NBE Transthoracic Echocardiography 5

Question 1

Which TTE finding is characteristic of an ostium secundum atrial septal defect (ASD)?

Accepted Answer

Dropout in the fossa ovalis region with right ventricular volume overload

Answer

Ostium secundum ASD appears as a central defect in the fossa ovalis with left-to-right shunting and consequent RV volume overload on TTE.

Question 2

In a patient with dilated cardiomyopathy, which diastolic pattern on mitral inflow Doppler is associated with the worst prognosis?

Accepted Answer

Restrictive filling pattern (E/A > 2, short DT)

Answer

A restrictive filling pattern (E/A > 2, deceleration time < 150 ms) in DCM indicates severely elevated filling pressures and portends the poorest prognosis.

Question 3

Which condition is most likely when TTE reveals a linear echogenic structure in the right atrium moving independently of the atrial walls?

Accepted Answer

Chiari network or Eustachian valve variant

Answer

A Chiari network is a remnant of the right valve of the sinus venosus — a mobile, filamentous structure in the RA that is a normal variant.

Question 4

When performing TTE on a patient post-cardiac surgery with a prosthetic mechanical mitral valve, which Doppler parameter is most useful for detecting valve obstruction?

Accepted Answer

Peak transmitral velocity and pressure half-time

Answer

Elevated peak transmitral velocity and prolonged PHT (≥ 130 ms) indicate increased resistance across the prosthetic valve, suggesting obstruction or pannus.

Question 5

Which echocardiographic criterion is used to define a positive bubble study (agitated saline contrast) for patent foramen ovale (PFO)?

Accepted Answer

≥ 3 bubbles in the left heart within 3 cardiac cycles of right atrial opacification

Answer

A positive bubble study for PFO requires ≥ 3 microbubbles appearing in the left heart within 3 cardiac cycles of right atrial opacification, especially with Valsalva.

(NBE) National Board of Echocardiography Practice Test

(NBE) National Board of Echocardiography Practice Test

NBE Transthoracic Echocardiography 5