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ECHOCARDIOGRAPHY BOARD REVIEW PDF

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Echocardiography Board Review, 2nd Edition. Multiple Choice Questions with Discussion. Ramdas G. Pai, MD, Professor of Medicine. Echocardiography board review: multiple choice questions with prepare for the National Board of Echocardiography and should be helpful both to the. Echocardiography Board Review - Free download as PDF File .pdf), Text File . txt) or read online for free. Echocardiography Board Review: Multiple Choice .


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Request PDF on ResearchGate | On Sep 1, , Vincent L. Sorrell and others published Echocardiography Board Review: Multiple Choice Questions with . Adult Echocardiography Review. A Q&A REVIEW FOR THE ARDMS ADULT ECHOCARDIOGRAPHY EXAM. 2nd Edition. Carol Mitchell, PhD, RDMS. Practical Handbook of Echocardiography Case Studies pdf. ameerhunzai, Jun 19 Echocardiography Board Review - MCQs (Wiley, ).pdf.

Free Access. Summary PDF Request permissions. Tools Get online access For authors. Email or Customer ID. Forgot password? Old Password. New Password. Your password has been changed. Answer: A. Hence travel time at a depth of 15 cm is roughly 0. This is independent of transducer frequency and depends only on the medium of transmission. Answer: C. High LA pressure. Abnormal LV relaxation has exactly the opposite effect on the mitral flow profile.

Very young children may have a pattern mimicking high LA pressure because of superefficient LV relaxation, which promotes early LV filling. Answer: B. Reducing the sector angle will reduce the time required to complete a frame by reducing the number of scan lines. This increases the temporal resolution.

Decreasing depth will increase the frame rate as well. Adding color Doppler will reduce the frame rate. This is normal and results from a very efficient relaxation process, which facilitates early diastolic LV filling. Rapid E-wave deceleration results in physiological S3. And also, as most of the filling occurs in early diastole, children are able to tolerate rapid heart rates and loss of atrial kick without much of a problem. In other words, efficient relaxation mimics high LA pressure in terms of mitral inflow pattern.

The law of conservation of mass is the basis of the continuity equation.

In a nonobstructed mitral valve, significant energy is expended in accelerating the flow flow acceleration. As viscous losses in this situation are minimal, the other two components flow acceleration and convective acceleration of the Bernoulli equation have to be taken into account.

In the simplified Bernoulli equation, the flow acceleration component is ignored. Put simply, when you deal with low-velocity signals from pulsatile flows, the simplified Bernoulli equation does not describe the pressure flow relationship accurately. Lateral resolution depends on beam width, which increases at increasing depths.

Axial resolution depends on spatial pulse length, which is a function of transducer frequency, pulse duration and propagation velocity in the medium. Depth of focus equals crystal diameter squared divided by wavelength multiplied by 4.

Lateral resolution diminishes at depths due to beam divergence. Frame rate determines the temporal resolution. Wavelength is a function of the transducer and is independent of depth and frame rate adjustments. Amplitude or strength of the reflected beam and its temporal registration, which determines depth registration. Pulse duration is the characteristic of the pulse and does not change with depth.

Increasing depth will reduce pulse repetition period, frequency and hence the duty factor. Backscatter or diffuse reflection produces most of the clinical images. Specular reflection reaches the transducer only when the incident angle is to the surface, which is not the case in most of the images produced. Refracted and transmitted ultrasounds do not come back to the transducer. Attenuation is the loss of ultrasound energy as it travels through the tissue and is caused by absorption and random scatter.

It is greater with longer travel path length as it has to go through more tissue. Attenuation is greater at higher frequencies due to smaller wavelength. Attenuation is greatest for air followed by bone, soft tissue and water. It is a measure of attenuation and reflects the depth at which the ultrasound energy is reduced by half. For example, for an ultrasound frequency of 3 MHz the half-intensity depth is 2 cm, and for 6 MHz it is 1 cm.

The PRF is independent of transducer frequency and only determined by time of flight, which is the total time taken by ultrasound in the body in both directions.

Echocardiography Board Review: 500 Multiple Choice Questions With Discussion

In other words, at 1 cm depth 2 cm travel distance the technical limit to the number of pulses that can be sent is per second Hz. Answer: D. Pedoff is a continuous wave Doppler modality for velocity recording. All other modalities utilize the pulsed wave technique where each of the crystals performs both transmit and receive functions. Increase in frame rate occurs with reducing sector angle and depth. It is independent of transmit frequency and power.

Focusing increases lateral resolution. Increasing transducer diameter and increasing frequency also increase lateral resolution. Increasing the transmit frequency will reduce the wavelength and hence the spatial pulse length. This will increase the PRF and the axial resolution. Beam diameter and focusing have no effect on axial resolution.

Ultrasound in the MHz range is used for acoustic microscopy. Doppler shift is typically in: A. Ultrasound range B. Infrasound range C. Audible range Duty factor refers to: A. Power the transducer can generate B. Range of frequencies the transducer is capable of C. Physical properties of the damping material D. Fraction of time the transducer is emitting ultrasound Duty factor increases with: A.

Increasing gain B. Increasing pulse duration C. Decreasing pulse repetition frequency PRF D.

Decreasing dynamic range Which of the following will increase the PRF? Reducing depth B. Decreasing transducer frequency C.

Reducing sector angle D. Reducing filter Persistence will have this effect on the image: A. Smoothing of a two-dimensional image B. Better resolution C. Eliminating artifacts D.

Spuriously reducing wall thickness Aliasing occurs in this type of imaging: A. Pulsed wave Doppler B.

Continuous wave Doppler C. None of the above D. All of the above Cannot calculate 18 8 Echocardiography Board Review The Nyquist limit can be increased by: A. Increasing the PRF B. Reducing the PRF C. Neither The Nyquist limit can also be increased by: A. Increasing transducer frequency B. Reducing transducer frequency C. Reducing filter D. None of the above Aliasing can be reduced by: A.

Decreasing the depth B. Increasing the PRF C. Reducing the transducer frequency D.

Changing to continuous wave Doppler E. What is the purpose of the depth or time gain compensation process adjusted by the echo cardiographer and performed in an ultrasound s receiver? Corrects for attenuation and makes the image uniformly bright B. Eliminates image artifacts C.

Echocardiography Board Review

Eliminates aliasing D. Which of the following increases the Nyquist limit? Reducing the sample volume depth C. Increasing the transducer frequency D. Depends on depth D. Cannot be determined The PRF is influenced by: A. Transducer frequency B. Depth of imaging C.

Both D. Two identical structures appear on an ultrasound scan. One is real and the other is an artifact, the artifact being deeper than the real structure.

What is this artifact called? Shadowing B. Ghosting 19 Chapter 2 9 C. Speed error artifact D. Mirror image What is determined by the medium through which sound travels?

Wavelength B. Speed C. Wavelength and speed D. Image quality on an ultrasound scan is dark throughout? What is the first best step to take?

Increase output power B. Increase receiver gain C. Change to a higher frequency transducer D. Decrease receiver gain All of the following will improve temporal resolution except: A. Decreasing line density B. Decreasing sector angle C. Increasing frame rate D. Multifocusing Sound travels faster in a medium with which of the following characteristics? High density, low stiffness B. Low density, high stiffness C. High density, high stiffness D. Low density, low stiffness Which of the following is associated with continuous wave Doppler compared to pulsed wave Doppler?

Aliasing B. Range specificity C.

Echocardiography Board Review

Ability to record higher velocities D. Doppler shift resulting from moving blood is generally audible. Audible frequency is Hz. It is pulse duration divided by pulse repetition period. Typical value for two-dimensional imaging is 0. Example for a 2 MHz transducer: the wavelength in tissue is 0. Proportional to pulse duration if the PRP is constant. If pulse duration is constant, decreasing the PRF will reduce the duty factor.

Gain and dynamic range have no effect on duty factor. Reducing depth reduces time of flight of ultrasound in the body and hence will increase the PRF. Persistence is the process of keeping the prior frames on the display console and will smoothen the image.

This reduces random noise and strengthens the signal. However, fast-moving structures can produce artifacts and make the structures look thicker than they are. Some of the other smoothing algorithms include interdigitation and blooming to reduce the spoking appearance produced by the scan lines.

Aliasing or wrap-around occurs when the Nyquist limit or upper limit of measurable velocity is reached. The Nyquist limit is determined by the PRF. Spectral pulsed wave Doppler and color flow imaging are pulsed wave modalities. Reducing transducer frequency will increase aliasing velocity and reduces range ambiguity.

For a given detected Doppler shift, the lower the transducer frequency, the higher is the measured velocity. Answer: E. All of the above. It is postprocessing, which adjusts for loss of ultrasound that occurs at increasing depths. Hence decreasing the sample volume depth will increase the PRF, which in turn will increase the Nyquist limit. Depth influences the PRF. The PRF is influenced by pulse duration and time need for ultrasound to travel in tissue. Increasing depth will increase the time spent in the body.

Mirror image artifact is a type of artifact where the artifact is always deeper than the real structure and occurs because of the structure or the surface between the two functioning as a mirror. Speed is determined only by the medium through which sound is traveling.

For a given frequency, speed will determine the wavelength: the greater the speed, the longer the wavelength. Period is the time taken for one cycle and is determined by frequency and is independent of the transmission medium. The first best action to take is to increase output power. This will brighten the overall image. If the image is still dark, then the receiver gain should be increased. Multifocusing will decrease temporal resolution by decreasing the frame rate, whereas all the others will improve temporal resolution by facilitating an increase in the frame rate.

Sound travels faster in a medium with low density and high stiffness. Chapter Answer: C. Aliasing and range specificity are properties of pulsed wave Doppler. Continuous wave Doppler is associated with range ambiguity. Continuous wave Doppler will also permit recording of higher velocities than pulsed wave Doppler, as it is not limited by the PRF.

As frequency increases, backscatter strength: A. Decreases B. Increases C. Does not change D. Refracts If an echo arrives 39 ms after a pulse has been emitted, at what depth should the reflecting object be on the scan line? Reflected ultrasound from an object moving away from the sound source will have a frequency: A. Higher than original sound B. Lower than the original sound C. Same as the original sound D. Variable, depending on source of sound and velocity of the moving object Reflected ultrasound from an object moving perpendicular to the sound source will have a frequency: A.

Variable, depending on source of sound and velocity of the moving object 24 14 Echocardiography Board Review Doppler shift frequency is independent of: A. Operating frequency B. Doppler angle C. Propagation speed D. Amplitude On a continuous wave Doppler display, amplitude is represented by: A.

Brightness of the signal B.

Amplitude or strength of the reflected beam and its temporal registration, which determines depth registration. Pulse duration is the characteristic of the pulse and does not change with depth. Increasing depth will reduce pulse repetition period, frequency and hence the duty factor. Backscatter or diffuse reflection produces most of the clinical images. Specular reflec- tion reaches the transducer only when the incident angle is to the surface, which is not the case in most of the images produced.

Refracted and transmitted ultrasounds do not come back to the transducer. Attenuation is the loss of ultrasound energy as it travels through the tissue and is caused by absorption and random scatter. It is greater with longer travel path length as it has to go through more tissue. Attenuation is greater at higher frequencies due to smaller wavelength.

Attenuation is greatest for air followed by bone, soft tissue and water.

It is a measure of attenuation and reflects the depth at which the ultrasound energy is reduced by half. It is given by the formula: For example, for an ultrasound frequency of 3 MHz the half-intensity depth is 2 cm, and for 6 MHz it is 1 cm. The PRF is independent of transducer frequency and only determined by time of flight, which is the total time taken by ultrasound in the body in both directions. In other words, at 1 cm depth 2 cm travel distance the technical limit to the number of pulses that can be sent is 77 per second Hz.

Pedoff is a continuous wave Doppler modality for velocity recording. All other modalities utilize the pulsed wave technique where each of the crystals performs both transmit and receive functions.

Increase in frame rate occurs with reducing sector angle and depth. It is independent of transmit frequency and power. Focusing increases lateral resolution.

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Increasing transducer diameter and increasing frequency also increase lateral resolution. Increasing the transmit frequency will reduce the wavelength and hence the spatial pulse length. This will increase the PRF and the axial resolution. Beam diameter and focusing have no effect on axial resolution. Typical frequency is 2—30 MHz: Ultrasound in the — MHz range is used for acoustic microscopy. Echocardiography Board Review Uploaded by khlnguyen.

Echocardiography Board Review: Flag for inappropriate content. Related titles. Comprehensive Textbook of Echocardiography Volume 2. Jump to Page. Search inside document. Chapter 1 Questions 1. The speed of sound in tissues is: High LA pressure D D. None of the above TE 3. Increasing the depth GH B. Adding color Doppler to B-mode imaging RI 4.

Suggestive of high LA pressure D. Is pseudonormal 5. Jet momentum analysis 6. Mean gradient across a stenotic tricuspid valve 7. Lateral resolution 8. The wavelength Pulse duration Duty factor Transmission Half the ultrasound beam width Nonimaging Doppler probe Pedoff Increase transmit power Reducing transmit frequency Increase transmit frequency Chapter 1 5 8.

Victoria Besleaga. YOshie Parras. Deepak Ghimire. Sundara Rami Reddy. Dianna Arzumanova. Monica Surdu. Carina Ureche.

Pai R., Varadarajan P. Echocardiography Board Review: 400 Multiple Choice Questions With Discussion

Jessica E Isom. Dr Edi Hidayat.Decreasing transducer frequency C. This does not take the place of a standard textbook of echocardiography, but complements the textbook reading by bringing out the salient concepts in a clear fashion.

Color flow imaging D. Acute severe mitral regurgitation MR. The PRF is independent of transducer frequency and only determined by time of flight, which is the total time taken by ultrasound in the body in both directions. None of the above D. Beam focusing C. High density, low stiffness B. Answer: D.

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