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NIMS JUNE 2012 DM CARDIOLOGY entrance paper

NIMS JUNE 2012 DM CARDIOLOGY entrance paper

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  • 1. NIZAM’S INSTITUTE OF MEDICAL SCIENCES Punjagutta, Hyderabad – 500 082, A.P., India. Set A 2012 DM Cardiology Question Booklet Entrance Examination for Admission toSubject DM Cardiology24 June 2012 Marks 90 Time: 1 hr: 30 min  Please verify whether the number printed on this question booklet corresponds to your hall-ticket number  Please read the instructions on the OMR-Answer sheet carefully  Please mark set A at appropriate place on OMR sheet  Each question in this booklet is followed by four alternative answers Select the one that is most appropriate and darken the corresponding Oval in the OMR-Answer sheet  At the end of the examination please return this question booklet along with your OMR-Answer sheet. Please wait in your seat for the above material to be collected  Answer sheets not accompanied with the question booklets will not be corrected 1 of 25
  • 2. Q1. Radiofrequency catheter ablation therapy is recommended over implantablecardioverter-defibrillator for which of the following VT A) LV fascicular VT B) LV Scar VT C) VT in Arrhythmogenic RV Dysplasia. D) VT in Idiopahic Dilated Cardiomyopathy.Q2. All the following are tributaries of coronary venous sinus except A) inferior cardiac vein B) posterior cardiac vein C) middle cardiac vein D) small cardiac vein.Q3. Renal artery stenosis may occur in all of the following except A) atherosclerosis B) fibromuscular dysplasia C) Takayasus arteritis D) polyarteritis nodosaQ4. Preferred angiographic view to evaluate ostial portion of the left anteriordescending and circumflex coranary arteries is A) LAO caudal B) LAO cranial C) AP cranial D) RAO cranial 2 of 25
  • 3. Q5. During sinus impluse activation of the atria , following is the last part of theatrium to get activated A) crista terminalis part of right atrium B) lower septal porion of the right atrium C) superolateral part of left artium D) inferolateral part of left atriumQ6. Isomerism of left atrial appendages is associated with A) anterior position of inferior vena cava B) trilobed lungs C) asplenia D) atrial arrythmiasQ7. Regarding ductus arteriosus A) during intrauterine life , its diameter is smaller than that of branch arteries. B) functional closure begins 24 hours after birth C) post natal closure is hastened by high altitude. D) anatomical closure begins near pulmonary artery and progresses towards aortaQ8. A patients serological report reveals HBsAg +ve, HBeAg Negative, Anti HBe+ve, anti HBc IgM negative, HBV DNA quantitative 19,00,000 IU/ml. The diagnosisbased on serology is A) chronic HBsAg carrier wild type B) chronic HBsAg carrier with acute exacerbation C) chronic HBsAg carrier with pre core mutation D) HBV related acute viral hepatitisQ9. Which of the following criteria is most likley to affect the generalizability of theresults of a clinical trial to patients seen in routine practice A) enrollment criteria B) power of the study C) selection bias D) randomisation strategyQ10. In a carcinoma with unknown primary the most common histology seen is A) squamous cell carcinoma B) neuroendocrine histology C) well differentiated adenocarcinoma D) poorly differentiated adenocarcinoma 3 of 25
  • 4. Q11. Regarding precordial lead V6 in ECG A) is located in left 6th intercostal space B) is located in the same horizontal plane as V4 C) is in left posterior axillary line D) shows ST depression in acute lateral myocardial infarctionQ12. A patient who has undergone AICD implantation reports to emergency room withhistory of multiple AICD shocks in the last one hour. ECG done in the emergency roomshows atrial fibrillation with rapid ventricular rate. Management would be A) I.V amiodarone bolus followed by infucion over 12 hours B) I.V adenosine C) I.V verapamil D) Apply magnet over AICD pulse generatorQ13. Which of the following food types have a significant effect on altering the risk ofcoronary heart disease1. high fruit and vegetable intake2. total coffee intake3. dairy food consumption4. intermittent moderate alcohol consumption A) only 1, 2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ14. A 50 year old man, an alcoholic and a smoker presents with a 3 hours history ofincreasing shortness of breath and chest pain. He started having this pain while eating,which was constant and radiated to the back and interscapular region. He was a knownhypertensive. On examination, he was cold and clammy with a heart rate of 130/min, anda BP of 80/40 mmHg. JVP was normal. All peripheral pulses were present and equal.and ejection systolic murmur was heard.Which one of the following is the most likelydiagnosis A) acute aortic dissection B) acute myocardial infarction C) rupture of the esophagus D) acute pulmonary embolism 4 of 25
  • 5. Q15. Regarding postural orthostatic tachycardia syndrome - on upright tilt patientsexhibit A) significant increase in heart rate and blood pressure. B) significant increase in heart rate with no significant change in BP. C) significant increase in heart rate with significant fall in BP. D) inappropriate increase in resting heart rates with no significant further change.Q16. Large v waves on pulmonary capillary wedge (PCW) tracing are seen in all of thefollowing except A) papillary muscle dysfunction B) rheumatic mitral regurgitation C) acute AR D) ventricular septal defectQ17. Inducible ischemia can be diagnosed by exercise testing in symptomatic patientswith A) complete RBBB. B) WPW syndrome. C) complete LBBB. D) electronically paced ventricular rhythm.Q18. Assertion: during percutaneous coronary intervention smaller ST segmentchanges are noticed in balloon inflations subsequent to initial inflationReason: ischemic preconditioning is the proposed mechanism for cardiac protection A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 5 of 25
  • 6. Q19. Correct match of ECG pattern to the time range following onset of myocardialinfarction1) 2)3) 4) A) 1-week , 2-hour ,3-year ,4-minute B) 1-minute ,2-hour ,3-year ,4-week C) 1-minute ,2-hour ,3-week ,4-year D) 1-week ,2-year ,3-minute ,4-hourQ20. Which of the following measure/ measures is/ are highly recommended byACC/AHA in the treatment of patients with endstage heart failure1.cardiac transplantation2. intermitent infusion of positive inotrope agents3. left ventricular assist device in patients expected to survive for less than a year withmedical therapy4. mitral valve repair for severe secondary mitral regurgitation A) only 1, 2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct 6 of 25
  • 7. Q21. Which of the following drug/ drugs has / have the potential to precipitatedecompensation in patients with chronic heart failure1. allopurinol2. rosiglitazone3. alpha adrenergic blockers4. non steroidal anti-inflammatory drugs A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ22. Assertion : under stress myocardial oxygen delivery increases dominantly due toincreased extraction of oxygen from bloodReason: oxygen extraction is almost maximal under resting conditions A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ23. A 26 year old lady came with the complaints of fever with altered sensorium andreduced urine output of 1 week duration. On evaluation her hemoglobin was 7 gm/dl,platelet count of 30,000/cu.mm with peripheral smear showing schistocytes.Serumcreatinine was 3mg/dl.Prothrombin time and activated partial thromboplastin time werenormal. Enzyme most likely to be deficient in this situation is A) hexokinase B) pyruvate kinase C) ADAMTS 13 D) glucose-6 phosphate dehydrogenaseQ24. Regarding blood supply to the cardiac conduction system all are true except A) right bundle branch has dual blood supply from RCA and LAD B) left anterior fascicle has dual blood supply from LAD and RCA. C) left posterior fascicle has dual blood supply from LAD and RCA. D) AV node is supplied by dominant coronary artery 7 of 25
  • 8. Q25. Troponin - T is preferable to CPK - MB in the diagnosis of acute myocardialinfarction (MI) in the following situation/situations1. bedside diagnosis of acute MI2. postoperatively (after CABG)3. small infarcts4. reinfarction after 4 days A) only 1, 2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ26. Doppler principle states that A) change in received frequency is inversely proportional to the velocity of bloodmoving towards the transducer B) change in received frequency is directly proportional to the velocity of bloodmoving towards the transducer C) change in received signal amplitude is directly proportional to the velocity ofblood moving towards the transducer D) change in received signal amplitude is inversely proportional to the velocity ofblood moving away from transducerQ27. In an elderly hypertensive patient with depression which of the following drug isto be avoided A) sertaline B) phenelzine C) imipramine D) mirtazapineQ28. Bosentan used for treatment of pulmonary arterial hypertension is A) selective ET-A receptor antagonist B) both ET-A and ET-B receptor antagonist C) phosphodiesterase inhibitor D) prostacyclin 8 of 25
  • 9. Q29. A resident doctor inserted central venous catheter for a patient with hypotensionin the emergency medicine department. The cotton dressing stained with blood shouldthen be placed into A) yellow plastic bag B) red plastic bag C) black plastic bag D) white translucent plastic bagQ30. Which of the following is not used for bypass grafting of coronary arteries A) radial artery B) gastroepiploic artery C) ulnar artery D) inferior epigastric arteryQ31. Which of the following prehospital measures are acceptable in the care of apatient with snakebite A) application of splint to the bitten extremity B) incision and application of suction to the bite site C) application of ice or poultices D) application of tourniquetQ32. Which one of the following third generation beta blockers, is a beta-1- selective,vasodilator A) carvedilol B) labetalol C) nebivolol D) bucindololQ33. Regarding adverse drug reaction of chemotherapeutic agent which is a wrongmatch A) 5-FU- acute coronary syndrome B) doxorubicin-LV dysfunction C) cisplatin-Hypokalemia D) paclitaxel-Hypotension 9 of 25
  • 10. Q34. Which of the following is/are cardiac manifestations in primary antiphospholipidsyndrome1. pericarditis2. non bacterial endocarditis3. conduction system disease4. thrombotic coronary artery disease A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ35. Regarding the definition of pulmonary arterial hypertension1.pulmonary arterial pressure more than 25 mmHg at rest2.pulmonary capillary wedge pressure less than 15 mmHg3.increased pulmonary vascular resistance4.presence of pulmonary embolism A) only 1, 2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ36. Mason - Likar modification of 12 lead ECG placement during Tread mill Testcauses1. Right axis shift2. Appearance of Q wave in II , III , avf3. Appearance of Q wave in a v L4. Left axis shift A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ37. The graft with the highest patency rate in coronary artery bypass surgery is A) radial artery to the right coronary artery B) left internal mammary to the left anterior descending artery C) radial artery to the left anterior descending artery D) left internal mammary artery to the circumflex artery 10 of 25
  • 11. Q38. Patient with Primary VF (within first 24 hours) during Acute MyocardialInfarction requires A) long term amiodarone. B) subsequent Electrophysiologic study for inducibility of VT. C) implantable Cardioverter- Defibrillator D) none of the above.Q39. Given the following ECG of cyanotic child, the most likely diagnosis is A) d-transposition if great arteries B) TAPVC C) Ebsteins anomaly D) tricuspid atresia 11 of 25
  • 12. Q40. In which following conditions left atrium is not enlarged A) ventricular septal defect B) atrial septal defect C) aortopulmonary window D) patent ductus arteriosusQ41. During ventricular pressure pulses square root wave is seen in A) ASD B) MVPS C) dilated cardiomyopathy D) constrictive pericarditisQ42. A 15-year old girl presented with recurrent palpitations and central cyanosis.Auscultation revealed quadruple rhythm and holosystolic murmur at lower left sternalborder. Her electrocardiogram is depicted below.Most probable clinical diagnosis is A) Ebsteins anomaly B) tricuspid atresia C) Eisenmenger atrial septal defect (ASD) D) tetralogy of Fallot (TOF) 12 of 25
  • 13. Q43. Regarding prasugrel, a newer antiplatelet drug A) it is an 5-HT2A antagonist B) it is shortacting C) is a prodrug D) exhibits high inter-individual variablity in platelet responseQ44. In Brugada syndrome VF episodes are precipitated most with A) exercise. B) catecholamines. C) quinidine. D) fever.Q45. A 59 year man with severe myxomatous mitral regurgitation is asymptomatic,with a left ventricular ejection fraction of 45% and an endsystolic diameter index of2.9cm/m2. The most appropriate treatment is A) mitral valve repair or replacement B) no treatment C) ACE inhibitor therapy D) digoxin diuretic therapyQ46. Among the atrial septal defects shown below, the darkly shaded defect is of type A) ostium primum B) ostium secundum C) sinus venosus D) coronary sinus 13 of 25
  • 14. Q47. Regarding Stress ECG testing in an otherwise healthy individual1. diastolic pressure raises 5mm Hg at each stage2. isolated VPCs at peak exercise suggest left main disease3. false negative result more common in single vessel disease in LAD than other twovessels4. S-T-depression limited to recovery phase do not generally represent false-positiveresponse. A) only 1,2, and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ48. Which of the following situations would be rated as the most appropriateindication for the use of radionuclide imaging for detection of coronary heart disease(CHD) A) asymptomatic patient with intermediate risk of CHD according to ATP IIIcriteria with an uninterpretable ECG B) acute chest pain with definite acute coronary syndrome C) troponin elevation without additional evidence of acute coronary syndrome D) new onset atrial fibrillation with an unclear etiologyQ49. Drug B is investigated in a meta-analysis for its effect on mortality after acutemyocardial infarction. It is found that, when this drug is administered, the mortalitydrops from 11% to 3%. How many patients will have to be treated with drug B to preventone death A) 3 B) 11 C) 12.5 D) 24Q50. Which of the following investigation has the highest sensitivity for diagnosingmyocarditis A) CK-MB isoform B) Indium -111 antimyosin scintigraphy C) myocardial biopsy D) echocardiography 14 of 25
  • 15. Q51. True about Dresslers syndrome is all, except A) occurs with in hours after myocardial infarction B) recurrence may be seen C) chest pain is common D) responds well to salicylatesQ52. Which of the following hemodynamic changes occur in pregnancy1. decreased peripheral vascular resistance2. decreased pulmonary vascular resistance3. increased blood volume4. decreased venous pressure in lower extremities A) only 1, 2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ53. Regarding ranolazineAssertion: it is a piperazine derivative that has anti ischemic propertiesReason: it blocks rectifier potassium currents and also lowers heart rate A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ54. In patients with diabetes and kidney diseaseAssertion: Angiotensin converting enzyme blockers and angiotensin receptor antagonistsare the preferred over calcium channel blockers antihypertensives in patients withdiabetic nephropathyReason: Angiotensin converting enzyme blockers and angiotensin receptor antagonistsare more effective in lowering blood pressure in those with diabetes A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 15 of 25
  • 16. Q55. All of the following are useful in the treatment of instent restenosis except A) brachytherapy B) atherectomy devices C) Gp IIb IIIa inhibitors D) DES implantationQ56. Regarding cardiac output during rest and exercise in a normal person1. at rest is ~5 to 6 liters/minute and can increase approximately fivefold during strenuousexercise2. increases with a decrease in the pressure gradient (P1 - P2) generated by the heart3. during exercise blood flow to the skin and skeletal muscle increases to constitute asmuch as 85 % of the cardiac output4. during exercise the brain, kidney and splanchnic circulations receive about 1/3rd oftheir basal flow A) only 1,2 and 3,are correct B) only 1 and 3 are correct C) only 2and 4 are correct D) only 4 is correctQ57. Regarding vein graft in CABGAssertion: degeneration occurs significantly after 5 years of CABGReason: degenerative process in vein grafts is similar to native vessel atheroscleroticdisease A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ58. Discontinuity between the anterior mitral leaflet and coronary cusps are present in1. d-transposition of great arteries2. l-transposition of great arteries3. discrete sub-aortic stenosis4. mitral valve prolapse A) only 1, 2, and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correct 16 of 25
  • 17. Q59. The term "extensively drug-resistant tuberculosis (XDR-TB)" refers to isolates ofM.tuberculosis resistant to A) streptomycin, rifampicin, pyrazinamide, ethambutol and cycloserine B) isoniazid, rifampicin, flouroquinolones and atleast one injectable second linedrug C) pyrazinamide, isoniazid, ethambutol and atleast one injectable second line drug D) streptomycin, rifampicin, pyrazinamide, ethambutol and ethionamideQ60. Regarding statinsAssertion: Pravastatin should be taken in the evening whereas atorvastatin can be takenat any time in the day.Reason: Pravastatin causes day time drowsiness as a most common side effect. A) Both Assertion and Reason are true, and Reason is the correct explanation ofAssertion. B) Both Assertion and Reason are true, but Reason is not the correct explanation ofAssertion. C) Assertion is true but Reason is false. D) Assertion is false but Reason is true.Q61. Regarding MalariaAssertion: plasmodium vivax malaria is characterized by long term relapsesReason: the latent erythrocytic stage lasts for several years A) Both Assertion and Reason are true, and Reason is the correction explanation forthe assertion B) Both Assertion and Reason are true, and Reason is not the correction explanationfor the assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ62. Regarding normal ventricular activation A) activation front is directed from epicardium to endocardium. B) earliest LV activation is in apex on left side of septum. C) earliest RV activation involves pulmonary conus. D) posterobasal LV is last to be activated.Q63. Ezetimibe exerts its action by A) inhibiting intestinal cholesterol absorption B) inhibiting intestinal triglyceride absorption C) inhibiting HMG Co-A reductase activity D) binding to bile acids to form insoluble complexes 17 of 25
  • 18. Q64. Ideal emergency imaging modality for unstable patient with proximal aorticdissection is A) retrograde aortography. B) MRI C) transesophageal echocardiography D) intravasucular ultrasound / transthoracic echocardiographyQ65. Rastelli operation is done for A) Transposition of great arteries(TGA) with intact Ventricular septum B) TGA with ventricular septal defect(VSD) C) TGA, VSD with left ventricular outflow tract (LVOT) obstruction D) Tetralogy of FallotQ66. Which of the following combinations of lung volume abnormalities are mostlikely in idiopathic pulmonary fibrosis A) decreased total lung capacity (TLC), decreased vital capacity (VC), decreasedresidual volume (RV), increased FEV1/FVC ratio, normal maximum inspiratory pressure(MIP) B) normal TLC, normal residual volume RV, normal FEV1/FVC ratio, normal MIP C) increased TLC, decreased VC, decreased FEV1/FVC ratio D) decreased TLC, increased residual volume RV, normal FEV1/FVC ratio,decreased MIPQ67. The primary biochemical lesion in homozygotes with familialhypercholesterolemia A) the loss of apoprotein B B) the malfunctioning of acyl CoA cholesterol acyl transferase (ACAT) C) the functional deficiency of plasma membrane receptors for low densitylipoproteins D) the increased production of low density lipoproteins 18 of 25
  • 19. Q68. A specific predictor for higher risk of sudden cardiac death in patients withidiopathic dilated cardiomyopathy(non-ischemic CMP) is A) non-sustained ventricular tachycardia B) induction of polymorphic VT or VF during EP testing C) unexplained syncope D) any of the aboveQ69. All of the following are seen in cardiac tamponade except A) pulsus paradoxus B) diastolic collapse of right ventricle on echocardiogram C) electrical alternans D) Kussmauls signQ70. A 24 year old patient presents to casualty department with chest pain of 2 dayduration, pulse-110/min,BP:100/70mmhg, Temp 100F,Resp-22/min, Chest-B/l equal airentry ,CVS-normal heart sounds,no murmurs. The given electrocardiogram is suggestiveof A) acute pericarditis B) acute myocardial infarction C) pulmonary embolism D) early repolarization changes 19 of 25
  • 20. Q71. In TOF severity of cyanosis depends on1) severity of infundibular obstruction2) amount of aortic override3) systemic vascular resistance4) site of VSD A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ72. Regarding use of calcium channel blockers in management of acute coronarysyndromeAssertion: they are indicated as first line drugs in the management of acute coronarysyndromeReason: they inhibit vascular smooth muscle function and cause coronary and peripheralvasodilatation A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ73. A 45 year old male having a long history of cigarette smoking presented withgangrene of left foot. An amputation of the left foot was done. Representative sectionsfrom the specimen revealed presence of arterial thrombus with neutrophilic infiltrate inthe arterial wall. The inflammation also extended into the neighbouring veins and nerves.The most probable diagnosis is A) Takayasu arteritis B) Giant cell arteritis C) hypersensitivity angitis D) thromoboangitis obliteransQ74. Prospective gating in coronary computerised tomography angiography isassociated with A) low radiation dose B) x ray tube continuously on C) evaluation of both systole and diastole D) enables flexible reconstruction in the event of arrhythmias 20 of 25
  • 21. Q75. Infection /infections that occur in the first 2 weeks after allogeneic stem celltransplantation is/ are1. gram positive bacterial sepsis2. candida sepsis3. herpes simplex virus disease4. cytomegalovirus disease A) only 1, 2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ76. The antiretroviral drug implicated in the development of heart muscle disease A) nevirapine B) efavirenz C) zidovudine D) emtricitabineQ77. Regarding cryptococcal infection1. lifelong maintenance therapy is recommended to prevent a symptomatic clinicalrelapse in patients with HIV infection.2. pulmonary cryptococccosis in an immunocompetent host always progresses todisseminated cryptococcosis if not treated.3. complications of central nervous system cryptococcosis include cranial nerve deficits,vision loss and cognitive impairment.4. the echinocandins , caspofungin and micafungin are highly effective againstcryptococcus species A) only 1,2 and 3 are correct B) only 1 and 3 are correct C) only 2 and 4 are correct D) only 4 is correctQ78. Cardiac involvement in sarcoidosis is characterised by A) Right heart failure secondary to primary cardiac involvement B) Echocardiographic evidence of myocarditis is seen >80% cases C) Intraventricular delays and atrioventricular blocks D) Apical regional wall motion abnormality secondary to coronary involvement 21 of 25
  • 22. Q79. Regarding fondaparinux A) is a orally acting direct thrombin inhibitor B) requires dose adjustment with APTT levels C) excreted mainly through hepatic metabolism D) is a synthetic pentasacharide that inhibits factor XaQ80. In a patient with chronic congestive cardiac failure, all of the following drugsprolong survival except A) metoprolol B) carvedilol C) enalapril D) digoxinQ81. Which of the following is a minor criteria for diagnosis of infective endocarditis A) antiphase I IgG antibody titer for Coxiella brunetti > 1:800 B) new partial dehiscence of prosthetic valve C) single positive blood culture for coagulase negative staphylococci D) rheumatoid factorQ82. All of the following statements about mitral valve prolapse are true except A) it is more common in females B) most patients are symptomatic C) it has a benign clinical course D) transient cerebral ischemia is a known complicationQ83. Regarding digoxinAssertion: it controls ventricular response in CHF patients with atrial fibrillationReason: it has vagolytic action. A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is true 22 of 25
  • 23. Q84. The following pedigree is an example of what pattern of inheritance A) X-linked dominant B) X-linked recessive C) autosomal recessive D) autosomal dominantQ85. In which of the following category of patients with CHD does coronary bypasssurgery result in improved survival A) mild ischemia, two vessel disease, ejection fraction more than 50% B) mild ischemia,two vessel disease(LCX and RCA),ejection fraction < 50% C) mild ischemia, triple vessel involvement, ejection fraction less than 50% D) moderate ischemia, two vessel disease, ejection fraction more than 50%Q86. Which among the following is short RP tachycardia A) atypical AVNRT B) AVRT with slowly conducting pathway C) orthodromic AVRT D) sinus node re-entry 23 of 25
  • 24. Q87. Patient of HOCM underwent dual chamber pacemaker implantation, following arepressure traces at different AV(atrio-ventricular)intervalsAssertion: AV delay of 240msec is ideal in this patientReason: optimal AV delay involves minimal LVOT gradient, normal stroke volume withno significant rise in LA pressure A) Both Assertion and Reason are true, and Reason is the correct explanation forAssertion B) Both Assertion and Reason are true, and Reason is not the correct explanationfor Assertion C) Assertion is true, but Reason is false D) Assertion is false, but Reason is trueQ88. Multi drug resistant salmonella typhi infection is resistant to the following drugs A) quinolones and chloramphenicol B) chloramphenicol, ampicillin and trimethoprim C) ciprofloxacin, ampicillin and ceftriaxone D) nalidixic acid and chloramphenicol 24 of 25
  • 25. Q89. Augmented limb lead aVL has its negative terminal in A) wilson central terminal. B) combined output of right arm and left foot electrodes. C) left arm. D) combined output of right arm, left arm and left foot electrodes.Q90. Higher risk of sudden cardiac death is predicted by which one of the followingfeatures on exercise testing A) lower resting heart rate. B) large increments in heart rate during exercise. C) lower increment in heart rate during first minute of recovery D) lower decrement in heart rate during first minute of recovery. 25 of 25