Chapter 19

Questions

1. 361. The image shows:

   

   
   
   
   
   1. A. Normal native tricuspid valve
      
   2. B. Normal bioprosthetic valve
      
   3. C. Vegetation on a bioprosthetic valve
      
   4. D. Avulsion of the tricuspid valve
   
   
2. 362. This 31-year-old woman with no other medical history had two episodes of transient ischemic cerebral attacks, the first one after a long duration of air travel and the second one during straining in the restroom. The most likely cause of this patient’s attacks is:

   

   
   
   
   
   1. A. Paradoxical embolism
      
   2. B. Vagally mediated atrial fibrillation
      
   3. C. Left atrial thrombus
      
   4. D. None of the above
   
   
3. 363. This 35-year-old patient with AIDS and bicuspid aortic valve has Staphylococcus bacteremia. The parasternal long axis color flow image is suggestive of:

   

   
   
   
   
   1. A. Right coronary artery flow
      
   2. B. Pulmonary vegetation
      
   3. C. Fistulous communication between aorta and right ventricle (RV)
      
   4. D. None of the above
   
   
4. 364. This patient’s bilateral Staphylococcus lung abscesses are likely due to:

   

   
   
   
   
   1. A. Tricuspid valve endocarditis
      
   2. B. Pulmonary valve endocarditis
      
   3. C. Catheter-related infection of superior vena cava and right atrium (RA)
      
   4. D. None of the above
   
   
5. 365. The structure indicated by the arrow is:

   

   
   
   
   
   1. A. Coronary sinus
      
   2. B. Inferior vena cava
      
   3. C. Atrial septal defect
      
   4. D. None of the above
   
   
6. 366. This patient’s stroke is likely due to:

   

   
   
   
   
   1. A. Left atrial thrombus
      
   2. B. Left atrial myxoma
      
   3. C. Mitral valve endocarditis
      
   4. D. Patent foramen ovale (PFO)
   
   
7. 367. The structure indicated by the arrow is:

   

   
   
   
   
   1. A. Main pulmonary artery (PA)
      
   2. B. Ascending aorta
      
   3. C. Descending aorta
      
   4. D. None of the above
   
   
8. 368. This patient with a prosthetic tricuspid valve has evidence of:

   

   
   
   
   
   1. A. Normal function
      
   2. B. Stenosis
      
   3. C. Regurgitation
      
   4. D. Endocarditis
   
   
9. 369. The mass in the left atrium in this patient is most likely:

   

   
   
   
   
   1. A. Thrombus
      
   2. B. Myxoma
      
   3. C. Metastatic lung carcinoma
      
   4. D. Lipomatous septum
   
   
10. 370. The short axis view of the heart is indicative of:

    

    
    
    
    
    1. A. Severe pulmonary hypertension
       
    2. B. Severe tricuspid regurgitation (TR) with normal PA pressure
       
    3. C. RV infarct
       
    4. D. RV dysplasia
    
    
11. 371. The surgical procedure that this patient underwent is most likely to be:

    

    
    
    
    
    1. A. Orthotropic heart transplantation
       
    2. B. Mitral valve repair with annuloplasty
       
    3. C. Maze procedure
       
    4. D. Septal myectomy for hypertrophic obstructive cardiomyopathy
    
    
12. 372. This TR signal is from a patient with moderate TR. The most likely mechanism of TR is:

    

    
    
    
    
    1. A. Pulmonary hypertension with annular dilatation
       
    2. B. Flail tricuspid valve
       
    3. C. Tricuspid valve prolapse
       
    4. D. Cannot make a mechanistic diagnosis
    
    
13. 373. This image of the aortic arch from the suprasternal view is suggestive of:

    

    
    
    
    
    1. A. Patent ductus arteriosus (PDA)
       
    2. B. Coarctation of the aorta
       
    3. C. Severe aortic regurgitation
       
    4. D. Aortic pseudoaneurysm
    
    
14. 374. A 42-year-old woman presented with complaints of shortness of breath. An echocardiogram was obtained. Dynamic images showed an LV ejection fraction of 50% with abnormal appearance of the apex. Filling pressures were high, valves were normal. She had normal electrocardiogram, comprehensive and complete blood count except an eosinophil count of 20%. The appearance of the LV apex is suggestive of:

    

    
    
    
    
    1. A. LV apical thrombus
       
    2. B. LV noncompaction
       
    3. C. Apical hypertrophic cardiomyopathy
       
    4. D. Endomyocardial fibrosis
    
    
15. 375. The TR velocity profile shown here is suggestive of:

    

    
    
    
    
    1. A. Normal PA pressure
       
    2. B. Mild pulmonary hypertension
       
    3. C. Severe pulmonary hypertension with good RV function
       
    4. D. Severe pulmonary hypertension with poor RV function
    
    
16. 376. The amount of tricuspid regurgitation in this patient is:

    

    
    
    
    
    1. A. Mild
       
    2. B. Moderate
       
    3. C. Severe
       
    4. D. Cannot quantify
    
    
17. 377. The patient in question 376 is likely to have:

    

    
    
    
    
    1. A. Normal PA pressure
       
    2. B. Mild pulmonary hypertension
       
    3. C. Moderate or severe pulmonary hypertension
    
    
18. 378. The type of surgical procedure performed on this patient’s mitral valve is likely to be:

    

    
    
    
    
    1. A. Mitral annuloplasty
       
    2. B. Alfieri procedure
       
    3. C. Replacement with a bioprosthetic valve
       
    4. D. Replacement with a mechanical valve
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