Chapter 11

Questions

1. 201. Principal determinants of LV end systolic circumferential wall stress include all of the following except:
   
   
   
   1. A. Left ventricular (LV) end systolic dimension
      
   2. B. Left ventricular (LV) end systolic pressure
      
   3. C. Left ventricular (LV) systolic wall thickness
      
   4. D. Left ventricular (LV) pressure at mitral valve closure
   
   
2. 202. Increase in LV end systolic wall stress is likely to reduce all of the following except:
   
   
   
   1. A. Ejection fraction
      
   2. B. Fractional shortening
      
   3. C. Velocity of circumferential shortening
      
   4. D. LV positive dp/dt
   
   
3. 203. The response of LV end systolic volume to an increase in LV end systolic wall stress would be:
   
   
   
   1. A. An increase
      
   2. B. A decrease
      
   3. C. No change
   
   
4. 204. In a person with LV dysfunction, compared to a normal individual, a graph showing end systolic wall stress (ESWS) on the x-axis and end systolic volume (ESV) on the y-axis, would be:
   
   
   
   1. A. Steeper
      
   2. B. Flatter
      
   3. C. None of the above
   
   
5. 205. In response to dobutamine infusion, the ESV–ESWS curve will shift:
   
   
   
   1. A. Down
      
   2. B. Upward
      
   3. C. No shift
   
   
6. 206. The factor least likely to affect the mitral E/A ratio is:
   
   
   
   1. A. Tau
      
   2. B. Modulus of LV chamber stiffness
      
   3. C. Left atrial pressure
      
   4. D. LV elastic recoil
      
   5. E. Cardioversion for atrial fibrillation performed 2 h ago
      
   6. F. Pulmonary artery pressure
   
   
7. 207. Factors affecting LV isovolumic relaxation time (IVRT) are all of the following except:
   
   
   
   1. A. Tau
      
   2. B. Left atrial pressure
      
   3. C. Heart rate
      
   4. D. Moderate aortic regurgitation
   
   
8. 208. The factor least likely to diminish mitral A-wave amplitude is:
   
   
   
   1. A. Recent cardioversion
      
   2. B. Myopathic left atrium
      
   3. C. An acute rise in LV end diastolic pressure
      
   4. D. Severe aortic stenosis with mild LV hypertrophy and normal LV ejection fraction
   
   
9. 209. Both high left atrial (LA) pressure and atrial mechanical failure result in a high E/A ratio. The following is least likely to help in the differential diagnosis in this situation:
   
   
   
   1. A. E-wave deceleration time
      
   2. B. Amplitude and duration of AR-wave
      
   3. C. Pulmonary vein S/D time velocity integral ratio
      
   4. D. Mitral annular velocity with tissue Doppler imaging
   
   
10. 210. Which of the changes are least likely to occur in a patient with acute severe aortic regurgitation:
    
    
    
    1. A. Reduction of A-wave amplitude
       
    2. B. Premature presystolic closure of the mitral valve
       
    3. C. Diastolic mitral regurgitation
       
    4. D. Increased amplitude and duration of pulmonary AR-wave
       
    5. E. A decrease in mitral Em-wave amplitude
    
    
11. 211. A late peaking systolic velocity signal is found in which of the following conditions?
    
    
    
    1. A. Mitral valve prolapse causing late systolic mitral regurgitation (MR)
       
    2. B. MR due to systolic anterior motion of the mitral leaflet
       
    3. C. LV cavity obliteration
       
    4. D. Acute severe MR
    
    
12. 212. The following condition causes a reduction in the acceleration time of pulmonary arterial flow:
    
    
    
    1. A. Pulmonary stenosis
       
    2. B. Pulmonary hypertension
       
    3. C. Dilated pulmonary artery
       
    4. D. Right ventricular (RV) dysfunction
    
    
13. 213. Increased respirophasic variations in transvalvular flows may occur in all of the following conditions except:
    
    
    
    1. A. Status asthmaticus
       
    2. B. Constrictive pericarditis
       
    3. C. Cardiac tamponade
       
    4. D. A large RV infarct
       
    5. E. Hypovolemic shock
    
    
14. 214. Intrapericardial pressure is increased in all of the following conditions except:
    
    
    
    1. A. Cardiac tamponade
       
    2. B. Acute massive pulmonary embolism
       
    3. C. Acute traumatic rupture of tricuspid valve, causing acute tricuspid regurgitation
       
    4. D. Acute RV infarct
       
    5. E. Severe aortic stenosis with normal LV function
    
    
15. 215. A patient with a St. Jude mitral valve no. 29 has a mean diastolic gradient of 3 mmHg and a pressure half-time of 70 ms at a heart rate of 70 beats/min. This is consistent with:
    
    
    
    1. A. Normal prosthetic valve function
       
    2. B. Prosthetic valve thrombosis
       
    3. C. Significant pannus growth
       
    4. D. Severe MR
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