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Question 1 of 45

1. Question
2D sonoanatomy of IVC and surrounding structures

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Deep part of the liver
  
  Shows IVC – Right atrial junction
  
  Shows Lung tissue
  
  Shows Right atrium
  
  Shows Superficial part of the liver
  
  Shows Inferior vena cava (IVC)
Correct 5 / 5 Points

Incorrect / 5 Points
Question 2 of 45

2. Question
Sonoanatomy 1

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Left atrium
  
  Shows Inferior-medial wall
  
  Shows Left ventricle
  
  Shows Anterior wall of the left ventricle
  
  Shows Coronary sinus
  
  Shows Apex
Correct 5 / 5 Points

Incorrect / 5 Points
Question 3 of 45

3. Question
Sonoanatomy 2

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Anterior mitral leaflet
  
  Shows Posterior mitral leaflet
  
  Shows Anterior wall of the left ventricle
  
  Shows Inferior-medial wall
  
  Shows Apex
  
  Shows Left atrium
Correct 5 / 5 Points

Incorrect / 5 Points
Question 4 of 45

4. Question
Sonoanatomy 3

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Left atrium
  
  Shows Right ventricle
  
  Shows Left ventricular outflow tract
  
  Shows Left ventricle
  
  Shows Apex
  
  Shows Aortic valve
Correct 5 / 5 Points

Incorrect / 5 Points
Question 5 of 45

5. Question
Sonoanatomy 4

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows LV Inferior lateral wall
  
  Shows Left atrium
  
  Shows Ascending aorta
  
  Shows Posterior mitral leaflet
  
  Shows Anterior-medial wall
  
  Shows Anterior mitral leaflet
Correct 5 / 5 Points

Incorrect / 5 Points
Question 6 of 45

6. Question
Sonoanatomy 5

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Right atrium
  
  Shows Right ventricle
  
  Shows Left ventricle
  
  Shows Ascending aorta
  
  Shows Left ventricular outflow tract
  
  Shows Aortic valve
Correct 5 / 5 Points

Incorrect / 5 Points
Question 7 of 45

7. Question
PSAX view mitral level test: 2D sonography of the cardiac structures – 1

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Anterior mitral leaflet
  
  Shows Posterior wall
  
  Shows Right ventricle
  
  Shows Interventricular septum
  
  Shows Lateral wall
  
  Shows Posterior mitral leaflet
Correct 5 / 5 Points

Incorrect / 5 Points
Question 8 of 45

8. Question
PSAX view mitral level test: 2D sonography of the cardiac structures – 2

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows A3
  
  Shows A2
  
  Shows P3
  
  Shows A1
  
  Shows P2
  
  Shows P1
Correct

Incorrect
Question 9 of 45

9. Question
PSAX pulmonary artery: 2D sonography of the cardiac structures

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Tricuspid valve
  
  Shows Right pulmonary artery
  
  Shows Pulmonary valve
  
  Shows Left pulmonary artery
  
  Shows Right ventricle
  
  Shows Pulmonary trunk
Correct 5 / 5 Points

Incorrect / 5 Points
Question 10 of 45

10. Question
PSAX aortic level: 2D sonography of the cardiac structures

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Right atrium
  
  Shows Tricuspid valve
  
  Shows Right aortic cusp
  
  Shows Pulmonary valve
  
  Shows Left aortic cusp
  
  Shows Non-coronary cusp
Correct 5 / 5 Points

Incorrect / 5 Points
Question 11 of 45

11. Question
Suprasternal view: 2D sonography of the cardiac structures

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Left common carotid artery
  
  Shows Ascending aorta
  
  Shows Left subclavian artery
  
  Shows Aortic arch
  
  Shows Brachiocephalic trunk
  
  Shows Right pulmonary aretry
Correct 5 / 5 Points

Incorrect / 5 Points
Question 12 of 45

12. Question
Understanding the Doppler image

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows Continuous wave spectral Doppler curves
  
  Shows Baseline = 0 velocity line
  
  Shows Time line
  
  Shows Pulsed wave spectral Doppler curves
  
  Shows Scale of negative velocities
  
  Shows Scale of positive velocities
Correct 5 / 5 Points

Incorrect / 5 Points
Question 13 of 45

13. Question
Diastolic Function – PWD and TDI

Test yourself: Insert missing letters. In the image each letter labels a structure. Please compare the image with the statements. Insert the correct letter missing in each statement and click the
- Shows A’ = diastolic atrial contraction (tissue Doppler at mitral annulus)
  
  Shows E’ = diastolic early velocity (tissue Doppler at mitral annulus)
  
  Shows A = atrial contraction (mitral inflow with pulsed wave Doppler)
  
  Shows E = early diastolic velocity (mitral inflow with pulsed wave Doppler)
  
  Shows S = systolic peak velocity (tissue Doppler at mitral annulus)
  
  Shows P-wave in the ECG (synchronized with A and A’)
Correct 5 / 5 Points

Incorrect / 5 Points
Question 14 of 45

14. Question
Colour gain. The picture shows two ultrasound images, where B is an optimised image of A. How is B optimised? Only one true answer
- Colour gain is increased
- Baseline is increased
- Colour gain is decreased
- Depth is decreased
- Sector is narrowed
Correct

Incorrect
Question 15 of 45

15. Question
Doppler modalities. Which of the statements about Doppler modalities are correct?
- Pulsed wave Doppler and continuous wave Doppler can be active at the same time
- 2D imaging and colour Doppler can be active at the same time
- Colour Doppler is typically superimposed on a 2D image
- Colour Doppler is not possible on a dynamic 2D image
- Baseline shift is not only a graphic optimisation but allows you to interrogate higher velocities
Correct

Incorrect
Question 16 of 45

16. Question
Right place for measuring the diameter of IVC. Where should the IVC diameter be measured?
- At 1
- At 2
- At 3
- At 4
- 2 and 3 are equally good
Correct

Incorrect
Question 17 of 45

17. Question
IVC statements 1. Which of the following statements about the IVC long axis view are correct ?
- The subcostal IVC view is obtained by placing the transducer in the subcostal position, slightly to the right of the midline
- The orientation marker on the transducer can advantageously be directed to the left
- The orientation marker on the transducer should be directed cranially
- The abdominal aorta is an important landmark in the correct IVC image
- Pulsating pattern synchronously with ECG should lead to re-evaluation of the vessel as this is most likely the aorta
Correct

Incorrect
Question 18 of 45

18. Question
IVC statements 2. Which of the following statements about the IVC are correct?
- It is well known that the diameter of the IVC may not change with respiration in long distance runners
- In the subcostal short axis view the aorta is to the right of the screen and the IVC to the left
- IVC can advantageously be displayed through the spleen
- IVC can often be displayed through the liver from position 4
- 50% variation of IVC during spontaneous inspiration is normal
Correct

Incorrect
Question 19 of 45

19. Question
Key points of the extended apical views 1. Which of the following statements about the apical 2 chamber and long axis views are correct?
- The best position of the patient is generally 90 degrees left lateral position
- From the apical 4Ch view the transducer should be rotated 60 degrees counterclockwise to obtain the apical 2Ch view
- Together with the apical 4Ch view, the apical 2Ch and long axis view give a detailed evaluation of the left ventricular global and regional function
- From the apical 2Ch view the transducer should be rotated 60 degrees counterclockwise to obtain the apical long axis view
- From the apical 4Ch view tilting the transducer and directing the US beam anteriorly will optimise the apical 2Ch and long axis view
Correct

Incorrect
Question 20 of 45

20. Question
Key points of the extended apical views 2. Which of the following statements about the apical 5 chamber view are correct?
- The best position of the patient is generally 45 degrees left lateral position
- From the apical 4Ch view the transducer should be rotated clockwise to obtain the apical 5Ch view
- The left atrium is perfectly evaluated from the apical 5Ch view
- From the apical 4Ch view the ultrasound beam should be directed more anteriorly in order to obtain the apical 5Ch view
- An approx. angle difference between the apical 4Ch and 5Ch view is 60 degrees
Correct

Incorrect
Question 21 of 45

21. Question
PSAX view at the mitral level. Which of the following statements about the PSAX view at the mitral level are correct?
- The best position of the patient is supine
- Inspiration will often improve the image quality
- This view is perfect for the assessment of LV global function
- The orientation marker should be aimed towards the left shoulder
- Navigation between the different views is done predominantly by tilting the transducer and moving the tail to and away from the right shoulder
Correct

Incorrect
Question 22 of 45

22. Question
PSAX view at the aorta level. Which of the following statements about the PSAX view at the aortic level are correct?
- The best placement of the patient is 70-90 degrees left lateral position
- Inspiration will often improve the image quality
- The orientation marker should be directed towards the left shoulder
- In contrast to the parasternal long axis view all three aortic cusps can be displayed
- The pulmonary artery bifurcation will appear in the near field
Correct

Incorrect
Question 23 of 45

23. Question
Key points of the suprasternal view. Which of the following statements about suprasternal view are correct?
- The best position of the patient is supine
- The position of the head is individually adjusted
- Basal part of both right and left ventricular myocardium can be evaluated
- The neck should be extended
- Aortic dissection should not be considered in this view
Correct

Incorrect
Question 24 of 45

24. Question
Doppler theory 1. Which of the following statements about the Doppler equation are correct?
Correct

Incorrect
Question 25 of 45

25. Question
Doppler modalities 1. Which of the following statements about the different Doppler modalities are correct?
- An advantage of continuous wave Doppler is the measurement of velocities locally
- An advantage of pulsed wave Doppler is the measurement of very high velocities
- PWD requires only one piezo electric crystal
- CWD requires two piezo electric crystals, one emitting and one receiving at the same time
- In PWD emitting and receiving takes place at the same time
Correct

Incorrect
Question 26 of 45

26. Question
Doppler modalities 2. Which of the following statements about the different Doppler modalities are correct?
- An advantage of colour flow Doppler is the measurement of very high velocities
- In pulsed wave Doppler the velocity limit is approximately 1.5 – 2 m/s
- In colour Doppler, blue is away from the transducer and red is towards the transducer
- Colour Doppler is based on the pulsed Doppler principle
- On a spectral curve, positive velocities are displayed above the baseline
Correct

Incorrect
Question 27 of 45

27. Question
TEST 1: Pressure estimation. Which of the following statements about pressure estimation are correct?
- For pressure estimation CW Doppler is generally used
- PW Doppler can be used for pressure estimation but the velocity limit is low and not clinically relevant
- Peak pressure can be estimated from squaring the maximum Doppler velocity alone
- For pressure estimation across the aortic valve the left atrial pressure should be added
- Clinically relevant pressure estimation with Doppler relies on the simplified Bernoulli equation
Correct

Incorrect
Question 28 of 45

28. Question
TEST 2: Pressure estimation. Which of the following statements about Doppler pressure estimation are correct?
- Right ventricular (RV) peak pressure can be estimated across the mitral valve
- RV systolic peak pressure across the tricuspid valve equals the pulmonary artery peak pressure if no PA stenosis is present
- Measuring the right side peak pressure across the tricuspid valve, use colour Doppler to search for an insufficiency jet
- The Doppler angle error always overestimates the velocity
- A Doppler insonation angle of up to 60 degrees is clinically acceptable
Correct

Incorrect
Question 29 of 45

29. Question
TEST 3: Pressure estimation. Which of the following statements about the pressure estimation are correct?
- A small mitral regurgitation of no clinical relevance can easily be misinterpreted as a severe aortic stenosis (AS)
- Very accurate peak aortic pressure can be assessed from both the apical 5 chamber view and the parasternal long axis view
- The pressure drop across the aortic valve can be measured in the apical 5 chamber or apical long axis view
- The target view for right side peak pressure estimation is the apical 5 chamber view
- RV pressure measured across the tricuspid valve should include the right atrial pressure
Correct

Incorrect
Question 30 of 45

30. Question
TEST 4: Spectral Doppler curves obtained across the aortic valve. The image shows 3 different spectral Doppler curves obtained across the aortic valve. Which of the following statements are correct?
- A is a typical pulsed wave Doppler curve
- B is a typical pulsed wave Doppler curve
- C is a typical pulsed wave Doppler curve with a narrow velocity band measuring relatively low peak velocities
- A and B are typically continuous wave Doppler curves and are used to measure relatively high peak velocities
- In C an estimate of peak pressure can be given if the curve represents the highest velocity of interest
Correct

Incorrect
Question 31 of 45

31. Question
TEST 5: Aortic peak pressure. Which of the following statements about the aortic peak pressure are correct?
- The 2D image at the top of the image is an apical long axis view
- The red line should be used for assessment of the aortic peak pressure
- The yellow line should be used for assessment of the aortic peak pressure
- The peak pressure on the image is approx. 100 mmHg
- From the image it cannot be justified whether the spectral display represents a PW or CW Doppler curve
Correct

Incorrect
Question 32 of 45

32. Question
TEST 6: Spectral Doppler curves obtained across the aortic valve. The image shows 3 different spectral Doppler curves obtained across the aortic valve. Which of the following statements are correct?
- In A, the maximum velocity is approx. 3 m/s which equals a pressure drop of 36 mmHg plus the left atrial pressure
- In B, the maximum velocity is 5 m/s which equals a pressure drop of 100 mmHg minus the left atrial pressure
- In C, the peak velocity is slightly less than 1 m/s and could be a pulsed wave spectral Doppler curve
- In A, the maximum velocity is approx. 3 m/s which equals a pressure drop of 36 mmHg
- In B, the maximum velocity is approx. 5 m/s which equals a pressure drop of 100 mmHg
Correct

Incorrect
Question 33 of 45

33. Question
TEST 7: CW Spectral Doppler curves obtained across the aortic valve. The image shows a CW spectral Doppler curve across the aortic valve. Which of the following statements are correct?
- The peak pressure can be estimated from the maximum velocity and is approx. 1 times 4 = 4mmHg
- This is a pulsed wave spectral Doppler curve with aliasing and the pressure drop cannot be evaluated
- The peak pressure is approx. -5 m/s times 5 and squared = 400mmHg
- The peak pressure is approx. -5 m/s squared times 4 = 100 mmHg
- A pressure estimate cannot be given because the left atrial pressure is missing
Correct

Incorrect
Question 34 of 45

34. Question
TEST 8: CW Spectral Doppler curves obtained across the tricuspid valve. The image shows a CW spectral Doppler curve across the tricuspid valve. Which of the following statements are correct?
- The green dotted horizontal line indicates the maximum velocity and the peak pressure is < 64 mmHg
- The green dotted horizontal line indicates the maximum velocity and the pressure is approx. 4 mmHg
- The maximum velocity is -4.47 m/s and equals a peak pressure drop of 80.01 mmHg
- The green dotted horizontal line indicates V1 according to the Bernoulli equation and can be neglected
- Assuming no pulmonary stenosis, the RV and pulmonary artery pressure are equal (approx. 80 mmHg plus RA pressure)
Correct

Incorrect
Question 35 of 45

35. Question
TEST 9: Right side peak pressure estimation. Which statements are correct about right side peak pressure from this 4 ch view?
- The colour bar is not correctly placed to guide alignment of the CW Doppler beam
- The regurgitant jet at A should be used for alignment of the CW Doppler beam
- The regurgitant jet at B should be used for alignment of the CW Doppler beam
- Both A and B can be used to guide the alignment of the CW Doppler beam
- Because the pressures in the atria are generally low, pulsed wave Doppler should be used
Correct

Incorrect
Question 36 of 45

36. Question
TEST 10: CW Doppler curves across the tricuspid valve. A-C represents CW Doppler curves across the tricuspid valve, which of the following statements are correct ?
- C represents the highest right ventricular pressure of the 3 cases
- In B, the red line represents the maximum velocity
- In B, the velocities on the yellow line will underestimate the peak velocity
- The right ventricular pressure is higher in A than in B if the right atrial pressure is the same in the two cases
- In A, B and C, colour Doppler should be used to guide the alignment of the CW Doppler beam
Correct

Incorrect
Question 37 of 45

37. Question
TEST 1: Assessment of cardiac output using Doppler. Which statements are true regarding the assessment of cardiac output using Doppler in the left ventricle outflow tract?
- D is optimal for the assessment of cardiac output using Doppler echocardiography
- C can be used for the assessment of cardiac output and right ventricular pressure
- B is perfect for the Doppler curve recording to measure cardiac output
- A is optimal for the Doppler recording of the velocity data and B for the diameter measurement to obtain the CSA
- Both A and C but not B can be used for collection of the velocity data
Correct

Incorrect
Question 38 of 45

38. Question
TEST 2: Assessment of cardiac output using Doppler. Which of the following statements regarding the assessment of volume flow with Doppler are correct?
- In theory all vessels can be used
- Flow can be measured from the product of blood velocity time integral, heart rate and the corresponding CSA
- The Doppler equation is not valid for the measurement of flow because the angle of insonation is too small
- For the assessment of volume flow with PWD colour flow should always be superimposed on the 2D image
- Tracing of the pulsed spectral Doppler curve provides the velocity time integral
Correct

Incorrect
Question 39 of 45

39. Question
TEST 3: Cardiac output – CSA assessment. Where should the diameter be measured for the assessment of CO in the LVOT?
- At A
- At B
- At C
- At D
- B and C are equally good
Correct

Incorrect
Question 40 of 45

40. Question
TEST 4: Cardiac output. Which of the following statements about cardiac output are correct?
- Assessment of cardiac output with Doppler in the clinical setting is extremely accurate and reliable
- Continuous wave Doppler is theoretically as accurate as pulsed wave Doppler
- The velocity data and cross sectional area should be measured at the same location
- Aliasing risk is the reason that pulsed wave Doppler is recommended for the calculation of CO
- The angle of insonation is not relevant for Doppler based cardiac output measurement
Correct

Incorrect
Question 41 of 45

41. Question
Diastolic function – mitral inflow curve. Which of the following statements about the assessment of diastolic function are correct?
- Mitral inflow patterns with PWD cannot be used for the assessment of diastolic function
- Pulsed wave Doppler is an important method for the assessment of mitral inflow patterns
- Continuous wave Doppler is not first choice for the assessment of mitral inflow patterns
- A combination of PWD and CWD is mandatory for the assessment of LV diastolic function
- PWD is one of many Doppler methods used in the assessment of diastolic function
Correct

Incorrect
Question 42 of 45

42. Question
Diastolic function – mitral inflow curve. Which of the following statements regarding the assessment of diastolic function are correct?
- An ECG signal is not relevant for the assessment of diastolic function with PWD
- The best view for the recording of mitral inflow velocities is the apical 4 chamber view
- A parasternal long axis view can be used in the case of a suboptimal apical view
- The E wave corresponds to the early systolic contraction
- The E wave corresponds to early diastolic filling and the A wave to atrial contraction
Correct

Incorrect
Question 43 of 45

43. Question
Diastolic function. Which of the following statements about diastolic function are correct?
- LV hypertrophy and LA enlargement are suggestive of impaired diastolic function
- The E wave is generally higher than the A wave but this finding does not necessarily imply normal diastolic function
- E/A normal range is 1-2
- DT does not differentiate between a normal E/A and pseudonormalisation of E/A
- DT is normally 140 to 240 ms and increases with the severity of diastolic dysfunction
Correct

Incorrect
Question 44 of 45

44. Question
Diastolic function – PWD and TDI. Which of the following statements regarding diastolic function assessed by pulsed wave and tissue Doppler are correct?
- E and E’ express the same entity and are interchangeable
- Both E and E’ are diastolic events that occur before the P wave in the corresponding ECG
- Both E/A and E’/A’ ratios change as diastolic dysfunction worsens
- In severe diastolic dysfunction (restrictive filling), E/A >2
- S is a tissue Doppler event and does not apply to mitral inflow recordings with PWD
Correct

Incorrect
Question 45 of 45

45. Question
Diastolic function – PWD and TDI. Which of the following statements regarding diastolic function assessed by pulsed wave and tissue Doppler are correct?
- E and A expressed as E/A ratio is sufficient for the evaluation of diastolic function
- E combined with A’ is the best way to evaluate diastolic function
- As diastolic dysfunction worsens the E’ decrease and the A’ increase in numeric velocity
- Combining E with E’ is a much stronger tool for the evaluation of the diastolic function than E and E’ alone
- E’ can be measured at the mitral annulus septal wall but not at the lateral wall
Correct

Incorrect

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