Cardiology

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Cardiology

  1. 1. NIZAM’S INSTITUTE OF MEDICAL SCIENCESPunjagutta, Hyderabad – 500 082, A.P., India.2013Question BookletEntrance Examination for Admission to DM / MchSubject Cardiology16 June 2013 Marks 90 Time: 1 hr 30 mins Please verify whether the number printed on this question bookletcorresponds to your hall-ticket number Please read the instructions on the OMR-Answer sheet carefully Each question in this booklet is followed by four alternative answersSelect the one that is most appropriate and darken the correspondingOval in the OMR-Answer sheet Please return this question booklet along with your OMR-Answer sheet Answer sheets not accompanied with the question booklets will not becorrected Please Mark Set as ‘A’ in the OMR Sheet No negative Marks1 of 25
  2. 2. Q1. Which one of the following constitutes the major cell type of the normalcoronary artery intima?A) MacrophageB) Smooth muscle cellC) Endothelial cellD) Foam cellQ2. Which one of the following is the prototypic cardiac anomaly associatedwith Trisomy 21?A) Atrioventricular canal defectB) Transposition of Great ArteriesC) Mitral valve prolapseD) Pulmonary stenosisQ3. Which among the following is an iso-osmolar contrast agent?A) IopamidolB) IohexolC) IoxilanD) IodixanolQ4. Regarding management of pulmonary hypertension:Assertion: Prostacyclin is used in the management of idiopathicpulmonary artery hypertension.Reason: Prostacyclin stimulates platelet function and vascular smoothmuscle proliferation.A) Both Assertion and Reason are true, and Reason is the correctexplanation for Assertion.B) Both Assertion and Reason are true, and Reason is not the correctexplanation for Assertion.C) Assertion is true, but Reason is false.D) Assertion is false, but Reason is true.2 of 25
  3. 3. Q5. A 35 year old female patient presents with sudden onset of severeshortness of breath. Her previous medical history is unremarkable exceptfor the use of oral contraceptives. On examination cardiac and pulmonaryfindings are unremarkable except for tachycardia and tachypnea. Whichone of the following investigations would be most useful to excludepulmonary embolism in this patient?A) Normal echocardiographyB) Normal Pao2 by arterial blood gas determinationC) Intermediate probability radionuclide perfusion scintigraphyD) Normal plasma level of d-dimer by ELISA.Q6. Regarding the anomaly depicted in the following diagram:1. In adults it can be mistaken for rheumatic mitral stenosis.2. Systolic overload of the right ventricle is possible.3. Results from failure of incorporation of common pulmonary veinto left atrium during embryogenesis.4. Balloon dilatation is the treatment of choice.A) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correct3 of 25
  4. 4. Q7. Which of the following statement(s) is/are true regarding isolated diastolichypertension seen in the middle age group (30-50 years)?1. It is associated with weight gain2. It remains isolated for long periods of time3. It has a benign prognosis4. It usually resolves spontaneously usuallyA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ8. Which among the following is not a large vessel vasculitis?A) Takayasu arteritisB) Giant cell arteritisC) Idiopathic aortitisD) Polyarteritis nodosaQ9. Which one of the following is a poor prognosis factor in patients ofpulmonary artery hypertension?A) Functional class-IIB) Recurrent syncopeC) Resting systolic blood pressure <120mmhgD) 6 min walking distance < 500mQ10. Regarding DiGeorge syndrome1. It is caused by microdeletion of the chromosomal region 22q11.22. It is associated with conotruncal heart defects3. It is associated with cleft palate4. It is associated with hyperparathyroidismA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correct4 of 25
  5. 5. Q11. Long QT3 syndrome is caused by an abnormal gene involving which ofthe following ion channels?A) SodiumB) PotassiumC) CalciumD) ChlorideQ12. Correct statement(s) regarding normal cardiac action potential are:1.Action potential duration is longer in endocardium than epicardium2 Action potential duration is longer in epicardium than endocardium3 Ventricular repolarisation is from epicardium to endocardium4 Ventricular repolarisation is from endocardium to epicardiumA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ13. Co-trimoxazole is used in the eradication therapy regimen to preventrecrudescence or relapse following initial intensive therapy, against whichone of the following bacterial infections?A) Pseudomonas aeruginosaB) Burkholderia pseudomalleiC) Acinetobacter baumanniiD) Citrobacter freundiQ14. Regarding the thermodilution technique for cardiac output measurement,the true statement is:A) It is ideal for low cardiac output states.B) It is suitable in left to right shunt conditions.C) Cardiac output is calculated using the Stewart-Hamilton formula.D) Multi-lumen balloon tipped catheter placed in the aorta is used for thestudy.5 of 25
  6. 6. Q15. The ECG of an athlete with family history of sudden cardiac death is asfollows:The condition is most likely:A) Brugada syndromeB) Long QT syndromeC) Arrhythmogenic right ventricular dysplasiaD) Hypertrophic obstructive cardiomyopathyQ16. In patients with the following significant single vessel coronary arterystenosis, ST displacement during exercise stress test is more frequentlyseen in:A) Left anterior descending coronary arteryB) Left circumflex coronary arteryC) Right coronary arteryD) Posterior descending coronary artery6 of 25
  7. 7. Q17. Assertion: Radial artery catheterization is safe if Allen test is normal.Reason: Allen test establishes patency of the radial artery.A) Both Assertion and Reason are true, and Reason is the correctexplanation for AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is trueQ18. When using the Gorlin equation for calculating aortic valve area, which ofthe following value is not required?A) Heart rateB) Diastolic filling periodC) Cardiac outputD) Mean valve gradient across the valveQ19. Which one of the following statements is true regarding fetal pulmonaryarterial mean blood pressure at term?A) It is higher than the mean aortic BP by 1-2 mm Hg.B) It is lower than the mean aortic BP by 1-2 mm Hg.C) It is higher than the mean aortic BP by 10-20 mm Hg.D) It is lower than the mean aortic BP by 10-20mm Hg.Q20. Recurrent ischemic events following thrombolysis has beenpathophysiologically linked to which one of the following factors?A) Antibodies to thrombolytic agentsB) Fibrinopeptide AC) Lipoprotein AD) TriglyceridesQ21. Haemodynamic responses in a normal individual during exercise include:1. Increase in systolic blood pressure2. Increase in mean arterial pressure3. Increase in pulse pressure4. Increase in peripheral arterial resistanceA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correct7 of 25
  8. 8. Q22. Which one of the following tachycardias is mediated by the triggeredactivity mechanism?A) Atrial flutterB) Antidromic atrioventricular reciprocating tachycardiaC) Orthodromic atrioventricular reciprocating tachycardiaD) Right ventricular outflow tract ventricular tachycardia.Q23. Regarding recurrent pericarditis, the following is/ are true:1.Majority culminate into chronic constrictive pericarditis2.The long term prognosis is good3 Maintenance corticosteroid therapy is recommended4.Colchicine therapy is effectiveA) Only 1,2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ24. Regarding dialysis-associated pericardial diseases the correct option(s) is/are:1. It is more common than uremic pericarditis.2. Intensification of dialysis is the treatment of choice.3 It is associated with normal or mildly elevated blood urea nitrogenand creatinine.4. Corticosteroids play a crucial role in the treatment.A) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ25. Simultaneous administration of Sildenafil and nitrates causes:A) QT prolongation with ventricular arrhythmiaB) MethemoglobinemiaC) Profound hypotensionD) Nitrate tolerance8 of 25
  9. 9. Q26. Isoproterenol is useful in the treatment of electrical storm in which one ofthe following conditions?A) Congenital Long QT SyndromeB) Acquired Long QT SyndromeC) Catecholaminergic polymorphic ventricular tachycardiaD) Ischemic ventricular tachycardiaQ27. Anti arrhythmic drugs with Reverse Use Dependence property exhibitwhich one of the following properties?A) Increased efficacy in tachycardiaB) Bradycardia dependent proarrhythmiaC) Maximal effect at normal sinus ratesD) Block predominantly the sodium channel.Q28. Regarding ACC/AHA Guidelines for Coronary Angiography to establish adiagnosis in patients with suspected angina1.Patients with known or possible angina pectoris who have survivedsudden cardiac death is a class1 indication2.Patients in whom coronary artery spasm is suspected andprovocative testing may be necessary is a class 2a indication3.Patients who cannot undergo noninvasive testing because ofdisability, illness, or morbid obesity is a class 2a indication4.Patients with recurrent hospitalization for chest pain in whom adefinite diagnosis is judged necessary is a class 1 indicationA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ29. Which of the following syndromes is characterized by supravalvular aorticstenosis, elfin facies, idiopathic hypercalcemia of infancy, intellectualdisability and a gregarious personality?A) Di George syndromeB) Williams syndromeC) Cri-du-chat syndromeD) Alagille syndrome9 of 25
  10. 10. Q30. In mitral valve prolapse syndrome, histopathology of mitral valve showsA) Hyaline degenerationB) Elastic degenerationC) Myxomatous degenerationD) Fibrinoid necrosisQ31. Which one of the following inborn errors of metabolism is a peroxisomalbiogenesis disorder?A) Propionic acidemiaB) Niemann-Pick diseaseC) Metachromatic leucodystrophyD) Zellweger syndromeQ32. Regarding cardiac sarcoidosis the following is/ are correct:1. Common arrhythmias are atrial fibrillation and atrial flutter.2. Myocardial involvement is focal or patchy.3. Implantable cardioverter defibrillator is a class I indication forprimary prevention.4. Conduction blocks can be present.A) 1, 2 and 3 are correctB) 1 and 3 are correctC) 2 and 4 are correctD) Only 4 is correctQ33. A specific genetic mutation results in a disease only when it is present onthe paternally derived copy of the gene but not when it is present on thematernally derived copy of the gene. This is an example of:A) Genomic imprintingB) Mitochondrial inheritanceC) Y-linked inheritanceD) Chromosomal disorderQ34. Regarding blunt cardiac trauma, one of the following is not trueA) Ventricular rupture most frequently involves the left ventricle.B) Ventricular septal rupture commonly occurs in the membranous portion.C) Strangulated heart results from left sided cardiac herniation through apericardial tear.D) Sinus tachycardia is commonly seen.10 of 25
  11. 11. Q35. In a patient who has recently suffered from ST- elevation myocardialinfarction (STEMI), use of coronary arteriography will not be indicated if:A) Patient has intermediate risk findings on noninvasive testing.B) Spasm is believed to be the cause of STEMI.C) Patient is due for definitive therapy of acute mitral regurgitation followingSTEMI.D) Coronary revascularisation is not planned.Q36. Coronary vascular resistance is best measured during which phase of thecardiac cycle?A) Mid diastoleB) Mid systoleC) Early diastoleD) End diastole before atrial contractionQ37. Linked angina refers to:A) Angina linked to exertion beyond usual stress.B) Angina linked to anxiety, fear and psychological stress.C) Angina linked to gastrointestinal causes or stooping.D) Angina linked to arrhythmias especially with ischemia.Q38. Which of the following is a wrong match with regard to clinicalmanifestation of cardiac tumor?A) Papillary fibroelastomas- embolic symptomsB) Myxomas- mechanical obstructionC) Lipomatous hypertrophy-embolic symptomsD) Lymphomas-constitutional symptomsQ39. The innate immune response is mediated by:A) T cellsB) T & B cellsC) Natural killer (NK) cellsD) Natural killer cells, complement & phagocytesQ40. Which of the following coagulation factors causes cross linking andstabilization of clot?A) Factor IXB) ThrombinC) Factor VIIID) Factor XIII11 of 25
  12. 12. Q41. Which of the following is true regarding the cardiac size in infants andchildren?A) The cardiac size correlates better with height than weight.B) For the same body size, heart weight is greater in girls than in boysC) For the same body size, heart weight is greater in boys than in girlsD) Heart weight does not vary with gender in infancy and childrenQ42. Regarding prevention of cardiovascular diseases:Assertion: Class 1 interventions have a clear causal relationship withheart diseaseReasoning: Reliable data from randomised clinical trials demonstrate themagnitude of the class 1 interventions benefit as well as its risks and costA) Both Assertion and Reason are true, and Reason is the correctexplanation for AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is trueQ43. Regarding polio vaccination:Assertion: IPV (inactivated polio vaccine) is safe in patients withimmunodeficiency.Reason: IPV does not cause vaccine-associated paralytic poliomyelitis.A) Both Assertion and Reason are true and Reason is the correctexplanation for the Assertion.B) Both Assertion and Reason are true but Reason is not the correctexplanation for the Assertion.C) Assertion is true but Reason is false.D) Assertion is false and Reason is true.Q44. Which one of the following is true about the ejection click in valvularpulmonary stenosis?A) S1-ejection click interval increases with increasing severity of stenosisB) S1-ejection click interval decreases with increasing severity of stenosisC) S1 - ejection click interval remains constant irrespective of the degree ofstenosisD) During inspiration the ejection click is louder.12 of 25
  13. 13. Q45. Which among the following is not a continuous murmur?A) Venous humB) Mammary souffléC) Portosystemic shuntsD) Severe aortic stenosis murmurQ46. Which of the following is an example of a neuro-endocrine reflex?A) Milk- ejection reflex.B) Micturition reflex.C) Stretch reflex.D) Mark time reflexQ47. Which of the following ECG abnormalities can be seen in Ebsteinsanomaly:1)Type B WPW (Wolff-Parkinson White) preexcitation2)Right bundle branch block3)Atrial fibrillation4)Deep Q waves in lateral leads I,avl ,V5, V6A) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ48. Regarding ventricular arrhythmia:Assertion: Ischemic ventricular tachycardia is initiated and terminatedwith programmed electrical stimulation.Reason: The most common mechanism of ventricular arrhythmia inischemic heart disease is reentry.A) Both Assertion and Reason are true, and Reason is the correctexplanation for AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is true13 of 25
  14. 14. Q49. Severity of mitral stenosis is assessed by which one of the followingparameters?A) Loud opening snapB) Length of the murmurC) Loud S1D) Splitting of S2Q50.Likely diagnosis of this ECG isA) Situs inversus with dextrocardiaB) Situs solitus with levocardiaC) Situs solitus with dextrocardiaD) Situs inversus with levocardiaQ51. A 30 year old female presented with shortness of breath and hemoptysis.There is no leg swelling and the ECG is normal. A chest radiograph showsa triangular, pleurally based opacity in the right mid zone with an ipsilateraleffusion. Which investigation would be most helpful in making thediagnosis?A) Ventilation-perfusion scanB) CT pulmonary angiogramC) Conventional pulmonary angiogramD) High resolution CT scan14 of 25
  15. 15. Q52. Regarding measles infection:1. It is caused by Varicella zoster virus2. Koplik spots are the pathognomonic sign of measles3. It has a feco-oral route of transmission4. Acute otitis media is one of the most common complications ofmeaslesA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ53. Regarding coronary flow reserve1. Absolute flow reserve is the ratio of coronary flow during maximalvasodilation to the resting value.2. Relative flow reserve compares maximal vasodilated flow in astenotic region with an assumed normal region in the sameheart.3. Fractional flow reserve assesses maximal flow indirectly fromcoronary pressure measurements distal to a stenosis duringvasodilation.4. Fractional flow reserve can identify the contribution ofabnormalities in microcirculatory resistance to the developmentof myocardial ischemia.A) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ54. Assertion: Cardiac hemodynamic respone during exercise does not varyin supine or upright position.Reason: SV increases 100% with maximal exercise when the patient isupright and only 20% to 50% when the patient is supine.A) Both Assertion and Reason are true, and Reason is the correctexplanation for AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is true15 of 25
  16. 16. Q55. Regarding sarcoidosis and cardiac involvement which is not true:A) Infiltration of the left ventricle is more common.B) Gallium imaging may be helpful in determining the need for immuno-suppression.C) Steroid therapy is indicated in active sarcoidosis.D) Pump dysfunction is more common than conduction system involvementQ56. What is the diagnosis from the picture given below?A) Tetralogy of FallotB) Tricuspid atresiaC) d-Transposition of great arteriesD) Congenitally corrected Transposition of great arteriesQ57. Which of the following clinical signs is not seen in a patient with atrialseptal defect?A) Left atrialization of jugular venous pressure (JVP)B) Wide fixed split second heart soundC) Hyperdynamic left ventricular impulseD) Palpable pulmonary artery pulsations16 of 25
  17. 17. Q58. The pullback trace with end hole catheter from left ventricular (LV) apex tobase and further to aorta is given here. The likely diagnosis is:A) Valvular aortic stenosisB) Supravalvular aortic stenosisC) Hypertrophic obstructive cardiomyopathyD) Restrictive cardiomyopathyQ59. Provocative agents used during the Tilt- Table test include:1.Intravenous isoproterenol2.Intravenous metoprolol3.Sublingual nitroglycerine4. Intravenous atropineA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ60. Implantable Cardioverter Defibrillator (ICD) therapy is indicated in which ofthe following conditions?A) Idiopathic right ventricular outflow tract ventricular tachycardia (VT).B) Left ventricular fascicular VT.C) VT storm.D) Catecholaminergic polymorphic VT17 of 25
  18. 18. Q61. The size of the Judkins left catheter is determined by:A) The length between the primary curve and the tip of the catheter.B) The length between the primary curve and the secondary curve.C) The length between the secondary curve and the tip of the catheter.D) The radius of curvature of the secondary curve.Q62. Regarding microRNAs (miRNAs)1.They are non-coding RNAs2.They are involved in post-translational gene regulation3.They play a role in tumorigenesis through regulation of oncogenicsignaling pathways4.They are 100-200 nucleotides in lengthA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ63. Which of the following cardiac diseases is not associated with high risk inpregnancy?A) Tetralogy of FallotB) Primary pulmonary artery hypertensionC) Hypertrophic cardiomyopathyD) Coarctation of aortaQ64. C-reactive protein is1. Alpha-1 globulin2. Beta globulin3. Tumor marker4. Non-specific inflammatory proteinA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ65. Leading cause of Sudden Cardiac Death is:A) Dilated cardiomyopathyB) Coronary artery diseaseC) MyocarditisD) Left ventricular hypertrophy18 of 25
  19. 19. Q66. For a study a sample was built by initially dividing the population into agegroups 21-30 yrs, 31-40 years, 41-50 years, 51-60 years, 61-70 years andabove 70 years. From each group subjects were selected using a randomnumber table. This sample is called:A) Systematic random sampleB) Stratified random sampleC) Hemi random sampleD) Simple random sampleQ67. During exercise stress test:Assertion: Exercise-induced ventricular arrhythmias are more frequent inearly recovery phase.Reason: Plasma norepinephrine levels continue to rise even aftercessation of exercise.A) Both Assertion and Reason are true, and Reason is the correctexplanation for the AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for the AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is trueQ68. eNOS (Endothelium nitric oxide synthase) expression is reduced by:A) HypoxiaB) Hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors-statinsC) Exercise trainingD) Increased shear stress on vessel wallQ69. Which of the following is true regarding the pericardial effusion associatedwith hypothyroidism?A) It is often associated with cardiac tamponade.B) It is associated with underlying endocarditis.C) It has high concentration of cholesterol.D) It does not respond to replacement with thyroxine.19 of 25
  20. 20. Q70. Regarding PCI (percutaneous coronary intervention) in acute myocardialinfarction:1. PCI should not be performed in a noninfarct artery at the time ofprimary PCI in patients without hemodynamic compromise2.Patients receiving fibrinolytic therapy can undergo angiogram withan intent for PCI if they are in severe congestive heart failureand/or pulmonary edema (Killip Class III)3.Primary PCI should not be performed in asymptomatic patientsmore than 12 hours after the onset of STEMI (ST segmentelevation myocardial infarction) if they are hemodynamically andelectrically stable4.PCI should not be performed if there are hemodynamicallycompromising ventricular arrhythmiasA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ71. Which one of the following promotes platelet activation and coagulation?A) Prostacyclin (PGI2)B) Activated Protein CC) Thromboxane A2D) Heparan sulfate proteoglycansQ72. Regarding incidence and prevalenceAssertion: Prevalence can increase even if incidence is constantReason: Prevalence depends on both incidence and duration of illnessA) Both Assertion and Reason are true and Reason is the correctexplanation for AssertionB) Both Assertion and Reason are true and Reason is not the correctexplanation for AssertionC) Assertion is true but Reason is falseD) Reason is true but Assertion is false20 of 25
  21. 21. Q73. Assertion: Pretesting with small dose of radio contrast is recommendedin all patients to determine risk of adverse reaction.Reason: Patients with known prior anaphylactic reactions to contrast dyeshould be pretreated with steroids and an H1 blocker.A) Both Assertion and Reason are true, and Reason is the correctexplanation for AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is trueQ74. Useful drug to treat the electrical storm in Brugada syndrome is:A) FlecainideB) PropranololC) ProcainamideD) QuinidineQ75. Cardiac Allograft Vasculopathy is a dreaded complication which limits thelong-term benefits of Heart Transplantation.It is best managed by:A) Medical managementB) Percutaneous interventions e.g Stenting the coronariesC) Coronary artery bypass graftingD) Redo Cardiac TransplantationQ76. In evaluation of patients with syncope:Assertion: Induction of monomorphic ventricular tachycardia duringelectrophysiologic testing is considered as positiveReason: Induction of polymorphic ventricular tachycardia or ventricularfibrillation is considered as a non- specific responseA) Both Assertion and Reason are true, and Reason is the correctexplanation for the AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for the AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is true21 of 25
  22. 22. Q77. Regarding autosomal recessive genetic disorders:1.At least one parent of an affected individual must also be affectedwith the disease2.There is an equal chance for individuals of both sexes beingaffected3.There is a 50% risk of recurrence of the disease in offspring ofheterozygous parents4.The risk of autosomal recessive disorders is greater with parentalconsanguinityA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correctQ78. Malignant premature ventricular contractions (PVCs) refers toA) PVCs in association with infiltrative sarcomas of the heartB) PVCs in association with predisposition to ventricular arrhythmiasC) PVCs in excess of 100/hrD) PVCs associated with malignant hypertensionQ79. Regarding exercise stress test in normal persons:Assertion: Resting cardiac output increases before start of exercisestress test.Reason: Increase in vagal tone is the predominant cause for this.A) Both Assertion and Reason are true, and Reason is the correctexplanation for the AssertionB) Both Assertion and Reason are true, and Reason is not the correctexplanation for the AssertionC) Assertion is true, but Reason is falseD) Assertion is false, but Reason is trueQ80. During the exercise stress test parameters associated with adverseprognosis include1.Angina at high exercise work load2.Exercise induced ST elevation3.Sustained increase in blood pressure levels above rest levels4.Symptomatic ventricular tachycardiaA) Only 1, 2 and 3 are correctB) Only 1 and 3 are correctC) Only 2 and 4 are correctD) Only 4 is correct22 of 25
  23. 23. Q81. Long QT syndrome is characterized by which one of the following:A) Abnormal depolarizationB) Abnormal repolarization.C) Myocardial hypertrophyD) Rapid monomorphic ventricular tachycardiaQ82. Cardiac catheterization data in pulmonary veno-occulsive disease will beas follows:A) ↑ Pulmonary artery pressure, ↓ Wedge pressure, ↑Left ventricular enddiastolic pressure (LVEDP)B) ↑ Pulmonary artery pressure, ↑ Wedge pressure, ↑LVEDPC) ↓ Pulmonary artery pressure, ↑ Wedge pressure, ↓LVEDPD) ↑ Pulmonary artery pressure, normal wedge, normal LVEDPQ83. The worst prognosis in terms of duration of survival is seen in:A) Peripartum cardiomyopathyB) Cardiomyopathy due to ischemic heart diseaseC) Infiltrative myocardial diseaseD) Doxorubicin induced cardiomyopathyQ84. Which one of the following is true regarding pulsus bisferiens?A) It is associated with severe aortic stenosis.B) It is associated with a low stroke volume.C) It is associated with pure aortic regurgitation.D) It is associated with restrictive cardiomyopathy.23 of 25
  24. 24. Q85. Cardiac action potential below shows:A) Early after-depolarizationB) Delayed after-depolarizationC) Late phase 2 early after-depolarizationD) Hyper-polarizationQ86. Nyquist limit applies toA) Continuous wave DopplerB) Harmonic imagingC) Pulse wave DopplerD) Strain rateQ87. Type II dysfunction in Carpentiers classification of mitral regurgitationrefers toA) Restricted leaflet openingB) Restricted leaflet closureC) Increased leaflet motionD) Normal leaflet motion24 of 25
  25. 25. 25 of 25Q88. Assertion: Protamine sulfate should be used with caution in patientstaking NPH insulin.Reason: The use of protamine sulfate in patients taking NPH insulin leadsto reactions in 70% of patients.A) Both Assertion and Reason are true, and Reason is the correctexplanation for Assertion.B) Both Assertion and Reason are true, and Reason is not the correctexplanation for Assertion.C) Assertion is true, but Reason is falseD) Assertion is false, but Reason is true.Q89. Which of the following is true about the peptide hormone Hepcidin?A) It decreases dietary iron absorption.B) It is a 45 amino acid peptide synthesized by liver cells.C) Majority of Hereditary Haemochromatosis patients have increasedhepcidin levelsD) Hepcidin promotes release of iron from macrophages.Q90. Tall R in V1 is a feature ofA) True posterior wall myocardial infarctionB) Acute pulmonary embolismC) Peroneal muscular dystrophyD) Cardiac sarcoidosis

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