmonary artery
mean aortic

During a right heart catheterization, oxygen saturations may be obtained in each of the following except:

vena cava
pulmonary veins
right atrium
right ventricle

The most commom method of determining cardiac output during a right heart cardiac catheterization procedure is the:

Fick
thermodilution
indicator dye
angiography

The cardiac catheterization procedure that allows calculation of pressures on either side of the arotic valve is the:

right heart catheterization
left heart catheterization
pulmonary artery wedge
coronary arteriogram

All of the following pressures may be measured during a left heart catheterization EXCEPT:

left ventricular systolic/diastolic
arotic systolic/diastolic
arotic mean
pulmonary artery wedge

The left heart cardiac procedure that allows the evaluation of aortic regurgitation is:

ventriculogram
arteriogram
aortogram
venogram

The left heart cardiac cath procedure that allows for the evaluation of mitral regurgitation is:

ventriculogram
arteriogram
aortogram
venogram

The cardiac cath procedure that allows for the evaluation of the coronary arterial system is:

ventriculogram
arteriogram
aortogram
venogram

Which of the following cardiac cath procedure is used to determine the percent stenosis of a coronary artery?

ventriculogram
arteriogram
aortogram
venogram

Which of the following coronary arteries provides blood flow to the anterior interventricular septum and anterior wall of the left ventricle?

left main
left anterior descending
left circumflex
posterior descending

Which of the following coronary arteries provides blood flow to  the right ventricle?

left main
anterior descending
circumflex
right coronary

Which of the following coronary arteries provides blood flow to the inferior walls of the ventricles and the inferior IVS in a right dominant systems?

left main
anterior descending 
circumflex
posterior descending

In a left dominant coronary artery system, which of the following coronary arteries provides the posterior descending coronary artery?

left main
left anterior descending
left circumflex
right coronary artery

The most common invasive method of determining cardiac output is:

Fick
thermodilution
indicator dilution
angiography

Which invasive method to determine cardiac output measures the concentration of dye that has been injected into the heart and measured at a distal arterial site?

Fick
thermodilution
indicator dilution
angiography

Which of the following invasive methods used to determine cardiac output is considered to be the most accurate?

Fick
thermodilution
indicator dilution
angiography

Which of the following invasive techiniques determine cardiac output by injectiong dye into the left ventricle and measuring ventricular volumes?

Fick
thermodilution
indicator dilution
angiography

Which of the following procedures during a cardiac cath allows for the detection of an intracardiac shunt?

aortography
arteriography
oximetry
pressure waveforms

The following oxygen saturation have been recorded: SVC 72%, IVC 78%, RA 87%, RV 87% and main PA 87%. What is the diagnosis?

normal
atrial septal defect
ventricular septal defect
patent ductus arteriosus

The following oxygen saturation have been recorded: SVC 72%, IVC 78%, RA 75%, RV 85% and main PA 85%. What is the diagnosis?

normal
atrial septal defect
ventricular defect
patent ductus arteriosus

The following oxygen saturation have been recorded: SVC 72%, IVC 78%, RA 75%, RV 75% and main PA 89%. What is the diagnosis?

normal
atrial septal defect
ventricular septal defect
patent ductus arteriosus

The forward flow across a normal valve is determined to be 60 cc. The total stroke volume across a regurgitation valve is 120 cc. The regurgitatant volume is:

0 cc
60 cc
120 cc
180 cc

The forward flow across a normal valve is determined to be 60 cc. The total stroke volume across a regurgitation valve is 120 cc. What is the regurgitation fraction?

0%
50%
60%
90%

The cardiac cathetherization examination that injects a radioapaque dye into cardiac chambers/great vessels and is recorded on cine film is:

angiography
contrast study
hemodynamic recording
ejection fraction

Which of the following cardicac cath exmas allows for the evaluation of ventricular function parameters (i.e..ejection fraction, stroke volume, cardiac output, cardiac index), regional wall motion abnormalities and atrioventricualar regurgitation?

arteriography
angiography
radiography
Doppler

Which of the following cardiac catheterization exams allows for the evaluation of aortic regurgitation?

angiography
arteriography
aortography
ventriculogram

Which of the following cardiac cath exams allows for the evaluation of pulmonary artery stenosis and pulmonary thrombosis?

cardiac Doppler
aortography
ventriculography
angiography

The difference in pressures between two cardiac chambers is called a pressure:

velocity
gradient
area
increase

The cardiac cath laboratory may express a pressure gradient all of the following ways EXCEPT:

peak to peak
peak to mean
peak instantaneous
mean

The pressure gradient measurement that expresses the difference between the peak systolic pressure of a ventricle and great artery is all:

peak to peak
mean
peak
peak instantaneous

The pressure gradient that expresses the average pressure gradient between two chambers is the:

peak to peak
peak
peak instantaneous
mean

The pressure gradient that express the maximum gradient between two chambers is:

mean
peak to mean
peak to peak
peak instantaneous

Which of the following cardiac Doppler measurements would correlate best with the cardiac cath gradient measurement?

peak velocity
peak instantaneous
mean
peak to peak

A patient with valvular aortic stenosis has a peak instantaneous gradient of 100 mmHG. The cardiac cath peak to peak gradient is 60 mmHG. The reason for the difference in the gradient is:

cardiac Doppler is unreliable
cardiac cath is a tarnished gold standard
Doppler peak instantaneous gradient will always be greater than the cath peak to peak
the difference cannot be predicted

Which of the fofllowing chest x-ray projections is useful in evaluating the heart?

posterior-anterior
lateral
anterior oblique
right lateral

Cardiomegaly on chest x-ray is associated with all of the following EXCEPT:

pericardial effusion
ventricular hypertrophy/dilatation
acute myocardial infarction
dilated cardiomyopathy

All of the following are types of increased pulmonary vascularity as seen on chest x-ray EXCEPT:

pulmonary artery hypertension
shunt vascularity
pulmonary venous hypertension
pulmonary embolism

The chest x-ray findings for coronary artery disease is/are:

left atrial enlargement
right ventricular enlargment
figure 3 sign
nonspecfic

A left ventricular bulge on chest x-ray may indicate the presence of a left ventricular:

thrombus
aneurysm
infarction
normal ventricle

All of the following chambers may appers enlarged on a chest x-ray of a patient with mitral valve stenosis EXCEPT:

left atrium
left ventricle
right ventricle
right atrium

Which of the following cardiac chambers would most likely appear enlarged on chest x-ray in a patient with mitral regurgitation?

left atrium, right atrium
left ventricle, right ventricle
left atrium, left ventricle
right atrium, right ventricle

The most likely chest x-ray finding in a patinet with significant chronic aortic regurgitation is:

left atrium
left ventricle
right atrium
right ventricle

The chest x-ray finding of left ventricular enlargement due to concentric left ventricular hypertrophy, blunting of the cardiac apex and post stenotic dilatation of the ascending aorta most likely indicates:

mitral vavle stenosis
significant, chronic mitral regurgitation
valvular aortic stenosis
significant, chronic aortic regurgitation

All of the following are possible chest x-ray findings for atrial septal defect EXCEPT:

right ventricular enlargement
main pulmonary artery enlargement
figure 3 sign
increased pulmonary vascularity

All of the following are possible chest x-ray findings for patent ductus arteriosus EXCEPT:

increased pulmonary vascularity
left atrial enlargement
left ventricular enlargement
rib notching

Right ventricular enlargement due to right ventricular hypertrophy and post stenotic dilatation of the main pulmonary artery on chect x-ray is most likely associated with:

valvular aortic stenosis
valvular pulmonic stenosis
mitral valve stenosis
mitral regurgitation

All of the following chest x-ray findings are associated with coarctation of the aorta EXCEPT;

left ventricular enlargement
right ventricular enlargement
figure 3 sign
rib notching

Which of the following is associated with an increase of the cardiac silhouette as seen on chest x-ray?

pleural effusion
constrictivev pericarditis
pericardial effusion
aortic aneurysm

A

All of the following may be diagnosed by chest x-ray EXCEPT:

aortic dilatation/aortic dissection
pleural effusion
myocardial ischemia
calcified pericardium

Which of the following nuclear cardiology isotopes would be best to use to rule out a decrease in myocardial perfusion?

Thallium-201
technetium-99
pyrophosphate
Albunex

Which of the following nuclear cardiology isotopes would be best to use to evaluate ejection fraction?

Thallium-201
technetium-99
Cardiolyte
Albunex

Which of the following nuclear cardiology isotopes would be best to use to image infarcted myocardium?

Thallium-201
technetium-99
Cardiolyte
pyrophosphate

Which of the following noninvasive examination is also called cold spot scanning?

myocardial perfusion
infarct avid imaging
radionuclide angiography
MUGA

Which of the following nuclear studies is also referred to as hot spot scanning?

myocardial perfusion
infarct avid imaging
radionuclide angiography
MUGA