6

Chapter 6


Questions



  1. 101. An intraoperative transesophageal echocardiogram (TEE) revealed mitral regurgitation with the following measurements: regurgitant jet area 4 cm2, PISA radius 0.8 cm at a Nyquist limit of 50 cm/s at a heart rate of 82 beats/min, and arterial blood pressure 80/40 mmHg. This represents:

    1. A. Mild mitral regurgitation (MR)
    2. B. Moderate MR
    3. C. Severe MR

  2. 102. For the patient in the above question, if the systolic blood pressure is increased to 145 mmHg, assuming that the effective orifice area is unchanged, then the:

    1. A. MR jet size will double
    2. B. MR jet size will not change
    3. C. MR jet size will more than double

  3. 103. For a given regurgitant volume, all of the following result in a reduction in the jet size except:

    1. A. Fast heart rate
    2. B. Doubling the sector angle
    3. C. Increasing the imaging depth
    4. D. Increasing the blood pressure

  4. 104. In a patient with severe MR, all of the following factors increase its hemodynamic impact except:

    1. A. Mitral stenosis
    2. B. Left ventricular hypertrophy
    3. C. Compliant left atrium
    4. D. Concomitant aortic regurgitation

  5. 105. In a patient undergoing aortic valve replacement (AVR) for aortic stenosis, there was evidence of moderate MR on a preoperative transthoracic echocardiogram. After the AVR, the next step to be taken is:

    1. A. Replace the mitral valve
    2. B. Leave the mitral valve alone
    3. C. Assess for MR with intraoperative TEE, and decide if repair or replacement is needed
    4. D. None of the above

  6. 106. A patient with old inferior wall myocardial infarction (MI) has severe MR with a posterolaterally directed jet in the left atrium. The most likely cause of MR in this patient is:

    1. A. Flail posterior leaflet
    2. B. Dilated mitral annulus
    3. C. Tented or apically tethered posterior mitral leaflet
    4. D. Tented or apically tethered anterior mitral leaflet

  7. 107. Presence of severe aortic regurgitation (AR) in a patient with mitral stenosis is likely to do the following to the calculated mitral valve area by the pressure half-time method:

    1. A. Overestimate the valve area
    2. B. Underestimate the valve area
    3. C. No effect

  8. 108. Presence of atrial septal defect (ASD) in a patient with mitral stenosis is likely to do the following to the calculated mitral valve area by the pressure half-time method:

    1. A. Overestimate the valve area
    2. B. Underestimate the valve area
    3. C. No change

  9. 109. In a patient with mitral stenosis, the following diastolic flow measurements were obtained: maximal radius of proximal isovelocity surface area (PISA) 0.8 cm at an aliasing velocity of 50 cm/s, inlet angle 120 degrees, peak inflow velocity 2 m/s. The mitral valve area is:

    1. A. 0.7 cm2
    2. B. 1 cm2
    3. C. 1.2 cm2
    4. D. 1.5 cm2

  10. 110. A patient with mitral stenosis without any MR or AR has a stroke volume of 70 cc/beat, a transmitral flow integral of 50 cm, and the mitral valve area is:

    1. A. 0.7
    2. B. 1
    3. C. 1.4
    4. D. None of the above

  11. 111. A patient with MR has a transaortic flow of 70 cc/beat by the left ventricular outflow tract (LVOT) method and a transmitral flow of 112 cc/beat by the mitral annular method. The time velocity integral (TVI) of the MR signal by continuous wave Doppler is 60 cm. The effective regurgitant orifice (ERO) area of this patient is:

    1. A. 1.5 cm2
    2. B. 0.7 cm2
    3. C. 0.4 cm2
    4. D. 0.2 cm2

  12. 112. For a patient with MR and AR, the following measurements were obtained using echo Doppler: flow across the pulmonary valve 75 cc/beat, flow across the mitral valve 120 cc/beat, flow across the aortic valve 90 cc/beat, TVI of MR signal 90 cm, TVI of AR signal 75 cm. The following statement is accurate in this patient:

    1. A. MR ERO is 0.5 cm2 and AR ERO is 0.2 cm2
    2. B. MR ERO is 1.3 cm2 and AR ERO is 1.2 cm2
    3. C. Cannot be calculated

  13. 113. In a patient with isolated AR, the following measurements were obtained: transmitral flow 80 cc/beat, flow across aortic valve 140 cc/beat, TVI of AR signal 100 cm. The AR in this patient is:

    1. A. Mild
    2. B. Moderate
    3. C. Severe
    4. D. Cannot be determined

  14. 114. A patient with dilated cardiomyopathy has an end diastolic pulmonary regurgitation (PR) velocity of 2 m/s and the estimated right atrial pressure is 10 mmHg. The following statement is true about this patient:

    1. A. Pulmonary artery (PA) pressure is normal
    2. B. Has mild or moderate pulmonary hypertension
    3. C. Has severe pulmonary hypertension
    4. D. Cannot estimate pulmonary pressure

  15. 115. If the patient in question 114 had valvular pulmonary stenosis (PS) with a peak gradient of 36 mmHg, the estimated PA end diastolic pressure would be:

    1. A. 16 mmHg
    2. B. 26 mmHg
    3. C. 36 mmHg
    4. D. 62 mmHg

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Jun 12, 2016 | Posted by in CARDIOLOGY | Comments Off on 6

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