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Free PTE Practice Questions

10 free, exam-style Basic Perioperative Transesophageal Echocardiography (PTE) (PTE) practice questions with answers and explanations. No signup required. Work through them below, then take the full free PTE practice test to study every exam domain.

The PTE exam has 150 questions and runs 3 hours 30 minutes.

These 10 free PTE questions are organized by exam domain, so you can see how each part of the Basic Perioperative Transesophageal Echocardiography (PTE) blueprint is tested. Reveal the answer and explanation under each question.

Domain 1: Patient Safety Considerations

Question 1

During preoperative planning, which of the following is an ABSOLUTE contraindication to placement of a transesophageal echocardiography (TEE) probe?

  1. Recent esophageal perforation
  2. Symptomatic sliding hiatal hernia
  3. History of gastroesophageal reflux disease
  4. Platelet count of 90,000/µL
Show answer & explanation

Correct answer: A - Recent esophageal perforation

Question 2

Shortly after a benzocaine spray is used to topicalize the oropharynx for TEE probe insertion, the patient becomes cyanotic with an SpO2 of 84% that does not improve with 100% oxygen, and the arterial blood appears chocolate-brown. What is the MOST appropriate treatment?

  1. Increase FiO2 and add PEEP
  2. Give intravenous dantrolene
  3. Give intravenous methylene blue
  4. Start inhaled nitric oxide
Show answer & explanation

Correct answer: C - Give intravenous methylene blue

Domain 2: Echocardiographic Imaging: Acquisition and Optimization

Question 3

Compared with a 3 MHz transducer, selecting a 7 MHz transducer to image a mid-esophageal structure will MOST likely result in:

  1. Improved axial resolution but reduced penetration
  2. Improved penetration but reduced axial resolution
  3. Improved penetration and improved axial resolution
  4. Reduced axial resolution and reduced temporal resolution
Show answer & explanation

Correct answer: A - Improved axial resolution but reduced penetration

Question 4

While interrogating transmitral flow with pulsed-wave Doppler, the spectral signal 'wraps around' and appears on both sides of the baseline. Which single adjustment is MOST likely to eliminate this artifact WITHOUT switching Doppler modes?

  1. Decrease the color Doppler gain setting
  2. Narrow the imaging sector width
  3. Increase the transducer frequency
  4. Increase the velocity scale (Nyquist limit)
Show answer & explanation

Correct answer: D - Increase the velocity scale (Nyquist limit)

Question 5

An examiner needs to accurately measure the peak velocity of a high-velocity jet across a stenotic aortic valve. Which characteristic makes continuous-wave (CW) Doppler the appropriate choice for this measurement?

  1. It is not subject to aliasing at high velocities
  2. It provides precise range resolution along the beam
  3. It displays flow direction using a color map
  4. It samples velocity from a single gated depth
Show answer & explanation

Correct answer: A - It is not subject to aliasing at high velocities

Question 6

In the mid-esophageal ascending aortic view, a mobile linear echo is seen crossing the aortic lumen. It appears at twice the depth of a strong anterior reflector, has no independent motion, and shows no color-flow separation on either side. This finding is MOST consistent with:

  1. An aortic dissection flap
  2. A reverberation artifact
  3. An atheromatous plaque
  4. A side-lobe artifact
Show answer & explanation

Correct answer: B - A reverberation artifact

Domain 3: Normal Cardiac Anatomy and TEE Imaging Plane Correlation

Question 7

In the mid-esophageal aortic valve short-axis view, which cusp of the aortic valve lies adjacent to the interatrial septum?

  1. Right coronary cusp
  2. Left coronary cusp
  3. Non-coronary cusp
  4. Anterior cusp
Show answer & explanation

Correct answer: C - Non-coronary cusp

Question 8

An anesthesiologist wants a single view for continuous intraoperative monitoring of left ventricular preload and global systolic function. Which standard TEE view is BEST suited for this purpose?

  1. Transgastric mid short-axis (mid-papillary) view
  2. Mid-esophageal long-axis view of the aortic valve
  3. Mid-esophageal four-chamber view of both atria
  4. Deep transgastric long-axis view of the outflow
Show answer & explanation

Correct answer: A - Transgastric mid short-axis (mid-papillary) view

Question 9

The mid-esophageal long-axis view of the mitral valve (obtained at approximately 120-140 degrees) typically displays which specific leaflet segments?

  1. The A1 and P1 scallops
  2. The P1, A2, and P3 scallops
  3. The A2 and P2 scallops
  4. The A3 and P3 scallops
Show answer & explanation

Correct answer: C - The A2 and P2 scallops

Domain 4: Global Ventricular Function

Question 10

Which of the following tricuspid annular plane systolic excursion (TAPSE) values indicates ABNORMAL right ventricular longitudinal systolic function according to ASE chamber-quantification recommendations?

  1. 22 mm
  2. 19 mm
  3. 14 mm
  4. 25 mm
Show answer & explanation

Correct answer: C - 14 mm

The rest of the PTE blueprint

The PTE exam also covers these domains. Drill them in the full free practice test:

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