-
The ASE adopted the "leading edge" method of measurements because:
* People were turning up the gain too much
* nature of the interaction between ultrasound & anatomical interfaces make this advisable
* the advent of gray scale M mode made this possible
* it produces the most consistent and reproducible measurements
it produces the most consistent and reproducible measurements
-
The term basilar area of the ventricle refers to the:
ventricular myocardium at the apex
mid segments of the ventricle
ventricular myocardium at the AV valves
non of the above
ventricular myocardium at the AV valves
basilar area of the heart is at a level near the AV valves
-
Dextracardia indicates:
enlargement of all cardiac chambers
an abnormal conduction system
heart located in the right side of the chest
dual chambers of the right ventricle
heart located in the right side of the chest
when all the organs are reversed
-
In M mode, the structure used to pinpoint end systole for measurements is:
R wave of the EKG
maximum anterior motion of the LVPW
maximun posterior motion of the IVS
Q wave of the EKG
maximum anterior motion of the LVPW
-
T/F The coronary sinus returns blood to the left atrium
False
coronary sinus is the terminal portion of the great cardiac vein, and it returns blood to the right atrium
-
The motion of the septum should be evaluated by M mode at the:
basal level
mitral level
midventricular level
apical level
midventricular level
-
T/F The ostium of the coronary arteries may sometime be visualized in a PSAX 2-D echo view at the level of the aortic valve.
True
narrow opening on the left coronary cusp of the AV valve at approx 4-5 o'clock may define the ostium(opening) of the left coronary artery
-
What phase would be occuring during atrial filling?
diastole
systole
isovolumic phase
systole
-
In the EKG cycle, late ventricular filling occurs after the:
P wave
Q wave
R wave
T wave
P wave
P wave on the EKG is the electrical stimulus that creates the mitral A wave, which coincides with the atrial kick and late diastolic filling
-
T/F: If a patient presents with an early diastolic murmur you would concentrate interest on the which to valves:
aortic valve
mitral valve
tricuspid valve
pulmonic valve
aortic valve, pulmonic valve
ealry diastolic murmurs are due to arotic or pulmonic insufficiency
-
Which valve would you suspect to be abnormal if acuscultation revealed an Austin-Flint mumur?
aortic valve
mitral valve
tricuspid valve
pulmonic valve
aortic valve
Austin-Flint murmur is associated with aortic insufficiency
-
The heart sound most often associated with mitral valve prolapse is:
Gallop rhythm
ejection sounds
opening snap
systolic click
systolic click
most important physical findings in patierns with mitral valve prolapse. clicks may be single or multiple and maybe brought out by changes in position or valsalva maneuver
-
The heart sound associated with mitral and/or tricuspid stenosis is:
Gallop rhythm
ejection sound
opening snap
friction rub
opening snap
sounds are sharp & high pitched. In isolated MS increasing severity of the lesion causes highter atrial pressures and early opening of the valve, relatively short interval between the aortic component of the 2nd heart sounds & the opening snap implies severe MS.
-
T/F: Early diastolic murmurs are due to aortic or pulmonic insufficieny.
True: severity of the reg is often inversely related to the duration of the mumur. With servere reg, aortic diastolic psi falls rapidly and may equalize with ventricular psi relatively early, causing marked reduction of intensity or cessation of the murmur. AS may also cause diastolic rumble at the apex-Austin Flint murmur. PI is associated with 2 forms of murmurs. In PI due to pulmonary HTN, there is a large diastolic gradient, high pitched murmur, follows the 2nd heart sound immediately and continues throughout diastole. In PI caused by valvular disease, there is usually a silent period between the pulmonic 2nd heart sound & the initiation of the murmur, which is relatively low in frequency.
-
T/F: Myxomas are the most common type fo cardiac tumor. They comprise half of all reported cases. Which of the following is a true statement?
* tumors can be located either inside or outside of the heart
* Approx 40% of patients with LA myxomas have systemic emboli to the brain or extremities
* myxomas occur only in the left atrium
* females are affected slightly more often than males
F, T, F, T
these tumors are located only intarcardially, can occur in either atrium, on the mitral valve, or in the ventricles
-
T/F: Symptoms associated with pericardits include:
* severe, sharp pain located precordially that may radiate into the shoulders and neck
* ankle swelling.
* changing positions and taking deep breaths increase the pain.
* the pain is dull and radiates into the jaw.
T, F, T, F
-
True/False: Symptoms noted with mitral valve prolapse syndorme include:
palpitations and sharp pain unrelated to exercise
lower back pain and headache
fatigue and dyspnea
palpitations and dizzy spells
T, F, T, T
-
A pseudonym for mitral valve prolapse syndrome is:
Ebstein's anomaly
Barlow's syndrome
Crohn's disease
Prinzmetal angina
Barlow's syndrome
-
True/False: The term trepopnea is the sensation of dyspnea or palpitation, or an uncomfortable feeling that may occur when patients with cardiac disease lie on their left side.
True
-
The term dyspnea refers to the condition of:
difficulty in digesting food
difficulty in breathing
rapid breathing
deep breathing
difficulty in breathing
-
If a patient awakens in the night with shortness of breath, 1 to 2 hours after falling asleep, what disease might be suspected?
angina pectoris
mitral valve prolapse
constrictive pericarditis
congestive heart failure
congestive heart failure
-
True/False: Anemia or cyanosis maybe a manifestation of serious underlying heart disease.
True
-
True/False: Dextrocardia can be detected by chest x-ray, percussion, EKG exam, auscultation and asking the patient:
True
-
True/False: Palpation of arterial pulses is a method used to help determine the presence or absence of diagnostic physical signs for certain cardiac diseases. Whicho f the following statements is/are correct?
*heart failure, obstruction of flow by valvular stenosis, and constrictive pericarditis can cause a diminished stroke volume.
* normal peripheral pulses arrive later then the carotid pulse
* pulsus alternans implies impaired ventricular function and is often present in massive pericardial effusion, particularly pericardial tamponade
* AR, & carotid atherosclerosis cause a large storke volume, wide pulse pressure, and lowered peripheral resistance with resultant bounding hyperkinetic pulses
All are True
-
True/False: Which of the following signs are indicative but not diagnostic of heart disease?
sharp chest pains
cyanosis
clubbing
obesity
All of them
all of the above may be indicators of cardiac disease but are not specifically diagnostic
-
Which one of the following is most likely to cause a decrease in cardiac output?
a decrease in peripheral resistance
hyperemia
decreased in LV stroke volume
increase in heart rate
hypertension
decrease in LV stroke volume
- LV stroke volume is directly realted to CO, therefore any decrease in LV stroke volume will reduce CO.
- Coverserly, an increase in LV stroke volume will raise cardiac output
-
A decrease in LV contractility secondary to acute myocardial infarction will:
increase CO(Q) by increasing resistance(R)
decrease CO(Q) by decreasing pressure(delta P)
increase velocity of flow in the aorta
decrease delta P with no effect on CO
decrease CO(Q) by decreasing pressure(delta P)
LV contractility will decrease delta P and in doing so will reduce cardiac ouptut
-
In all other factors remain constant, you would expect a reduction in vessel diameter to:
increase velocity
decrease the likelihood of turbulence
decrease viscosity
decrease kinetic energy
increase flow
increase velocity
- reduction in vessel diameter increases velocity within the constricted segment.
- reduction also increases the likelihood of turbulence, and if the diameter is sufficiently reduced flow will be reduced (critical stenosis)
-
Which one of the following is most likely to cause turbulent flow of blood in the aorta?
an increase in CO from 5L/min to 20L/min
an increase in hematocrit
decrease in cardiac output to one-half of normal
an increase in arterial pressure of 5mmHG
hypertensive episode
an increase in CO from 5L/min to 20L/min
-
True/False: Which of the following are characteristics of turbulent flow?
can be predicted by Reynold's number
is responsible for murmurs, bruits and thrills
it can increase pressure downstream
it occurs where there are abrupt variations in vessel diameter
is affected by velocity
T, T, F, T, T
-
A laboratory animal sudently develops 2:1 heart block, effectively reducing heart rate by one-half. Which one of the following responses would account for pressure being maintained at the same level as before the heart block?
peripheral resistance decreased by one-half
massive vasodilatation of the arterial sphincters
peripheral resistance doubled
arteriovenous shunting
peripheral resistance doubled
Ohm's Law. CO and pressure are governed not by how much blood the heart can put out in a given period but rather by how much blood the peripheral vessels are capable of accepting. With CO halved the peripheral resistance doubled, pressure remains the same.
-
A subject has cardiac output of 5 L/M at a heart rate of 75 beats/min. If stroke volume reamins constant, what will be the effect of an increase in heart rate at 150 beats/min?
CO would increase to 22.5 L/min
CO would increase to 22 L/min
CO would increase to 10 L/m
nothing, cardiac out is independent of heart rate
CO would triple
CO would increase to 10 L/m
-
The minimal pressure in the arterial system during a cardiac cycle is termed:
systolic pressure
pulse pressure
diastolic pressure
mean pressure
mean pulse pressure
diastolic pressure
-
A subject has a cardiac output of 5 L/min at a heart rate of 75 beats/min. If stroke volume remains constant, what will be the effect of an increase in heart rate of 150 beats/min?
CO would increase to 22.5 L/min
CO would increase to 25 L/min
CO would increase to 10 L/min
Nothing, CO is independent of HR
CO would triple
CO would increase to 10 L/min
-
In measuring human blood pressure, the first sound was heard at 130 mmHG, the second is 105, the third at 100, and the last at 95. What is the estimated mean blood pressure?
118 mmHG
115 mmHG
122 mmHG
107 mmHG
107 mmHG
-
Which ONE of the following is correct statement describing transmission of the arterial pressure wave?
it originates at the level of the arterioles
it slows with increasing age
it slows with increasing calcification of the vessels
it is caused in part by the inerita of blood in the aorta
it is caused in part by the inerita of blood in the aorta
-
In laminar flow, the velocity of the blood is:
* directly proportional to the cross-sectional area of the vessel.
* lowest when kinetic energy is highest
* lowest at the center of the vessel
* zero at the vessel wall
* highest at the vessel wall
zero at the vessel wall
fact that normal blood flow is zero at the vessel wall and highest at center stream is one reason why CW doppler show wider frequency shifts (decreased windowing) when spectrally analyzed.
-
The principal site of peripheral resistance in the vascular bed is determined to be in the arterioles because:
blood pressure does not change across these vessels
blood flow is slowest in the arterioles
pressure drop across these vessels is greatest
blood pressure is the highest here
pressure drop across these vessels is greatest
-
As the arterial pressure wave moves toward the periphery, all of the following occurs EXCEPT:
pulse amplitude is increased by the presence of reflected waves
speed of propagation disminishes
pulsatile changes in arterioles and capillaries are dampened owing to vascular distensibility and resistance
speed of propagation increases
speed of propagation disminishes
-
The incisura on the aortic pressure wave:
indiates closure of the AV valves
occurs when the aortic valve opens
is inscribed just after the aortic valve closes
occurs during rapid ventricular filling
is inscribed just after the aortic valve closes
-
Starling's law of the heart can best be expressed by which one of the following?
* as heart rate increases, venticular contractility also increases
* increasing the arterial pressure decrease the stroke volume
* within limits, an increase in venous return resuts in an increase in stroke volume
* the product of heart rate and stroke volume equals the cardiac output
within limits, an increase in venous return resuts in an increase in stroke volume
-
Which ONE of the following best describes the role of the heart as a pump?
* regulating cardiac output
* forcing blood from the venous to the arterial circulation, restoring energy necessary for the blood flow
* suctioning blood from the venous circulation
* removing carbon dioxide from venous blood and supplying oxygen
forcing blood from the venous to the arterial circulation, restoring energy necessary for the blood flow
|
|
