RCCS study plan

Diagram the normal fetal circulation pathway from placenta to aorta, labeling all shunts and oxygen saturations

Sequence the segmental approach (situs, ventricular looping, ventricular-arterial connection) and apply it to 5 normal cases

Label a full transthoracic view set (subcostal, apical, parasternal, suprasternal) with the structures each view demonstrates

Recite normal pediatric echocardiographic reference values (z-scores) for valve annuli and ventricular dimensions by body surface area

Differentiate fetal from postnatal circulation and predict which lesions decompensate at ductal closure

Classify congenital lesions by shunt direction (left-to-right, right-to-left, bidirectional, no shunt) with 3 examples each

Explain ventricular septal defect physiology across small, moderate, and large defects and predict the echo findings for each

Compare cyanotic vs acyanotic presentations using saturation, pulmonary blood flow, and ductal dependency

Trace pathophysiology of obstructive left heart lesions (coarctation, aortic stenosis, HLHS) and predict the resulting ventricular and atrial findings

Contrast single-ventricle physiology before and after each palliative stage in terms of blood flow and saturation targets

Predict Eisenmenger physiology and explain why shunt reversal changes management

Explain the physiology of mixing lesions (TAPVR, truncus, single atrium) and how they differ from simple shunts

Set up a machine from scratch for a pediatric study (probe selection, frequency, depth, focus, frame rate, harmonics) and justify each choice

Demonstrate how to optimize 2D, color, and spectral Doppler settings to eliminate aliasing and artifact

Identify and correct common artifacts (side-lobe, mirror-image, reverberation, range ambiguity) in 10 practice images

Calculate Nyquist limits and adjust scale, baseline, and wall filter for high-velocity jets

Perform continuous-wave and pulsed-wave Doppler measurements of valve gradients and derive peak and mean gradients from traces

Calculate shunt fraction (Qp/Qs) from right and left ventricular outflow Doppler and demonstrate the formula with worked examples

Measure chamber dimensions, wall thickness, and function (fractional shortening, ejection fraction) using M-mode and 2D

Apply color Doppler to grade valve regurgitation and distinguish physiologic from pathologic jets

Assess each cardiac valve for stenosis and regurgitation using 2D, color, and Doppler, and state severity thresholds

Evaluate great vessel anatomy and flow (aortic arch sidedness, branch pulmonary arteries, patent ductus arteriosus) in a systematic sweep

Quantify ventricular size and function in single-ventricle and post-operative patients and recognize when measurements are unreliable

Estimate pulmonary artery pressure non-invasively from tricuspid regurgitation velocity and septal position

Sequence the staged palliation pathway (Norwood, Glenn, Fontan) and list the echo parameters evaluated before each stage

Describe common interventional catheter and surgical procedures and the echo findings that confirm success or complication

Apply pediatric-specific patient-care and safety practices (sedation, infection control, thermal and acoustic safety, hand hygiene)

Select appropriate probe disinfection and electrical safety practices for the pediatric echo lab

Integrate all five domains by working through timed mixed-topic practice sets

Re-drill only the missed items from weeks 1-7 and log the underlying knowledge gap for each

Simulate a full-length timed exam under test conditions

Recite a condensed one-page summary of high-yield formulas, thresholds, and normal values from memory