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ARDMS AE Adult Echocardiography Examination Sample Questions (Q80-Q85):

NEW QUESTION # 80
How are pseudoaneurysms best distinguished from true aneurysms?

A. True aneurysms are lined with myocardium.
B. Pseudoaneurysms occupy the left ventricular apex.
C. True aneurysms contain thrombus.
D. Pseudoaneurysms have a wide neck.

Answer: A

Explanation:
True ventricular aneurysms are lined by scarred myocardium and have a broad neck. Pseudoaneurysms occur after myocardial rupture contained by pericardium or scar tissue and lack myocardium in the wall.
Pseudoaneurysms typically have a narrow neck and are more prone to rupture.
Pseudoaneurysms can occur at various locations, not exclusively the apex. Both true aneurysms and pseudoaneurysms may contain thrombus, so this is not a distinguishing feature.
This differentiation is important clinically and is detailed in adult echocardiography and surgical cardiology texts and ASE guidelines#16:Textbook of Clinical Echocardiography, 6ep.400-405##12:ASE Cardiac Masses and Aneurysms Guidelinesp.150-160#.

NEW QUESTION # 81
Which finding is NOT associated with severe mitral valve regurgitation?

A. Eccentrically directed mitral regurgitant jet
B. Systolic flow reversal in the pulmonary vein
C. Severely dilated left atrium
D. Mitral regurgitant jet velocity less than 0.5 cm/sec

Answer: D

Explanation:
Severe mitral regurgitation (MR) is typically characterized by significant left atrial dilation due to volume overload, and systolic flow reversal in the pulmonary veins caused by retrograde flow from the left ventricle into the left atrium during systole.
An eccentric mitral regurgitant jet is common in severe MR, often due to leaflet prolapse or flail, resulting in directed jets that hug the atrial wall.
Mitral regurgitant jet velocity, however, is usually significantly higher in severe MR due to the high pressure gradient between the left ventricle and left atrium during systole. A jet velocity less than 0.5 cm/sec is extremely low and inconsistent with severe MR. Typically, MR jet velocities are in the range of several meters per second.
Thus, a mitral regurgitant jet velocity less than 0.5 cm/sec is NOT associated with severe MR.
This is detailed in echocardiography literature discussing MR quantification and Doppler findings, emphasizing high-velocity regurgitant jets in severe MR and hemodynamic consequences seen on pulmonary vein flow and LA size .

NEW QUESTION # 82
Which wall is indicated by the arrow on this video?

A. Inferolateral
B. Anteroseptum
C. Anterolateral
D. Inferoseptum

Answer: A

Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
The apical two-chamber echocardiographic view displays the inferolateral wall (also called posterior lateral).
The arrow points to this inferolateral segment, which is located inferiorly and laterally in the left ventricle.
Anteroseptum and inferoseptum relate to the interventricular septum, while anterolateral is the anterior lateral wall, opposite the inferolateral wall. Correct regional wall motion assessment is essential for ischemic disease evaluation.
This identification and terminology are described in ASE stress echocardiography and chamber quantification guidelines#12:ASE Stress Echocardiography Guidelinesp.310-315##16:Textbook of Clinical Echocardiography, 6ep.380-385#.

NEW QUESTION # 83
Which finding is most consistent with this M-mode image?

A. Mitral valve prolapse
B. Systolic antenor motion of the mitral valve
C. Mitral valve annuloplasty ring
D. Rheumatic mitral stenosis

Answer: D

Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
This M-mode echocardiographic image shows thickened mitral valve leaflets with a characteristic "doming" or "hockey-stick" appearance during diastole, which is classic for rheumatic mitral stenosis. Rheumatic mitral stenosis leads to leaflet thickening, restricted opening, and calcification, which alters the normal mitral valve motion on M-mode.
Mitral valve prolapse would show systolic displacement of the leaflets into the left atrium, typically later in systole, not doming in diastole. Mitral valve annuloplasty ring would appear as a bright echogenic line around the annulus but is not seen in this image. Systolic anterior motion (SAM) of the mitral valve is usually seen in hypertrophic cardiomyopathy and presents as anterior motion during systole, not the diastolic pattern shown.
This classical M-mode appearance is described in "Textbook of Clinical Echocardiography, 6e", Chapter on Rheumatic Valve Disease#20:385-390Textbook of Clinical Echocardiography#.

NEW QUESTION # 84
During which phase of the cardiac cycle does mitral valve prolapse occur?

A. Atrial systole
B. Ventricular filling
C. Diastasis
D. Ventricular contraction

Answer: D

Explanation:
Mitral valve prolapse (MVP) occurs during ventricular contraction (systole). Specifically, during systole, the increased pressure in the left ventricle causes the mitral valve leaflets to billow or prolapse back into the left atrium. This abnormal systolic displacement of the mitral leaflets beyond the annular plane leads to mitral regurgitation in many cases.
The echocardiographic hallmark of MVP is systolic bowing or displacement of the mitral leaflets into the left atrium, best visualized in parasternal long-axis or apical views during ventricular contraction. MVP is not seen during ventricular filling phases such as early filling, atrial systole, or diastasis because the leaflets are normally open or positioned differently.
This is well-documented in the "Textbook of Clinical Echocardiography, 6e", Chapter on Mitral Valve Disease, explaining the pathophysiology of MVP and its timing during the cardiac cycle#20:390-
395Textbook of Clinical Echocardiography#.

NEW QUESTION # 85
......

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