Assistant Professor in Cardiology Question Paper and Answer Key


Question Paper Code: 2/2021/OL

Category Code: 011/2020

Exam: Assistant Professor in Cardiology

Date of Test 04-03-2021

Department Medical Education Services

Question1:-Myocardial bridging most commonly involves
        Correct Answer:- Option-A

Question2:-TIMI risk score (NSTE-ACS) includes all the following except
        A:-Age 65 yr or more
        B:-Three or more CAD risk factors
        C:-Two or more angina episodes in prior 24 hrs
        D:-Betablocker use within 30 days
        Correct Answer:- Option-D

Question3:-Which of the following is implicated in the pathogenesis of Takotsubo cardiomyopathy ?
        Correct Answer:- Option-C

Question4:-Which of the following is most commonly associated with spontaneous coronary artery dissection ?
        A:-Fabry disease
        B:-Fibromuscular dysplasia
        C:-Hypertrophic cardiomyopathy
        Correct Answer:- Option-B

Question5:-Which one of the following echocardiographic finding is the strongest predictor of survival following STEMI ?
        A:-Global longitudinal strain
        B:-Left ventricular diastolic function
        C:-Left atrial strain
        D:-Left ventricular ejection fraction
        Correct Answer:- Option-D

Question6:-All are true regarding free wall rupture of the ventricle following myocardial infarction except Occurs more often in
        A:-Single vessel disease without collateral circulation
        B:-First myocardial infarction
        C:-Inferior wall myocardial infarction
        D:-Female sex
        Correct Answer:- Option-C

Question7:-All the following atherosclerotic plaque characteristics indicate increased vulnerability to rupture except
        A:-Increased macrophage infiltration
        B:-Thin fibrous cap
        C:-Increased number of smooth muscle cells
        D:-Large necrotic core
        Correct Answer:- Option-C

Question8:-Angiotensin II receptors of AT1 subtype is responsible for all the following actions except
        A:-Induce hypertrophy and  hyperplasia of vascular smooth muscle
        B:-Induce aldosterone secretion
        C:-Sympathetic activation
        D:-Promotes endothelium dependent vasodilation
        Correct Answer:- Option-D

Question9:-Ticagrelor affects which one of the following ?
        B:-Platelet binding to fibrinogen
        C:-Synthesis of thromboxane A 2
        D:-ADP induced platelet aggregation
        Correct Answer:- Option-D

Question10:-The most common benign pediatric cardiac tumour is
        Correct Answer:- Option-B

Question11:-Most common site of fibroma affecting the heart is
        A:-Inter atrial septum
        B:-Right atrium
        C:-Ventricle and interventricular septum
        D:-Tricuspid valve
        Correct Answer:- Option-C

Question12:-Which of the following physical finding may be seen in patients with left ventricular failure ?
        B:-Corrigan pulse
        Correct Answer:- Option-A

Question13:-Right heart enlargement is usually not a feature of
        A:-Secondum ASD
        B:-Partial anomalous pulmonary venous return
        C:-Sinus venosus ASD
        D:-Patent foramen ovale
        Correct Answer:- Option-D

Question14:-Which of the following statements about Partial Anomalous Pulmonary Venous Return (PAPVR) is/are correct ?
 (i) Sinus venosus ASD is often associated with anomalous pulmonary veins
(ii) PAPVR can lead to right heart enlargement and always results in pulmonary hypertension
(iii) Upto 10% of secondum ASD may be associated with PAPVR
(iv) Saline contrast echocardiography can easily identify PAPVR
        A:-Only (i) is correct
        B:-Only (i), (ii) are correct
        C:-Only (i), (iii) are correct
        D:-All are correct
        Correct Answer:- Option-C

Question15:-A ventricular septal defect is usually not associated with which of the following congenital heart diseases?
        A:-Truncus arteriosus
        B:-Complete AVSD
        C:-Tetralogy of Fallot
        D:-Partial AVSD
        Correct Answer:- Option-D

Question16:-Square root sign in left ventricular pressure tracing is seen in
(i) Constrictive pericarditis
(ii) Restrictive cardiomyopathy
(iii) Cardiac tamponade
(iv) Left ventricular failure
        A:-(i) and (ii) are correct
        B:-(i) and (iii) are correct
        C:-Only (i) is correct
        D:-All are correct
        Correct Answer:- Option-A

Question17:-Most specific finding of constrictive pericarditis is
        A:-Square root sign
        B:-Exaggerated ventricular interdependence
        C:-IVC plethora
        D:-Diastolic dysfunction
        Correct Answer:- Option-B

Question18:-Echocardiographic findings suggestive of pericardial tamponade include all the following except
        A:-Late diastolic collapse of right atrium
        B:-Mitral valve respiratory flow variation of 30%
        C:-Tricuspid valve flow variation of 60%
        D:-Reduced lateral mitral annular velocity
        Correct Answer:- Option-D

Question19:-Annulus reversus is seen in which of the following condition?
        A:-Cardiac tamponade
        B:-Constrictive pericarditis
        C:-Restrictive cardiomyopathy
        D:-Pericardial effusion
        Correct Answer:- Option-B

Question20:-Which is the most important predictor of hemodynamic consequences of a pericardial effusion ?
        A:-Pericardial thickness
        B:-Volume of pericardial fluid
        C:-Rate of accumulation
        D:-Patients age
        Correct Answer:- Option-C

Question21:-McConnell's sign is an echocardiographic manifestation of which of the following condition ?
        A:-Cardiac tamponade
        B:-Constrictive pericarditis
        C:-Acute pulmonary embolism
        D:-Restrictive cardiomyopathy
        Correct Answer:- Option-C

Question22:-Bidirectional ventricular tachycardia is a manifestation of which of the following conditions ?
        A:-Brugada syndrome
        B:-Short QT syndrome
        C:-Long QT syndrome
        Correct Answer:- Option-D

Question23:-Which of the following is not a feature of metabolic syndrome ?
        A:-High HDL
        B:-Glucose intolerance
        D:-Predominance of small dense LDL
        Correct Answer:- Option-A

Question24:-In right atrial pressure tracing, X descent occurs during
        A:-Atrial diastole
        B:-Atrial systole
        C:-Ventricular diastole
        D:-Tricuspid valve opening
        Correct Answer:- Option-A

Question25:-All are true about short QT syndrome except
        A:-QTc of 330 milliseconds or less
        B:-QT may not change with heart rate
        C:-Prone to development of atrial fibrillation
        D:-Hypocalcemia may mimic short QT syndrome
        Correct Answer:- Option-D

Question26:-Cardiac events occurring during sleep or rest are associated with which of the following ?
        A:-LQT 1
        B:-LQT 2
        C:-LQT 3
        D:-LQT 8
        Correct Answer:- Option-C

Question27:-Diverticula of the coronary sinus is associated with
        A:-Myocardial infarction
        B:-Pre-excitation syndromes
        C:-Coronary artery aneurysm
        D:-Heart failure
        Correct Answer:- Option-B

Question28:-Which of the following FFR values are considered hemodynamically significant ?
        A:-Less than 0.80
        B:-Less than 0.90
        C:-Less than 0.89
        D:-Less than 0.86
        Correct Answer:- Option-A

Question29:-An anomalous left circumflex coronary artery from the right cusp is usually
        B:-Associated with sudden cardiac death
        C:-Accelerated atherosclerosis
        D:-Needs surgical revascularisation
        Correct Answer:- Option-A

Question30:-In patients with acquired long QT syndrome and torsades de pointes which of the following is least likely to prevent recurrence?
        A:-Magnesium supplementation
        B:-Temporary rapid pacing
        D:-Intravenous Amidarone
        Correct Answer:- Option-D

Question31:-In HOCM post extrasystolic beat produces which of the following ?
        A:-Increase in aortic pressure
        B:-Fall in LV systolic pressure
        C:-Fall in aortic pressure
        D:-Increase in stroke volume
        Correct Answer:- Option-C

Question32:-Kussmaul sign is associated with
(i) constrictive pericarditis
(ii) Restrictive cardiomyopathy
(iii) Right ventricular infarction
(iv) Pulmonary embolism
        A:-Only (i)
        B:-(i) and (iii)
        C:-Only (ii)
        D:-All of the above
        Correct Answer:- Option-D

Question33:-The most common site of drainage of congenital coronary artery fistula is to
        A:-Right atrium
        B:-Right ventricle
        C:-Pulmonary artery
        D:-Coronary sinus
        Correct Answer:- Option-B

Question34:-In which of the following conditions the heart is most likely to be structurally normal ?
        A:-Situs solitus with dextrocardia
        B:-Situs inversus with levocardia
        C:-Situs inversus with dextrocardia
        D:-Right isomerism
        Correct Answer:- Option-C

Question35:-Which of the following additional abnormality is most commonly associated with Ebstein anomaly ?
        B:-Biuspid aortic valve
        C:-PFO or ASD
        D:-Pulmonic stenosis
        Correct Answer:- Option-C

Question36:-Which of the following cardiac procedures can lead to protein-losing enteropathy ?
        A:-ASD repair
        B:-VSD repair
        C:-TOF correction
        D:-Fontan procedure
        Correct Answer:- Option-D

Question37:-Congenital aneurysm of the sinus of valsalva arising in the non coronary sinus most often rupture into which chamber ?
        A:-Right ventricle
        B:-Right atrium
        C:-Left atrium
        D:-Left ventricle
        Correct Answer:- Option-B

Question38:-Intensity of the click decreases with inspiration in which of the following conditions ?
        A:-Bicuspid aortic valve
        B:-Pulmonic valve stenosis
        C:-Mitral valve prolapse
        D:-Pulmonary arterial hypertension
        Correct Answer:- Option-B

Question39:-Which of the following is a reversible inhibitor of P2Y12 receptor ?
        Correct Answer:- Option-A

Question40:-All the following statements are true about Arrhythmogenic right ventricular cardiomyopathy except
        A:-Epsilon wave is a very sensitive finding
        B:-Monomorphic ventricular tachycardia, LBBB morphology, superior axis
        C:-T inversion extending to V3 or beyond
        D:-Fibrofatty replacement of the myocardium
        Correct Answer:- Option-A

Question41:-Which of the following conditions is most commonly associated with development of complete heart block ?
        A:-Atrialseptal defect
        B:-Supravalvar aortic stenosis
        C:-Tetralogy of fallot
        D:-Physiologically corrected TGA
        Correct Answer:- Option-D

Question42:-Which of the following condition is the most common cause of sudden death in young         athletes ?
        B:-Hypertrophic cardiomyopathy
        C:-Congenital long QT syndrome
        D:-Supra valvar aortic stenosis
        Correct Answer:- Option-B

Question43:-Which of the following structure is seen in the parasternal long axis view of the echocardiogram ?
        A:-Pulmonary veins
        B:-LA appendage
        C:-Right atrium
        D:-Descending thoracic aorta
        Correct Answer:- Option-D

Question44:-Surasternal "Crab view" is good to visualise which of the following ?
        A:-Left ventricular apex
        C:-Coarctation of aorta
        D:-Pulmonary veins
        Correct Answer:- Option-D

Question45:-Which is correct regarding Tissue Doppler Imaging signals ?
        A:-TDI-low amplitude
        B:-TDI-high velocity
        C:-TDI-low frequency
        D:-TDI-need high gain settings
        Correct Answer:- Option-C

Question46:-Which is the most common site of occurrence of Papillary fibroelastoma ?
        A:-Mitral valve
        B:-Aortic valve
        C:-Pulmonary valve
        D:-Tricuspid valve
        Correct Answer:- Option-B

Question47:-Which of the following finding is the most specific for the diagnosis of pericardial tamponade ?
        A:-Right atrial diastolic collapse
        B:-Inferior venacava plethora
        C:-Right ventricular diastolic collapse
        D:-Size of pericardial effusion
        Correct Answer:- Option-C

Question48:-Which of the following findings is not usually seen in acute mitral regurgitation ?
        A:-LVEF of 70%
        B:-Left sided S 4
        C:-Decrscendo murmur
        D:-LA enlargement
        Correct Answer:- Option-D

Question49:-Which statement is true regarding involvement of papillary muscle in coronary artery disease ?
        A:-Posteromedial papillary muscle is more frequently involved
        B:-Anterolateral papillary muscle is more frequently involved
        C:-Both are equally involved
        D:-Posteromedial papillary muscle has dual blood supply
        Correct Answer:- Option-A

Question50:-Right coronary artery dominance is seen in approximately
        Correct Answer:- Option-A

Question51:-Angiosarcoma involving the heart is predominantly found on the
        A:-Right side of the heart
        B:-Left side of the heart
        D:-Coronary arteries
        Correct Answer:- Option-A

Question52:-Which of the following is the most common cause of cardiac metastasis ?
        A:-Renal cell carcinoma
        B:-Lung cancer
        C:-Hematologic malignancies
        D:-Breast cancer
        Correct Answer:- Option-B

Question53:-In ARVC which of the following protein most likely has a defect in its gene coding ?
        A:-Laminin A and C
        C:-Myosin heavy chain
        Correct Answer:- Option-B

Question54:-Which of the following is likely to increase the risk of anthracycline induced cardiomyopathy ?
        A:-Family history of heart failure
        B:-Selinium deficiency
        D:-Prior mediastinal radiation
        Correct Answer:- Option-D

Question55:-Which of the following is not an ECG manifestation of Hyperkalemia ?
        A:-Tall peaked T waves
        B:-QT prolongation
        C:-Sine wave pattern
        D:-QRS prolongation
        Correct Answer:- Option-B

Question56:-Which of the following is not true regarding white coat hypertension ?
        A:-Elevated office readings but normal BP outside office
        B:-ABPM or HBPM may be used to screen white coat hypertension
        C:-Prevalence of white coat hypertension is 13% to 35%
        D:-No effect on cardiovascular risk or all cause mortality
        Correct Answer:- Option-D

Question57:-AIVR can be usually managed by
        A:-Transvenous pacing
        C:-Continuous ECG monitoring
        Correct Answer:- Option-C

Question58:-Which statement is/are true regarding lone AF ?
        A:-AF in patients younger than 60 yrs.
        B:-Do not have hypertension or any evidence of structural heart disease
        C:-Lower risk of thromboembolic complications
        D:-All of the above
        Correct Answer:- Option-D

Question59:-In mitral valve prolapse which is true ?
        A:-With standing click and murmur move close to S1
        B:-With squatting click and murmur move close to S1
        C:-Click disappears on standing
        D:-No change with squatting
        Correct Answer:- Option-A

Question60:-All of the following are true in cholesterol embolism except
        A:-Painful cyanotic toes
        B:-Livedo reticularis
        C:-Digital and foot ulcerations
        D:-Absent pedal pulses
        Correct Answer:- Option-D

Question61:-Following statements about oxygen saturation in a normal person are correct except
        A:-Oxygen saturation in IVC is greater than SVC
        B:-Coronary sinus has one of the lowest oxygen saturation
        C:-Flamm formula is based on IVC and SVC oxygen saturation
        D:-When cardiac output decreases venous oxygen saturation increases
        Correct Answer:- Option-D

Question62:-Well trained athletes may have
(i) First degree heart block
(ii) Mobitz 1 second degree AV block
(iii) Third degree AV block during sleep
(iv) Positive tilt table test
        A:-(i) and (ii) are correct
        B:-Only (i) is correct
        C:-(i), (ii), (iii) are correct
        D:-All are correct
        Correct Answer:- Option-D

Question63:-In which of the following men are more likely to be affected ?
        B:-Bicuspid aortic valve
        C:-Mitral stenosis
        D:-Pulmonary arterial hypertension
        Correct Answer:- Option-B

Question64:-Which of the following is among the most important determinants of mortality after aortic valve replacement ?
        A:-Presence of Bicuspid aortic valve
        B:-Rheumatic aortic valve regurgitation
        C:-Depressed LVEF
        D:-LV end systolic dimension of 40 mm
        Correct Answer:- Option-C

Question65:-Which among the following are identified as infectious agents in myocarditis ?
(i) Adeno viruses
(ii) Entero viruses
(iii) Parvo viruses
(iv) Influenza virus
        A:-(i) only
        B:-(i) and (iv) only
        C:-(i), (ii) and (iii) only
        D:-All of the above
        Correct Answer:- Option-D

Question66:-Cardiac hydatid cysts are most commonly located in
        A:-Interventricular septum or LV free wall
        C:-Right atrium
        D:-Coronary artery
        Correct Answer:- Option-A

Question67:-Which of the following is the most common ethanol induced arrhythmia ?
        A:-Ventricular Tachycardia
        B:-Atrial fibrillation
        C:-Ventricular fibrillation
        D:-Atrial flutter
        Correct Answer:- Option-B

Question68:-Which is correct about dobutamine in low doses ?
        A:-Increase in cardiac output and increase in systemic vascular resistance
        B:-Increase in heart rate and increase in systemic vascular resistance
        C:-Increase in heart rate and increase in pulmonary capillary wedge pressure
        D:-Increase in cardiac output and decrease in systemic vascular resistance
        Correct Answer:- Option-D

Question69:-Which of the following is the most important risk factor for in hospital mortality among patients with acutely decompensated heart failure ?
        A:-Elevated pulmonary systolic pressure
        B:-Serum sodium level
        C:-Elevated serumcreatinine and  blood urea
        D:-Normal systolic BP
        Correct Answer:- Option-C

Question70:-Which of the following is/are better to optimize stent expansion following stenting ?
        C:-Either IVUS or OCT
        Correct Answer:- Option-C

Question71:-Which of the following is useful to reduce radiation exposure in cardiac catheterization laboratory ?
        A:-Reduce steep angulations
        B:-Increase magnification
        C:-Increase frame rate
        D:-Radial access
        Correct Answer:- Option-A

Question72:-Which is preferred method of imaging for left heart structural interventions ?
        A:-Transthoracic echocardiography
        B:-Transesophageal echocardiography
        C:-Intracardiac echocardiography
        D:-Transthoracic contrast echocardiography
        Correct Answer:- Option-B

Question73:-Which of the following imaging modality can see 'behind' calcific plaques ?
        D:-Both IVUS and OCT
        Correct Answer:- Option-B

Question74:-Idarucizumab is used as a reversal agent for which of the following ?
        Correct Answer:- Option-D

Question75:-Which of the following is not correct regarding biological effects of X-ray exposure ?
        A:-Stochastic events have no minimal threshold
        B:-Deterministic effects have no minimal threshold
        C:-Gonads demonstrate the most sensitivity
        D:-Increased use of medical imaging has increased radiation exposure
        Correct Answer:- Option-B

Question76:-Which of the following not correct regarding coronary artery dissection occurring during coronary angioplasty ?
        A:-Coronary angiography can easily distinguish true and false lumen
        B:-Forceful injection of contrast should be avoided to prevent hydraulic dissection
        C:-IVUS is useful in identifying true and false lumen
        D:-True lumen is characterised by presence of media and adventia in all walls of the lumen
        Correct Answer:- Option-A

Question77:-Which of the following medications should be avoided in patients receiving sildenafil ?
        Correct Answer:- Option-D

Question78:-Which of the following medication is best suited for a 65 year old male with anterior wall STEMI with BP of 80/40, heart rate 100 bpm who is planned for percutaneous coronary intervention ?
        Correct Answer:- Option-A

Question79:-The following are true regarding acute coronary syndrome except
        A:-Plaque erosion seen in one third
        B:-Spontaneous coronary artery dissection in majority of patients
        C:-Lesion that precede acute plaque rupture is thin cap fibroatheroma
        D:-Thin cap fibroatheroma has a lipid rich necrotic core with overlying fibrous cap measuring less than 65 micrometers
        Correct Answer:- Option-B

Question80:-Which of the following is not true regarding diastolic heart sounds ?
        A:-Opening snap is a high pitched sound
        B:-Pericardial knock is a low pitched early diastolic sound
        C:-Left sided S3 is a low pitched sound
        D:-Tumor "Plop" rarely is heard with atrial myxoma
        Correct Answer:- Option-B

Question81:-Which of the following produce mid diastolic murmurs ?
(i) Mitral stenosis
(ii) Atrialmyxoma
(iii) Acute rheumatic valvulitis
(iv) Complete heart block
        A:-(i) only is correct
        B:-(i), (ii) are correct
        C:-(i), (ii), (iii) are correct
        D:-All are correct
        Correct Answer:- Option-D

Question82:-Which of the following is not correct ?
        A:-Intensity of murmur of HOCM increase with valsalvamaneuver
        B:-Murmur of HOCM becomes softer and shorter with squatting
        C:-The intensity of murmur of MR becomes louder in post premature beat
        D:-In MVP with squatting click and murmur move away from S1
        Correct Answer:- Option-C

Question83:-Which of the following is not associated with sudden cardiac death in hypertrophic cardiomyopathy ?
        A:-Wall thickness greater than 30 mm
        B:-Resting LVOT gradient greater than 30 mm Hg
        C:-Apical aneurysm
        D:-Sigmoid septum
        Correct Answer:- Option-D

Question84:-Regarding Athlete's heart all are true except
        A:-Absolute wall thickness greater than 15 mm are unusual even in elite athletes
        B:-A variable percentage of athletes have LVED more than 60 mm
        C:-Resting LVEF may be near the lower limit of normal range in trained athletes
        D:-Global longitudinal strain is below normal
        Correct Answer:- Option-D

Question85:-In adults the most common cardiac tumor affecting the cardiac valves is
        B:-Papillary fibroelastoma
        Correct Answer:- Option-B

Question86:-Echocardiographic description of a dumbbell-shaped mass in the inter atrial septum is classical of which of the following ?
        A:-Lipomatous hypertrophy of the inter atrial septum
        B:-Myxoma arising from interatrial septum
        D:-Hydatid cyst
        Correct Answer:- Option-A

Question87:-Intracardiac Echocardiography (ICE) is used to guide which of the following procedures ?
(i) Transseptal puncture
(ii) Percutaneous closure of ASD
(iii) Closure of PFO
(iv) Electrophysiological procedures
        A:-(i) only
        B:-(ii) and (iii) only
        C:-(i), (ii) and (iii) only
        D:-All of the above
        Correct Answer:- Option-D

Question88:-To match an FFR of 0.80 or less, the best iFRcutoff is
        Correct Answer:- Option-C

Question89:-Which of the following imaging modality has higher vessel wall penetration ?
        C:-Both have equal vessel wall penetration
        D:-IVUS is better to assess vascular endothelium
        Correct Answer:- Option-A

Question90:-Which of the following is better to understand coronary plaque lipid burden ?
        D:-OCT and IVUS are equal
        Correct Answer:- Option-C

Question91:-Which of the following imaging modality is better for discriminating between red and white thrombus ?
        D:-Coronary angiogram
        Correct Answer:- Option-B

Question92:-The following is/are the cause of elevated natriuretic peptide values
(i) Leftventricular systolic dysfunction
(ii) Leftventricular diastolic dysfunction
(iii) Constrictive pericarditis
(iv) Hyperdynamic states including sepsis
        A:-(i) is correct
        B:-(i) and (ii) are correct
        C:-(i), (ii), (iii) are correct
        D:-All are correct
        Correct Answer:- Option-D

Question93:-Which of the following is correct regarding Galectin 3 ?
        A:-Risk factor for coronary artery disease
        B:-Predicts adverse outcomes in heart failure
        C:-Risk factor for development of deep vein thrombosis
        D:-Predict risk for development of contrast induced nephropathy
        Correct Answer:- Option-B

Question94:-Which of the following statement is not correct regarding Levosimendan ?
        A:-Increase myocardial contractility
        B:-Peripheral vasoconstriction
        C:-PDE inhibitor activity
        D:-Increase cardiac output
        Correct Answer:- Option-B

Question95:-Which of the following is not correct regarding Omecamtiv mecarbil ?
        A:-Cardiac myosin activator
        B:-Increase cardiac output
        C:-Decrease systolic ejection time
        D:-Increased stroke volume
        Correct Answer:- Option-C

Question96:-Which of the following is the most common antecedent disease leading to HFpEF ?
        A:-Systolic hypertension
        B:-Ischemic heart disease
        C:-Diabetes mellitus
        D:-Chronic kidney disease
        Correct Answer:- Option-A

Question97:-Which of the following E/e' values on echo-Doppler indicate elevated PCWP ?
        A:-Greater than 15
        B:-Less than 8
        C:-Less than 5
        D:-Less than 6
        Correct Answer:- Option-A

Question98:-Which is the most significant adverse effect of ibutilide ?
        B:-QT prolongation related TdP
        C:-Coronary spasm
        D:-Atrial tachycardia
        Correct Answer:- Option-B

Question99:-Which of the following statement is true regarding adenosine and ventricular tachycardia ?
        A:-Adenosine has no effect on ventricular tachycardia
        B:-May terminate VT of RVOT origin
        C:-Terminate scar VT
        D:-Tachycardia termination with adenosine rules out ventricular  tachycardia
        Correct Answer:- Option-B

Question100:-A synchorised shock is used for all cardioversions except
        A:-Atrial flutter
        B:-Atrial fibrillation
        C:-Ventricular tachycardia
        D:-Ventricular fibrillation
        Correct Answer:- Option-D


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