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Guide for BSE-TTE: BSE Transthoracic Echo Exam (OnVUE)

Quiz BSE-TTE: BSE Transthoracic Echo Exam (OnVUE)

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Quiz

1/10
General Concepts and Clinical Role of Echocardiography
Which statement best describes the place of transthoracic echocardiography in the investigation of suspected structural heart disease?
Select the answer
1 correct answer
A.
It is a second-line test that should only be requested once cardiac computed tomography has excluded coronary disease
B.
It offers superior tissue characterisation to cardiac magnetic resonance and is therefore the preferred test for suspected infiltrative disease
C.
It is the first-line imaging investigation because it is non-ionising, portable and widely available, and provides structural, functional and haemodynamic information in a single examination
D.
It is principally a research technique with limited value in routine clinical decision making

Quiz

2/10
Imaging Physics and Instrumentation
Which statement correctly describes the nature of the ultrasound used in diagnostic echocardiography?
Select the answer
1 correct answer
A.
It is a longitudinal mechanical pressure wave above the audible range, typically 1.5 to 7.5 MHz in adult cardiac imaging, which requires a medium in which to propagate
B.
It is a transverse electromagnetic wave that can travel through a vacuum
C.
It is a longitudinal wave whose frequency progressively falls as it passes through tissue of increasing density
D.
It is a form of ionising radiation of extremely short wavelength

Quiz

3/10
Doppler Physics and Fluid Dynamics
Which statement best describes the Doppler shift detected during a transthoracic echocardiographic examination?
Select the answer
1 correct answer
A.
It is the difference between the propagation speed of sound in blood and in soft tissue
B.
It is the difference between the transmitted frequency and the frequency returning from moving blood
C.
It is the difference between the transducer centre frequency and the pulse repetition frequency
D.
It is the difference between the wavelength of the transmitted pulse and the depth of the sample volume

Quiz

4/10
Doppler and Colour Flow Instrumentation
What is the principal advantage of pulsed wave over continuous wave Doppler?
Select the answer
1 correct answer
A.
It can record higher velocities without aliasing
B.
It requires only a single piezoelectric element and so gives a stronger signal
C.
It provides range resolution, so velocities are sampled from a known depth
D.
It is unaffected by the intercept angle between beam and flow

Quiz

5/10
Safety of Ultrasound
Which statement best describes what the thermal index (TI) displayed on an echocardiography machine represents?
Select the answer
1 correct answer
A.
The absolute rise in tissue temperature, in degrees Celsius, at the focal zone of the beam
B.
The ratio of the acoustic power being emitted to the power estimated to raise tissue temperature by 1 degree Celsius
C.
The peak rarefactional pressure of the transmitted pulse divided by the square root of the centre frequency
D.
The time-averaged intensity measured at the transducer face during continuous wave Doppler

Quiz

6/10
Transoesophageal Echocardiography Instrumentation
Why does transoesophageal imaging generally provide better spatial resolution of posterior cardiac structures than transthoracic imaging?
Select the answer
1 correct answer
A.
The probe lies immediately adjacent to the heart without intervening lung or rib, permitting the use of higher transmit frequencies of about 5 to 7 MHz
B.
The oesophagus conducts ultrasound faster than the chest wall, increasing the sampling rate
C.
Transoesophageal probes use continuous wave transmission for two-dimensional imaging, which improves lateral resolution
D.
Transoesophageal probes have a much larger aperture than transthoracic probes, which improves axial resolution

Quiz

7/10
Cardiac Anatomy and Physiology
Why is the parasternal window usually best obtained from the left third or fourth intercostal space with the patient in the left lateral decubitus position?
Select the answer
1 correct answer
A.
It aligns the ultrasound beam parallel to the interventricular septum, which maximises axial resolution of septal thickness
B.
This position allows the heart to fall towards the anterior chest wall, displacing lung from between the transducer and the heart to provide an acoustic window
C.
The intercostal spaces are widest at this level, allowing a larger aperture and therefore higher frequency imaging
D.
The sternum acts as a useful acoustic reflector at this level, enhancing endocardial definition

Quiz

8/10
Cardiac Functional Parameters and Measurements
According to the BSE minimum dataset, where should linear left ventricular internal dimensions and wall thicknesses be acquired from the parasternal long axis view?
Select the answer
1 correct answer
A.
At the level of the mitral annulus, with the cursor angled towards the apex to include the whole basal segment
B.
Immediately distal to the mitral leaflet tips, perpendicular to the long axis of the ventricle
C.
At the level of the papillary muscle tips, using the trailing edge of the septum and the leading edge of the posterior wall
D.
At the widest point of the cavity wherever that appears, since maximum dimension is the most reproducible landmark

Quiz

9/10
Contrast and Bubble Contrast Studies
Which of the following describes appropriate preparation and administration of agitated saline for a bubble contrast study?
Select the answer
1 correct answer
A.
10 ml of 5 per cent dextrose drawn into a single syringe and injected slowly over 10 seconds
B.
10 ml of saline mixed with 5 ml of the patient's blood, injected through a 25 gauge butterfly needle in the hand
C.
Approximately 8 to 9 ml of 0.9 per cent sodium chloride with about 0.5 to 1 ml of air, optionally with a small volume of the patient's blood, agitated briskly between two syringes through a three way tap and injected rapidly through a large bore cannula
D.
20 ml of saline shaken inside a sealed infusion bag and infused over two minutes while recording the subcostal view

Quiz

10/10
Mitral Valve Disease
Which statement best describes normal mitral valve and mitral apparatus anatomy as assessed during transthoracic echocardiography?
Select the answer
1 correct answer
A.
The anterior leaflet occupies approximately two-thirds of the annular circumference and is divided into three scallops.
B.
The mitral annulus is a rigid planar fibrous ring that does not change size or shape during the cardiac cycle.
C.
The posterior leaflet is conventionally divided into three scallops, P1 laterally, P2 centrally and P3 medially, and occupies about two-thirds of the annular circumference.
D.
Both papillary muscles arise from the basal interventricular septum and each sends chordae only to the leaflet directly above it.
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  • Quiz name:BSE-TTE: BSE Transthoracic Echo Exam (OnVUE)
  • Total number of questions:500
  • Number of questions for the test:50
  • Pass score:80%

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