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Cardiac Knowledge Check

Cardiac POCUS Knowledge Check

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This Knowledge Check for cardiac point-of-care ultrasound (POCUS) gives you an opportunity to test your POCUS knowledge. Each question offers an explanation of the answer, and you'll receive feedback about your final score.

Anechoic fluid anterior to the descending aorta in the parasternal long-axis (PLAX) view is consistent with which of the following diagnoses?

Pleural effusion

Ascites

Pericardial effusion

Which of the following ejection fractions is severely decreased?

45 - 54%

Less than 30%

Greater than 55%

Which transducer is recommended for performing a POCUS transthoracic cardiac examination?

Low frequency phased array transducer

Low frequency curvilinear transducer

High frequency linear transducer

What is the recommended preset and image orientation for a cardiac POCUS exam?

General preset with image orientation towards the left side of the image

Vascular preset with image orientation marker towards the left side of the image

Cardiac preset with image orientation marker towards the right side of the image

A 75-year-old male with previous medical history of hypertension (HTN), diabetes mellitus (DM) type II and ongoing tobacco use presented with complaint of worsening dyspnea, orthopnea, weight gain and lower extremity edema. The patient also has a family history of ischemic heart disease, cardiovascular accident (CVA).

Temperature - 98.4 degrees Fahrenheit/36.9 C, HR - 68 BPM, BP – 137/84 mm Hg, RR – 20 per minute. EKG shows – Q waves in inferior and lateral leads. No ST-T changes.

Physical exam is remarkable for jugular vein distention (JVD), rales / crackles in lung bases, 1+ pitting edema up to the lower leg (bilateral). A POCUS cardiac exam was performed. An E-Point Septal Separation (EPSS) measurement was obtained.

What is the approximate ejection fracture (EF) range based upon the EPSS measurement?

The EF is approximately 50%

The EF is less than 30%

The EF is more then 60%

A 37-year-old African American male presented in the Emergency Department with complaint of weakness and shortness of breath for the past 3 months.

Heart rate was 124 beats/min, blood pressure was 90/40 mmHg, respiratory rate 21, temperature 99.6 degrees F/37.6 C, Oxygen saturation 95% at room air.

Jugular venous distension was noted. POCUS cardiac exam was performed. The following subxiphoid view was obtained.

What is the most likely diagnosis?

Pericardial effusion

Pleural effusion

Cardiac tamponade

The following view was obtained while performing a pre-op workup. What phase of the cardiac cycle does this represent?

Ventricular systole

Isovolumetric ventricular relaxation

Ventricular diastole

A 65-year-old Hispanic female was brought to the Emergency Department with a chief complaint of difficulty breathing for 2 days. On examination the patient is tachypneic and has altered mental status. Her BP was 80/40 mm Hg. Jugular venous distension was observed as well. On auscultation she had muffled heart sounds. The ultrasound fellow performed a POCUS cardiac examination. The above video was obtained.

What is the most likely diagnosis?

Normal echo findings

Cardiac tamponade

Pleural effusion

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