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The RDCS exam has 150 questions and runs 3 hours.
These 10 free RDCS questions are organized by exam domain, so you can see how each part of the Registered Diagnostic Cardiac Sonographer - Adult Echocardiography (RDCS) blueprint is tested. Reveal the answer and explanation under each question.
Subcostal imaging reveals a delicate, highly mobile, fenestrated mesh attached near the inferior vena cava entrance to the right atrium. It is separate from the tricuspid leaflets and lacks a solid mass or stalk. Identify this structure.
Correct answer: D - Chiari network.
The mitral valve has closed, but the aortic valve has not yet opened. In a normal heart, which pressure relationship characterizes this interval?
Correct answer: A - LV pressure exceeds LA pressure but remains below aortic pressure.
A patient with exertional dyspnea has a flail posterior mitral leaflet. The anteriorly directed regurgitant jet hugs the left atrial wall and occupies only a small color-flow area. The vena contracta is 0.85 cm, and pulmonary venous Doppler shows systolic flow reversal. How should these findings be reconciled?
Correct answer: C - Severe regurgitation; wall impingement reduces the apparent color-jet area.
A 61-year-old with edema and ascites has an LVEF of 62%. Echocardiography shows a respiration-related septal shift, medial mitral annular e' of 11 cm/s, lateral e' of 6 cm/s, and prominent hepatic vein diastolic flow reversal during expiration. This combination most strongly favors:
Correct answer: B - Constrictive pericarditis.
During dobutamine stress echocardiography, an inferior segment that is akinetic at rest develops systolic thickening at low dose, then loses that thickening again at peak dose. The same segment is well visualized at every stage. The response demonstrates:
Correct answer: D - Viable myocardium that becomes ischemic at higher demand.
A 68-year-old with hypertension and exertional dyspnea is in sinus rhythm. LVEF is 63%, and the mitral valve and annulus are structurally normal. Mitral E/A is 1.2, septal e' is 4 cm/s, lateral e' is 5 cm/s, average E/e' is 18, left atrial volume index is 46 mL/m², and peak TR velocity is 3.2 m/s. There is no known pulmonary disease. Assign the diastolic classification.
Correct answer: C - Grade II dysfunction with elevated left atrial pressure.
Soon after catheter ablation, a patient becomes pale and diaphoretic with a blood pressure of 78/48 mmHg. Bedside echocardiography shows a new 12-mm circumferential pericardial effusion, early-diastolic right ventricular collapse, and a dilated inferior vena cava with little inspiratory change. What takes priority over completing the standard examination?
Correct answer: C - Activate the emergency response and immediately report suspected tamponade.
For a calcified native aortic valve, technically satisfactory measurements are: LV outflow tract diameter 2.0 cm, LV outflow tract velocity-time integral 22 cm, and aortic jet velocity-time integral 110 cm. Peak aortic velocity is 4.4 m/s and mean gradient is 46 mmHg. The continuity-equation valve area and integrated stenosis grade are:
Correct answer: B - 0.63 cm²; severe aortic stenosis.
A patient with established valvar pulmonary stenosis has a complete tricuspid regurgitation continuous-wave Doppler envelope with a peak velocity of 3.6 m/s. Estimated right atrial pressure is 8 mmHg. No reliable pulmonary valve Doppler envelope is available. The tricuspid signal supports which pressure estimate?
Correct answer: A - Right ventricular systolic pressure of approximately 60 mmHg.
An outpatient needs an accurate left ventricular ejection fraction after an anterior myocardial infarction. Positioning and harmonic imaging have been optimized, but the endocardial borders of three contiguous apical segments remain indistinct. There is no contraindication to an ultrasound-enhancing agent. Which approach offers the most appropriate next improvement?
Correct answer: A - Use an intravenous ultrasound-enhancing agent for LV cavity opacification.
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