CCI EXAM, LATEST QUESTIONS WITH CORRECT DETAILED ANSWERS 2024 WITH RATIONALES ALREADY GRADED A+ Which valves separate the areas of greatest pressure differences (and lowest) - ANSWER- Mitral valve (TV) The LAD lies in the _______ interventricular sulcus? - ANSWER- Anterior From the left parasternal window which of the following are you most likely to get accurate velocity measurements? - ANSWER- pulmonary artery During which phase do the Coto Aries fill? - ANSWER- Easily diastole From the apical 4ch view how do you rotate the transducer to obtain the apical LAX? - ANSWER- Counterclockwise 120 Which valve sits at the opening of the coronary sinus? - ANSWER- Thebesian Which has the fastest intrinsic rate? - ANSWER- SA node With a velocity of .5 m/sec what is the gradient? - ANSWER- 1 mm Hg How do you eliminate aliasing on PW spectral Doppler? - ANSWER- Switch to CW Doppler What does VTI x CSA equal? - ANSWER- Doppler stroke volume Inhalation of amyl nitrite causes: - ANSWER- Decreased afterload Know isovolumetric timing with the ECH - ANSWER- After R wave= isovolumic contraction After T wave= isovolumic relaxation On the wingers diagram when is the mitral valve open? - ANSWER- 4-1 When is the LV and LA volumes highest? - ANSWER- LV- end diastole LA- end systole What are the normal pressure in the pulmonary artery - ANSWER- 25/10 Where is the O2 saturation the lowest? - ANSWER- coronary sinus O2 saturation in the pulmonary veins - ANSWER- 95% O2 saturation in pulmonary arteries - ANSWER- 75?st cath technique for LV function? - ANSWER- LV angiogram Left atrial pressure matches the pressure of what other area? - ANSWER- PCW What is PCW? - ANSWER- Left atrial pressure To determine AS where are the catheters placed? - ANSWER- 1. one in the LV and one in the Ao 2. or one in the LV and "pulled back" across the AoV or one catheter with two seperate sensors Apical swirling of the echo contrast for LVO is caused by: - ANSWER- High MI Sonographers should do peer to peer reviews how often for quality/ technical review? - ANSWER- 2 times per month Whose responsibility is it to obtain the informed consent prior to a TEE? - ANSWERPhysician A secondary finding in aortic stenosis is? - ANSWER- Left ventricular hypertrophy In aortic stenosis is pulse pressure wide or narrow - ANSWER- Narrow Systemic hypertension is a common symptom of - ANSWER- Aortic coarctation Best view to diagnosis a bicuspid aortic valve is the parasternal - ANSWER- Short-axis systole (football shaped) What is Takayasu arteritis? - ANSWER- Aortic arch syndrome Fibrosis of the arch and descending Ao of unknown etiology The normal aortic valve area is - ANSWER- 3-4 cm2 Using the continuity equation when would the severity of Aortic Stenosis be underestimated? - ANSWER- LVOT measured too large Which pressure is obtained during Doppler? - ANSWER- Peak or peak instantaneous (for AS it's the highest gradient anytime during systole) Know the echo gradients are usually higher than cath gradients - ANSWER- Peak instantaneous va peak to peak Norman syndrome - ANSWER- Cardiofacial syndrome with PS, HCM and ASD Does PS cause Pulmonary hypertension? - ANSWER- No MS murmur - ANSWER- low pitched, diastolic "rumble" with an opening snap Which cardiac valve is the second most common to be affected by rheumatic heart disease? - ANSWER- Aortic Patients with mitral stenosis often develop: - ANSWER- atrial fibrillation With atrial fibrillation mitral stenosis velocity calculations are best performed: - ANSWER- Averaged over 5-10 beats In the psax view which method is used to assess the MV area - ANSWER- Planimetry Given a mitral pressure half-time of 400 m/sec what would the area be? - ANSWER0.5cm2 *220/400=0.5, MVA= 220 divided by P 1/2T Given a mitral deceleration time of 400 m/sec calculate the mitral valve pressure halftime: - ANSWER- 116 *400x0.29=116 Carcinoid - ANSWER- Fixed body of the leaflets Rheumatic - ANSWER- Tethered leaflet tips Which anomaly goes with aortic dissection? - ANSWER- Marfan syndrome What kind of murmur would you hear in a patient with a rupture of a sinus of Valsalva aneurysm? - ANSWER- continuous What causes MV preclosure? - ANSWER- an elevated LVEDP (end diastolic pressure) How would you calculate pulmonary artery end diastolic pressure? - ANSWERPulmonic insufficiency velocity Systolic flow reversal of bubbles in the IVC is indicated of Tricuspid Regurgitation or tamponade? - ANSWER- Tricuspid Regurgitation Severe grade TR Regurgitation is a preload= volume = Dilitation It affects the chamber behind it. ( which is Left atria and the Ivc) What is the most common valvular problem associated with carcinoid syndrome? - ANSWER- Tricuspid regurgitation