10 exam-style questions with answers and explanations, straight from our 1,050-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The ASCeXAM exam has 200 questions and runs 4 hours 30 minutes.
These 10 free ASCeXAM questions are organized by exam domain, so you can see how each part of the Adult Echocardiography (ASCeXAM) blueprint is tested. Reveal the answer and explanation under each question.
A continuous-wave Doppler interrogation of a tricuspid regurgitant jet is obtained at an intercept angle of 60 degrees rather than parallel to flow. Compared with the true velocity, the measured peak velocity will be:
Correct answer: B - Underestimated by approximately 50%, because the cosine of 60 degrees is 0.5
All of the following will reduce or eliminate aliasing during pulsed-wave Doppler interrogation EXCEPT:
Correct answer: C - Increasing the imaging depth to include the entire jet
A sonographer adds two additional focal zones and widens the color sector to better capture an eccentric mitral regurgitant jet. The MOST likely consequence of these two adjustments together is:
Correct answer: A - A reduction in frame rate and therefore in temporal resolution
A patient with severe aortic stenosis and an ascending aorta measuring 2.6 cm has a Doppler-derived mean gradient of 52 mmHg. Catheterization the next day reports a mean gradient of 41 mmHg. The MOST likely explanation is:
Correct answer: A - Pressure recovery downstream of the stenosis, accentuated by the small aorta
LVOT diameter measures 2.1 cm, LVOT VTI is 17 cm, and aortic valve VTI is 92 cm. The calculated aortic valve area is approximately:
Correct answer: C - 0.64 cm²
A 74-year-old man has an aortic valve area of 0.9 cm², mean gradient 27 mmHg, ejection fraction 34%, and stroke volume index 29 mL/m². During low-dose dobutamine the valve area rises to 1.3 cm² while the mean gradient remains 26 mmHg. This indicates:
Correct answer: D - Pseudo-severe aortic stenosis with only moderate valve disease
Using a baseline-shifted aliasing velocity of 39 cm/s, the PISA radius measures 0.9 cm. Peak mitral regurgitant velocity is 5.4 m/s and the regurgitant jet VTI is 160 cm. The effective regurgitant orifice area is approximately:
Correct answer: B - 0.37 cm²
A patient 7 years after bioprosthetic aortic valve replacement has a mean gradient of 38 mmHg, dimensionless index 0.19, acceleration time 118 ms, and restricted leaflet motion. The immediate post-operative study showed a mean gradient of 12 mmHg. The MOST likely diagnosis is:
Correct answer: C - Prosthetic valve obstruction from pannus or structural deterioration
A patient with known severe tricuspid regurgitation has a dense, triangular, early-peaking CW Doppler envelope with a peak TR velocity of 2.1 m/s. The estimated RVSP should be interpreted as:
Correct answer: B - Unreliable, because right atrial and ventricular pressures have equalized
A woman receiving anthracycline chemotherapy has a baseline global longitudinal strain of −21% with an ejection fraction of 61%. Repeat study shows GLS of −17% with an ejection fraction of 58%. This change represents:
Correct answer: C - A relative GLS decline consistent with early cancer-therapy cardiac dysfunction
The ASCeXAM exam also covers these domains. Drill them in the full free practice test:
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