CV EXAME

26/06/2020
1- In severe mitral valve stenosis , all these factors are true
except.
A-valve area orifice is < 1.0 cm2
B-PHT is <150 ms.
C – Mean pressure gradient >10 mmHg.
D- Valve leaflets separation 11 mm.
E- Valve leaflet thickness ratio to posterior aortic wall > 5.
2- In M mode echo of mitral valve stenosis all these are false
except.
A- E-F slope is low due to increased intra-atrial pressure.
B- A-wave is present in atrial fibrillation.
C- loss of W shape of the posterior leaflet with anterior
displacement considered a specific finding in MS.
D- F-E slope 15-26 mm/s indicates severe MS.
E- DE amplitude 10-17 mm considered normal.
3- in CMR for valvular heart disease all these are true except.
A-phase contrast image indicated for assessment of blood
velocity and stroke volume.
B-SSFP cine sequence for valve anatomy, motion, ventricular
volume and fractional regurge volume.
C- gradient echo cine for valve anatomy, motion and turbulent
flow.
D-segmented inversion recovery for valve mass characterization.
E- Turbo spine echo (T1&T2 with or without fat saturation, for
valve mass characterization.
4-Severe pulmonary valve regurgitation suggested by.

A-Wide color jet >7.5 mm or filling the right ventricular outflow tract.
B-Diastolic flow reversal visible in the proximal main pulmonary artery
C-A steep dense signal (pressure half-time > 200 ms)
D-Active non-dilated right ventricle.
E-Dilated RVOT > 30 mm.
5-Regarding mitral valve prolapse , all these statements are true
except.
A- Most common causes are rheumatic fever, trauma, infective
endocarditis.
B- Back displacement of mitral leaflets more than 2 mm beyond
annular plane.
C- P2 segment of posterior leaflet is commonly affected.
D- In assessing mitral prolapse , two- and three-chamber views are
preferred .
E-Mitral prolapse, associated with annular dilatation.
,diffuse leaflet thickening >5 mm in diastole and regurgitation , susally
directed away from the prolapsing leaflet.
6-Plain chest x ray of chronic mitral regurge include all
except.
A-convexity or straightening of the left atrial appendage.
B- Double density sign on right heart shadow.
C-Elevation of the left main bronchus.
d-widening of carinal angle.
E-Walking man sign on frontal chest x ray.
7-Regarding normal left ventricle, all these are true except.

A- Wall thickness is 9-11 mm.

B-Systolic pressure is 120 mmHg and the diastolic pressure is
0-5 mmHg.
C-LVOT stroke volume is equal to aortic valve stroke volume.
D-EF%= LVEDV-LVESV/LVESV
E- LV stroke volume=LVEDV-LVESV
8- In severe aortic valve stenosis , all these are true
except
A-Transvalvular systolic velocity > 4 m/s
B- Aortic valve area is equal to 1.8 cm2
C-Mean pressure gradient is > 5o mmHg.
D-LVOT velocity/AV velocity <0.25
E-Indexed Av area cm2/m2 <0.6
9. A 30-year-old woman presents with shortness of breath and
fatigue. CT shows enlargement of the right atrium, right
ventricle and pulmonary artery and normal appearance of
the left atrium. What is the most likely diagnosis?
A. VSD - Ventricular Septal Defect
B. Bicuspid aortic valve
C. Coarctation of the aorta
D. ASD - Atrial Septal Defect
E. Mitral valve disease
10- A .34-year-old woman with chest pain, shortness of
breath and collapse is brought to the A&E
department. Initial chest X-ray is abnormal. Subject
to the abnormal appearance of the cardiac contour, an
MRI is obtained in the local cardiac centre on the
following day, which confirms a large congenital
pericardial defect. All of the following are imaging
features, except:
A. Abnormal cardiac contour on plain chest X-ray.
B. Failure to identify pericardium on CT or MR is
diagnostic.
C. Most commonly, a left-sided location.
D. Shift of cardiac axis to the left.
E. Association with ASD.
11-. A 42-year-old male presents with chest pain,
dyspnoea and palpitations. He undergoes cardiac
MRI, which reveals extensive scattered delayed
mesocardial enhancement in the anterior, lateral and
inferior wall and apex of the left ventricle. T2WI is
unremarkable. What is the most likely diagnosis?
A. Acute myocardial infarction.
B. Sarcoidosis.
C. Myocarditis.
D. Hypertrophic cardiomyopathy.
E. Amyloidosis
12- A 10-year-old boy with history of Down’s syndrome,
recurrent chest infection and dyspnoea on exertion
presents to the paediatrician. Chest X-ray shows mild
cardiomegaly and prominent pulmonary venous
markings. What is the most likely diagnosis?
A- Hypertrophic cardiomyopathy
B- VSD.
C-Ostium secondum ASD
D- Ostium primum ASD.
E- PDA.
13-Regarding tricuspid valve , all these are true
except.
A- It is more complex than other valves, with 5-5.5
cm2 orifice.
B- Its septal leaflet is more apical , attached to
posterior ventricular wall.
C- Its anterior leaflet is smaller than posterior one.
D- Primary diseases include rheumatic disease,
carcinoid and prolapse.
E-Secondary disease include, myocardial infarction,
right ventricular volume and pressure overload.
14-In tricuspid valve disease all the following are true
except.
A-Tricuspid stenosis (TS) is the least common stenotic
valve lesion.
B-In most cases, TS is of rheumatic origin and
associated with some degree of regurgitation.
C-In the presence of anatomic findings consistent with
TS by 2D echo, a mean pressure gradient of 5 mmHg,
T½ >190 ms, valve area by the continuity equation <
2 cm2 are consistent with significant stenosis.
D-Supportive findings are a more than moderately
enlarged right atrium and a dilated inferior vena cava.
E- all of the above .
15-Congenital absence of left pericardium,
associated with these congenital abnormalities
except.
A- Atrial or ventricular septal defects
B-Persistent ductus arteriosus
C-Mitral valve anomalies
D-Tetralogy of Fallot
E-Bronchopulmonary sequestration
16- An obese adult man presents with atypical
chest pain. Echocardiogram demonstrates
asymmetrical hypertrophy of the
interventricular septum, primarily affecting
the antero-inferior portion. What is the most
likely diagnosis?
A. Hypertrophic obstructive cardiomyopathy
B. Restrictive cardiomyopathy
C. Myocardial infarction
D. Dilated cardiomyopathy.
E. hypertension.
17- A 45-year-old woman, non smoker, no history of
hypertension or diabetes mellitus, presented with
angina like chest pain . Her ECG and troponin are
normal. Her resting heart rate is 56 bpm. To best
assess her further, what do you decide to perform
next?
A. CT calcium score.
B. Exercise stress testing.
C. Contrast enhanced cardiac MRI.
D. Retrospectively ECG-gated CT coronary
angiography.
E. Prospectively ECG-gated CT coronary angiography.
18- New born child presents with central
cyanosis and congestive cardiac failure. Chest
X-ray shows an enlarged heart with a figure of
eight pattern and prominent veins. What is the
likely diagnosis?
A. Transposition of the great vessels (TGA)
B. Aorto-pulmonary widow
C. Tetralogy of Fallot
D. Vein of Galen aneurysm
E. Total anomalous pulmonary venous connection
(TAPVC)
19- A 10-year-old boy with history of Down’s
syndrome, complains from recurrent chest
infection and dyspnoea on exertion, his chest X-
ray shows mild Cardiomegally with increased
pulmonary vascularity. What is the most likely
diagnosis?
A. Hypertrophic cardiomyopathy
B. ASD primum.
C. VSD
D. ASD secondum.
E. PDA
20- A 70 year old man has had routine CXR prior to an
elective total hip replacement . It is noted that the
heart is enlarged C/T=60% .What is the most likely
underlying pathology ?
A –ventricular enlargement.
B- Atrial enlargement.
C- Cardiac myxoma.
D- Constrictive pericarditis.
E-Pericardial effusion.
21- by continuity equation, calculate the mitral valve area if
LVOT diameter is 2 cm, LVOT TVI=18 cm and mitral valve
TVI=75 cm
22-describe the finding and diagnose
23- describe the finding and diagnose
24- 37 y o man with hypertension
describe and diagnose
25- Name the following

4
5 1
3
2
26-Describe the
finding
27- describe and diagnose
28- Describe and diagnose
29- describe and diagnose

RV

LV
RA

LA
30- diagnosis?