Buy Noncardiac Findings on Echocardiograms

Buy Noncardiac Findings on Echocardiograms
Buy Noncardiac Findings on Echocardiograms
1. What is the estimated incidence of management altering noncardiac
ndings on routine transthoracic
echocardiograms?
A. Very rare and reported at 0.5% to 1.0%
B. More common in outpatient requests compared to
inpatient requests
C. Relatively common, occurring at an incidence
of > 10.0% in most outpatient clinics
D. Relatively common, occurring at a reported incidence
of 9% in the hospital setting
E. Very common, occurring at a reported incidence of
15.5% and requiring a critical evaluation of noncardial
structures in all patients
2. The structure seen, as noted by the arrow in Figure 42.1, is
most likely:
A. Falciform ligament
B. Pericardial
brinous material
C. Ascites
brinous material
D. Pericardial cyst
Buy Noncardiac Findings on Echocardiograms
3. A 68-year-old male with diabetes, hypertension, and prior
myocardial infarction presents with a chief complaint of
dif
culty in breathing. Physical exam showed decreased
breath sounds at bilateral lung bases, cardiomegaly, and
lower extremity edema. Electrocardiogram showed old
anterior myocardial infarction. Chest x-ray showed moderate bilateral pleural effusions and mild prominence of pulmonary vasculature. Echocardiogram showed mild dilation
of the left ventricle and moderate reduction in left ventricular function with regional wall motion abnormalities, and
the image shown in Figure 42.2.
What is the large echo-dense mass shown?
A. Pericardial tumor
B. Left ventricular pseudoaneurysm
C. Atelectatic lung segment
D. Extramural cardiac tumor
Chapter 42
Noncardiac Findings on
Echocardiograms
Elizabeth B. Juneman
Figure 42.1 Figure 42.2
355
(c) 2015 Wolters Kluwer. All Rights Reserved.
356 Section IX Cardiac Masses
A. Acute right ventricular infarction; urgent coronary
angiography
B. Left ventricular failure; IV furosemide
C. Saddle pulmonary embolus; consider urgent thrombolysis
D. Saddle pulmonary embolus; IV heparin and close
follow-up
E. Chronic pulmonary hypertension; urgent left and right
heart cath
7. What is the structure denoted by the arrow in Figure 42.4?
A. Dilated coronary sinus
B. Thoracic descending aorta
C. Thoracic ascending aorta
D. Hepatic cyst
E. Pericardial cyst
4. Which of the following would be the most serious
noncardiac €nding on transthoracic echo?
A. Well-demarcated echo-lucent circular area within the
liver parenchyma on the subcostal view
B. Echo-free space posterior to the heart in a patient in
supine or left lateral position
Buy Noncardiac Findings on Echocardiograms
C. Highly re‚ective echo areas within the gallbladder, with
mobility upon repositioning the patient, and marked
posterior acoustic shadowing
D. Mobile lobulated echo-dense structure seen in the
inferior vena cava extending into the right atrium
E. Echo-free space located between the liver and
diaphragm, outside the pericardial sac.
5. Which of the following should be seen on transesophageal
echocardiography in a patient with a large renal mass invading the inferior vena cava and extending into the right atrium?
(The patient has no evidence for a pulmonary embolic event.)
A. Turbulent color Doppler ‚ow in the right atrium
B. Bowing of the intra-atrial septum toward the right atrium
C. Hepatic vein ‚ow reversal in inspiration
D. Echo-lucent mass seen in the inferior vena cava
entering the right atrium
E. Elevated tricuspid regurgitation jet velocity
6. A 64-year-old female with hypertension and obesity presents with substernal chest pain and rapid onset of dyspnea.
Stat echocardiogram showed the following (Fig. 42.3 and
Video 42.1):
What is the most likely etiology of the patient’s chest pain and
dyspnea and most optimal immediate course of management?
Figure 42.3
Figure 42.4
Figure 42.3 (Continued)
(c) 2015 Wolters Kluwer. All Rights Reserved.
Chapter 42 Noncardiac Findings on Echocardiograms 357
10. A 72-year-old female with hypertension and hyperlipidemia was referred for a transthoracic echocardiogram
for atypical chest pain. What structure is identied by the
arrow in Figure 42.7?
A. Descending aortic aneurysm
B. Dilated coronary sinus
C. Aortic dissection
D. Hiatal hernia
E. Pericardial tumor
8. The following (Fig. 42.5) is seen in the inferior vena cava
on subcostal view. Which is least likely to be the source?
A. Hypernephroma
B. Hepatoma
C. Colon carcinoma
D. Leiomyosarcoma
E. May be any of the above
9. An 82-year-old female presents for a transesophageal
echocardiogram prior to a cardioversion procedure. What is
the structure seen in Figure 42.6?
A. Right superior pulmonary vein
B. Transverse sinus
C. Oblique sinus
D. Coumadin ridge
E. Pulmonary vein
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