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Ultrasound Quiz 5: More Than Just Subxiphoid

Welcome to another iteration of Musig Mondays! Enjoy the quiz!

If you get an answer wrong, don't worry! There's a detailed explanation for each question (and if it's too much reading, just look at the words in bold).

Yes! Those are emboli!
We can see here some thrombi moving in the heart.
If we were to see gas, we wouldn't see anything at all, since gas disperses ultrasound waves. Rather, we see here echogenic (white) substances moving around in the heart. Those echogenic substances are thrombi. It does look like a washing machine though!
Yes great job! You were able to identify the hockey stick formation which is indicative of rheumatic mitral stenosis. 
The patient has rheumatic mitral stenosis. Although this is a more advanced view, in some of your courses you may have studied the classic "hockey stick formation". We can see this sign when the mitral valve is going straight up and bends straight down, like a hockey stick. This is indicative of rheumatic mitral valve stenosis. This is mitral stenosis caused by rheumatic heart disease.
Great job! Remember, unless you sweep the entire heart with the "lucky 7" in view, the scan remains inconclusive and you cannot exclude a pericardial effusion. You could have a minor effusion hiding somewhere!
This ultrasound is inconclusive.
Remember, unless you sweep the entire heart with the "lucky 7" in view, the scan remains inconclusive and you cannot exclude a pericardial effusion. You could have a minor effusion hiding somewhere!
You need to keep sweeping until the heart disappears entirely, and then sweep in the opposite direction until it disappears again.
Otherwise, there are no abnormalities seen on this ultrasound.