Lilly Coleman
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Aortic Valve

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Lilly Coleman
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Echo Path Test V

Question 1 of 44

1

The most common of etiology of aortic stenosis in the U.S. is ____

Select one of the following:

  • bicuspid AS

  • calcific AS of a normal trileaflet valve

  • rheumatic heart disease

  • all of the above

Explanation

Question 2 of 44

1

Aortic stenosis is the most common primary valve disease and is best evaluated with echo.

Select one of the following:

  • True
  • False

Explanation

Question 3 of 44

1

Aortic ____ is a thickened aortic valve that still opens well, with a peak velocity < = 2.5 m/s

Select one of the following:

  • congenital AS

  • rheumatic heart disease

  • sclerosis

  • stenosis

Explanation

Question 4 of 44

1

The three most common AS etiologies include ____.

Select one of the following:

  • calcific AS of a trileaflet AOV

  • congenital bicuspid AS with superimposed calcific changes

  • rheumatic AS

  • all of the above

Explanation

Question 5 of 44

1

Bicuspid AS usually becomes symptomatic between the ages of ___.

Select one of the following:

  • < 10 years

  • 10 - 20 years

  • 20 - 50 years

  • 30 - 40 years

Explanation

Question 6 of 44

1

Adults with bicuspid AS usually present with _____ that are reliable predictors of the need for a prosthetic valve, or the risk of heart failure/death.

Select one of the following:

  • aortic caoarctation

  • calcific changes

  • congenital membrane

  • raphe

Explanation

Question 7 of 44

1

___ aortic stenosis originates at the aortic valve cusps and moves out toward the commissures.

Select one of the following:

  • congenital

  • degenerative

  • prosthetic

  • rheumatic

Explanation

Question 8 of 44

1

A 25 year-old has valvular aortic stenosis, what most likely caused it?

Select one of the following:

  • biscuspid aortic vavle

  • coarctation of the aorta

  • congenital membrane across the outflow tract

  • degenerative aortic stenosis

Explanation

Question 9 of 44

1

What type of murmur is associated with aortic stenosis?

Select one of the following:

  • low pitched, diastolic rumble with an opening snap

  • mid-systolic click with/without a systolic murmur

  • murmur that radiates to the axilla

  • systolic crescendo decrescendo murmur

Explanation

Question 10 of 44

1

Serial echocardiograms track changes in the AS patient, to include ____

Select one of the following:

  • AS peak velocity

  • cardiac output

  • pressure half-time

  • RVSP

Explanation

Question 11 of 44

1

The echo report on AS should include details regarding the ____.

Select one of the following:

  • level of obstruction

  • LV size, wall thickness, and EF

  • cusp mobility, thickness, calcification

  • all of the above

Explanation

Question 12 of 44

1

Chest pain and syncope are symptoms of AS

Select one of the following:

  • True
  • False

Explanation

Question 13 of 44

1

___ is a minimally invasive procedure that uses a balloon catheter with a stent-mounted valve crimped on its tip.

Select one of the following:

  • AV repair

  • mini-thoracotomy

  • PMBV

  • TAVR

Explanation

Question 14 of 44

1

The patient is 84 years old and the echo findings include thickened, calcifies AOV cusps, left ventricular hypertrophy, left ventricular enlargement, decreased left ventricular systolic function, and post stenotic dilatation of the aortic root what is most likely the diagnosis?

Select one of the following:

  • acute aortic regurgitation due to AOV vegatation

  • aortic sclerosis with aortic regurgitation

  • bicuspid aortic stenosis

  • degenerative aortic stenosis

Explanation

Question 15 of 44

1

When is a raphe present?

Select one of the following:

  • biscuspid aortic valve

  • cleft aortic valve

  • degenerative aortic stenosis

  • rheumatic aortic stenosis

Explanation

Question 16 of 44

1

What would you expect to see on the M-mode of a bicuspid aortic valve?

Select one of the following:

  • diastolic doming

  • eccentric closure

  • football shaped opening

  • raphe

Explanation

Question 17 of 44

1

In the echo lab, we use the Bernoulli equation to describe the relationship between pressure and velocity. The simplified Bernoulli equation= ____

Select one of the following:

  • 220/ pressure half-time

  • 4V

  • 4(V)^2

  • (Vlvot)(Alvot)=(Vaov)(Aaov)

Explanation

Question 18 of 44

1

According to the Intersocietal Accreditation Commission (IAC), the non imaging CWD probe (PDEOF) must be utilized in the assessment of AS or suspected AS from multiple locations

Select one of the following:

  • True
  • False

Explanation

Question 19 of 44

1

The aortic valve Doppler waveform is below the baseline from every window

Select one of the following:

  • True
  • False

Explanation

Question 20 of 44

1

The continuity equation assumes that flow through a tube is constant, so if the area decreases, the velocity must also decrease

Select one of the following:

  • True
  • False

Explanation

Question 21 of 44

1

In order to acquire a quick maximum PG, the sonographer can utilize the modified Bernoull'is equation (4V)

Select one of the following:

  • True
  • False

Explanation

Question 22 of 44

1

According to the continuity equation, the aortic valve area AVA= (VTIlvot) (CSAlvot)/ (VTIaov)

Select one of the following:

  • True
  • False

Explanation

Question 23 of 44

1

The aortic valve area by the continuity equations requires _____.

Select one of the following:

  • Dlvot from the 5C

  • VTIaov with CWD or PEDOF

  • VTIlvot with CWD

  • all of the above

Explanation

Question 24 of 44

1

A thickened AOV with a peak velocity > = 2.6 m/s suggests aortic _____; whereas, a thickened AOV with a peak velocity < =2.5 m/s, suggests aortic ____

Select one of the following:

  • sclerosis / stenosis

  • stenosis / sclerosis

Explanation

Question 25 of 44

1

If the LVOT diameter = 2.0cm, V1= 1.0 m/sec and V2= 4.0 m/sec, what is the aortic valve area according to the simplified continuity equation?

Select one of the following:

  • 0.39 cm^2

  • 0.79 cm^2

  • 3.14 cm^2

  • 64 mmHG

Explanation

Question 26 of 44

1

With aortic stenosis, multiple doppler windows should be compared, to inlcude the 5C, 3C, suprasternal and left parasternal.

Select one of the following:

  • True
  • False

Explanation

Question 27 of 44

1

Aortic stenosis can be over or underestimated by _____

Select one of the following:

  • 3 -4 + aortic regurgitation

  • improperly measured LVOT diameter

  • tachycardia

  • all of the above

Explanation

Question 28 of 44

1

Reduced LVEF seriously impacts the AS severity scale and underestimates the AS peak velocity, consider using the AS velocity ration.

Select one of the following:

  • True
  • False

Explanation

Question 29 of 44

1

____ would most likely cause chronic aortic regurgitation.

Select one of the following:

  • Aortic dissection

  • Aortic stenosis

  • Left atrial myxoma

  • Trauma

Explanation

Question 30 of 44

1

Severe aortic regurgitation causes a ____

Select one of the following:

  • high-pitched, blowing, diastolic crescendo murmur at the apex

  • high-pitched, blowing, diastolic decrescendo murmur at the left sternal border

  • low-pitched, mid-diastolic rumble at the apex

  • low-pitched, systolic, rumble at the apex

Explanation

Question 31 of 44

1

Echo findings include diastolic flutter of the AMVL & AOV cusps, early closure of the MV, and early opening of the AOV; what is most likely the diagnosis?

Select one of the following:

  • aortic regurgitation

  • aortic stenosis

  • mitral regurgitation

  • mitral stenosis

Explanation

Question 32 of 44

1

Mild aortic regurgitation creates a flatter doppler waveform with a higher pressure half-time.

Select one of the following:

  • True
  • False

Explanation

Question 33 of 44

1

Severe aortic regurgitation causes the aorta's pressure to drop quickly, this creates a more rapid left ventricular pressure increase and higher pressure half-time.

Select one of the following:

  • True
  • False

Explanation

Question 34 of 44

1

The aortic regurgitation pressure half-time is 300 ms; what is most likely the diagnosis?

Select one of the following:

  • mild to moderate AR

  • moderate AR

  • moderate to severe AR

  • severe AR

Explanation

Question 35 of 44

1

The AR peak velocity is usually 3+ m/s due to the pressure difference between the left ventricle and aorta.

Select one of the following:

  • True
  • False

Explanation

Question 36 of 44

1

The heart responds to an increased preload by an increase in:

Select one of the following:

  • systolic pressure

  • diastolic pressure

  • afterload

  • contractility

Explanation

Question 37 of 44

1

How do we find the Cross Sectional Area ( CSA of the LVOT ) for the Continuity equation?

Select one of the following:

  • πr2

  • πrl+ πr2

  • π(D/2)

Explanation

Question 38 of 44

1

Patients with long standing aortic stenosis will usually have:

Select one of the following:

  • LVH

  • LV dilation

  • diastolic aortic flutter

  • mitral ring calcification

Explanation

Question 39 of 44

1

Doppler ultrasound may show retrograde flow velocities within the ascending aorta during diastole in the presence of:

Select one of the following:

  • aortic regurgitation

  • patient ductus arteriosus

  • aorticopulmonary window

  • aorticsubclavian shunts

Explanation

Question 40 of 44

1

Which of the following ausculatatory sounds is most suggestive of a bicuspid aortic valve?

Select one of the following:

  • S4

  • opening snap

  • mid-systolic click

  • systolic ejection click

Explanation

Question 41 of 44

1

Which technique would best allow you to assess the severity of aortic regurgitation?

Select one of the following:

  • pulsed wave doppler

  • continuous wave doppler

  • M-mode echocardiography

  • two-dimensional echocardiography

Explanation

Question 42 of 44

1

A patient with a crescendo/decrescendo systolic murmur and a decreased A2 would probably be sent to the echo lab to evaluate:

Select one of the following:

  • mitral insufficiency

  • tricuspid insufficiency

  • pulmonic stenosis

  • aortic stenosis

Explanation

Question 43 of 44

1

In aortic stenosis the:

Select one of the following:

  • LA diastolic pressure exceeds that of the LV

  • LV systolic pressure exceeds that of the aorta

  • LV diastolic pressure exceeds that of the aorta

  • aortic systolic pressure exceeds that of the LV

Explanation

Question 44 of 44

1

Which 2-D views are best for direct imaging of a discrete subaortic membrane?

Select one of the following:

  • parasternal long and short axis views

  • apical five chamber and apical long axis

  • subcostal long axis and apical four chamber views

  • parasternal long axis and apical two chamber views

Explanation

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