Assistant Professor in Cardiology Question Paper and Answer Key

Question Paper Code: 44/2024/OL
Category Code: 384/2023
Exam: Assistant Professor in Cardiology
Date of Test 20-04-2024
Department Medical Education

Question1:-The following is true about mitral valve apparatus
        A:-MV leaflets are divided into segments as A1, A2, A3 and P1, P2, P3 based on the scallops in anterior mitral leaflet.
        B:-MV leaflets are divided into segments A1, A2, A3 and P1, P2, P3 based on the scallops of posterior mitral leaflet.
        C:-Carpentier type II MR refers to restricted mitral leaflet motion.
        D:-The chordal free zones of MV apparatus are the commissures of the mitral valve
        Correct Answer:- Option-B

Question2:-Regarding iFR the following statements are true EXCEPT
        A:-iFR over estimates the functional significance of stenosis versus FFR in circumstances in which the resting flow is elevated (e.g. anemia)
        B:-The critical cut off value for iFR is less than or equal to 0.90
        C:-The "wave free period" is defined as starting 25% into cardiac diastole and 5 ms before the end of diastole.
        D:-In randomized trials iFR was found to be non-inferior to FFR
        Correct Answer:- Option-B

Question3:-The mechanism of action of inclisiran is
        A:-Monoclonal antibodies that reduce the expression of PCSK-9 leading to increased LDL-C uptake.
        B:-siRNA targeting Lp(a).
        C:-targets ACLY (ATP-citrate lyase)
        D:-siRNA that penetrates hepatocytes and blocks the translation of PCSK9 mRNA targeting PCSK9.
        Correct Answer:- Option-D

Question4:-Most common congenital cardiovascular malformation in turner syndrome is
        A:-Bicuspid aortic valve
        C:-Coarctation of Aorta
        D:-Conotruncal anomalies
        Correct Answer:- Option-A

Question5:-In Kirklin and Barrat boyes classification of unroofed coronary sinus defects, Type III is
        A:-Completely unroofed Cs without Left SVC
        B:-Completely unroofed Cs with LSVC
        C:-Partially unroofed terminal portion of the CS
        D:-Partially Unroofed mid portion of the CS
        Correct Answer:- Option-D

Question6:-The following is not a stochastic injury in radiation exposure
        A:-Lens injury
        C:-Pregnancy complications
        D:-Inheritable diseases
        Correct Answer:- Option-A

Question7:-A 56 year old diabetic male with acute coronary syndrome without heart failure and blood pressure of 90/60 undergoing conventional invasive coronary angiography with iodinated contrast is having a CI - AKI (Contrast induced acute kidney injury) risk as follows
        A:-Low risk
        B:-High risk
        C:-Very high risk
        D:-Intermediate risk
        Correct Answer:- Option-D

Question8:-Flamm's formula is
        A:-4X SVC O2 + 1 X IVC o2/4
        B:-2X SVC o2 + 2 X IVC O2/4
        C:-3X SVC O2 + 1 X IVC O2/4
        D:-1X SVC o2 + 3 X IVC O2/4
        Correct Answer:- Option-C

Question9:-LV global longitudinal strain map showing predominantly a "bulls eye" pattern is suggestive of
        A:-Hypertrophic cardiomyopthy
        B:-Restrictive cardiomyopathy
        Correct Answer:- Option-D

Question10:-Regarding Permanent Junctional Reciprocating Tachycardia (PJRT) all are true EXCEPT
        A:-It is a Long RP tachycardia
        B:-Affects infants and children
        C:-Due to manifest accessory pathway with slow retrograde, decremental conduction
        D:-Medical therapy is most often ineffective
        Correct Answer:- Option-C

Question11:-The following is not consistent with severe AR
        A:-Jet width of AR ≥ 65% of LVOT
        B:-Venae contracta ≥ 0.6 cm
        C:-Regurgitant volume > 50 ml/beat
        D:-ERO ≥ 0.3cm2
        Correct Answer:- Option-C

Question12:-Prosthetic mitral valve stenosis is defined as the following
(i) Mean mitral valve gradient ≥ 5 mmHG
(ii) Peak mitral inflow velocity ≥ 1.9 m/sec
(iii) Effective orifice area ≤ 1.5 cm2
CHOOSE an appropriate option from below
        A:-Statement i is true
        B:-Statements i and ii are true
        C:-Statements i, ii & iii are true
        D:-Statements i and iii are true
        Correct Answer:- Option-B

Question13:-Prosthesis Patient Mismatch in aortic position is defined as Indexed EOA
        A:-<0.85 cm2/m2        
        B:-<0.90 cm2/m2
        C:-<0.65 cm2/m2
        D:-<1.2 cm2/m2
        Correct Answer:- Option-A

Question14:-The famous statement that "Pathologists have long known that rheumatic fever (RF) licks at the joints but bites at the heart," was said by
        A:-Duckett jones
        B:-Gene H Stollerman
        C:-Carey F Coombs
        D:-Ernst-Charles Lasegue
        Correct Answer:- Option-D

Question15:-The following were the salient features of the OCTOBER trial except
        A:-OCT was compared with IVUS in complex bifurcation PCI
        B:-Oct guided PCI was superior to the comparative arm
        C:-True complex bifurcation lesions were recruited in the study
        D:-There were significant number of patients with LMCA bifurcation in both arms
        Correct Answer:- Option-A

Question16:-A 18 years lady was referred for cardiological evaluation for frequent symptoms of light headedness, palpitations, tremulousness, blurred vision, fatigue. On examination her pulses were 84/minute and BP of 110/80 in supine position and on standing upright her pulses were 128 beats/minute and BP 94/70 mm Hg Cardiovascular auscultation revealed normal heart sounds without any significant murmur and normal cardiac size. Most likely diagnosis is
        A:-POTS (Postural Orthostatic Tachycardia syndrome)
        B:-Pure Autonomic failure (Bradburry Eggleston syndrome)
        C:-Shy Dragger syndrome
        D:-Parkinsons disease
        Correct Answer:- Option-A

Question17:-Taussing Bing anomaly is
        A:-DORV with subaortic VSD and no pulmonary stenosis
        B:-DORV with subaortic VSD and Pulmonary stenosis
        C:-DORV with subpulmonary VSD bilateral conus and side by side semilunar valves
        D:-DORV with Mitral atresia, severely unbalanced AV canal defect.
        Correct Answer:- Option-C

Question18:-"ANNULUS REVERSUS" in tissue Doppler imaging of the mitral valve is seen in
        A:-Constrictive pericarditis
        B:-Hypovolemic shock
        C:-Endomyocardial fibrosis
        Correct Answer:- Option-A

Question19:-In Cavo-tricuspid isthmus dependent Atrial flutter the commonest form of circuit is
        A:-Counter clockwise loop
        B:-Perimitral loop
        C:-Clockwise loop
        D:-Loop around a scar tissue in the right atrium
        Correct Answer:- Option-A

Question20:-The acceptable cold ishemic time for donor heart in cardiac transplantation is
        A:-<24 hours
        B:-<18 hours
        C:-<12 hours
        D:-<5 hours
        Correct Answer:- Option-D

Question21:-Type A Aortic intramural Hematoma is best managed by
        A:-Conservative Management
        B:-Intensive Medical Therapy
        D:-Surgical Management
        Correct Answer:- Option-D

Question22:-Major exclusion criteria for TEER for mitral regurgitation in COAPT and EVEREST II trials EXCEPT
        A:-MV orifice area < 4.0 cm²
        B:-Mal coaptation of the A2 and P2 scallops of the mitral valve (MV)
        C:-Width of the flail segment ≥ 15 mm or flail gap ≥ 10 mm
        D:-Coaptation depth > 11 mm or vertical coaptation length is < 2mm
        Correct Answer:- Option-B

Question23:-In pre excited atrial fibrillation, the following statements are true EXCEPT
        A:-In hemodynamic instability DC cardioversion should be done
        B:-In hemodynamically stable patients - lbutilide, Procainamide or Class IC agents (flecaindie / propafenone) may be used
        C:-Class III agent Amiodarone can be used to restore Sinus rhythm
        D:-AV nodal blocking drugs should be avoided
        Correct Answer:- Option-C

Question24:-A possible benefit of Re-vasculrisation of non-culprit vessels at the time of primary PCI for STEMI was shown in the following trials EXCEPT
        Correct Answer:- Option-D

Question25:-The new drug approved by US FDA for use in HCM with obstruction is
        Correct Answer:- Option-A

Question26:-The characteristics of pre capillary pulmonary hypertension is
        A:-Mean Pulmonary arterial pressure > 20 mHg, Pulmonary artery wedge pressure > 15 mm HG, Pulmonary vascular resistance ≥ 3 WU.
        B:-Mean Pulmonary arterial pressure > 20 mHg, Pulmonary artery wedge pressure ≤ 15 mm HG, Pulmonary vascular resistance ≥ 3 WU.
        C:-Mean Pulmonary arterial pressure > 20 mHg, Pulmonary artery wedge pressure > 15 mm HG, Pulmonary vascular resistance < 3 WU
        D:-Mean Pulmonary arterial pressure > 20 mHg, Pulmonary artery wedge pressure ≤ 12 mm HG, Pulmonary vascular resistance ≥ 3 WU
        Correct Answer:- Option-B

Question27:-In a right heart catheterization study in a patient with pulmonary hypertension. Pulmonary artery pressure is 50/25 mm Hg with a mean of 32 mmHg
and PA wedge pressure was 25mmHg. Which of the following statement is true
i     The (TPG) Transpulmonary gradient is 7 mmHg
ii    The DPG Diastolic pulmonary gradient is zero
iii   The patient has passive pulmonary hypertension (PH)
iv   The patient has obstructive pulmonary hypertension (PH)
Choose the appropriate option
        A:-statements i, ii and iv
        B:-statements i, ii and iii
        C:-statements i and iii
        D:-statements ii and iv
        Correct Answer:- Option-B

Question28:-The treatment of choic for Chronic thromboembolic pulmonary hypertension (CTEPH) is
        A:-Pulmonary endarterectomy (PEA)
        B:-Intensive medical treatement with oral anticoagulants, diuretics and therapy, Bosentan and Riociguat
        C:-Interventional treatment - Balloon dilatation of the Pulmonary artery stenosis
        D:-All of the above
        Correct Answer:- Option-A

Question29:-The standard of care for Pulmonary vasoreactivity testing is
        A:-IV Adenosine
        B:-IV Epoprostenol
        C:-Inhaled nitric oxide at 10-20 parts per million
        D:-Inhaled iloprost
        Correct Answer:- Option-C

Question30:-Phasic ejection click is a manifestation of
        A:-Mitral valve prolapse
        B:-Tricuspid valve prolapse
        C:-Bicuspid aortic valve disease
        D:-Pulmonary valve stenosis
        Correct Answer:- Option-D

Question31:-The phenomenon of increase in the force of ventricular muscle contraction with increase in heart rate is
        A:-Starlings phenomenon
        B:-Anrep effect
        C:-Holding effect
        D:-Treppe phenomenon
        Correct Answer:- Option-D

Question32:-In normal individuals, atrial systole contributes to how much of left ventricular filling?
        Correct Answer:- Option-B

Question33:-The drug Omecamtiv mecabril is a
        A:-Cardiac myosin activator
        Correct Answer:- Option-A

Question34:-The rapid onset of action of intravenous frusemide given for acute decompensated heart failure is due to ______ action.
        A:-Diuretic activity
        C:-Arteriolar dilatation
        D:-Inotropic effect
        Correct Answer:- Option-B

Question35:-In heart failure with reduced left ventricular ejection fraction, the ejection fraction is usually less than
        Correct Answer:- Option-D

Question36:-Common causes of resistant hypertension include all of the following except
        B:-chronic kidney disease
        C:-Drug induced hypertension
        D:-Non-adherence to low-sodium diet
        Correct Answer:- Option-C

Question37:-Hypertension associated with episodes of flash pulmonary edema is seen in
        A:-Renal artery stenosis
        B:-Coarctation of aorta
        C:-Cushings syndrome
        D:-Drug induced hypertension
        Correct Answer:- Option-A

Question38:-Which of the following drugs is known to cause systemic hypertension
        B:-Sodium valproate
        D:-Recombinant Human Erythropoitin
        Correct Answer:- Option-D

Question39:-Spironolactone is used in the management of systemic hypertension in the following situation
        A:-Drug induced hypertension
        B:-Resistant hypertension
        C:-Hypertension of renal artery stenosis
        D:-Hypertension in the elderly
        Correct Answer:- Option-B

Question40:-Rebound hypertension after drug withdrawal is common with
        Correct Answer:- Option-A

Question41:-Tachycardia which exhibits warm up and cool down phenomenon (irregularity at the beginning and towards the end of the arrhythmia) is a feature of
        A:-Fascicular ventricular tachycardia
        B:-Focal atrial tachycardia
        C:-Atrial flutter
        D:-Atypical AVNRT
        Correct Answer:- Option-B

Question42:-Cavo-tricuspid dependant arrythmia is
        A:-Classical atrial flutter
        B:-Slow-slow AVNRT
        C:-Multifocal atrial tachycardia
        D:-Focal atrial tachycardia
        Correct Answer:- Option-A

Question43:-Ventricular tachycardia that responds best to verapamil is
        A:-Right ventricular outflow tract ventricular tachycardia
        B:-Mitral annular ventricular tachycardia
        C:-Scar ventricular tachycardia
        D:-Left fascicular re-entrant tachycardia
        Correct Answer:- Option-D

Question44:-Bidirectional ventricular tachycardia is a feature of
        A:-Digoxin toxicity
        B:-Long QT syndrome
        C:-Brugada syndrome
        D:-Scar ventricular tachycardia
        Correct Answer:- Option-A

Question45:-Drug of choice to prevent ventricular tachycardia in long QT syndrome
        Correct Answer:- Option-C

Question46:-All are echocardiographic features of Cardiac Amyloidosis except
        A:-Pericardial thickening
        B:-Biventricular hypertrophy
        C:-Thickening of interatrial septum
        D:-Reduced longitudinal strain, with sparing of apical areas.
        Correct Answer:- Option-A

Question47:-Radionuclide used specifically for diagnosis of Amyloidosis
        A:-Technetium 99 Sestamibi
        B:-Thallium 2013.
        C:-Technetium 99m Pyrophosphate
        D:-Technetium 99m Tetrafosmin
        Correct Answer:- Option-C

Question48:-Epsilon waves in the electrocardiogram is seen in
        A:-Hypertrophic cardiomyopathy
        B:-Long QT syndrome
        C:-Cardiac amyloidosis
        D:-Arrhythmogenic right ventricular dysplasia
        Correct Answer:- Option-D

Question49:-The classical pattern of ventricular tachycardia in Arrhythmogenic right ventricular dysplasia is
        A:-LBBB with superior axis
        B:-LBBB with inferior axis
        C:-RBBBB with superior axis
        D:-RBBB with inferior axis
        Correct Answer:- Option-A

Question50:-A common cause of tachycardia inducing tachycardiomyopathy in children is
        A:-Atrial flutter
        B:-Atrial fibrillation
        C:-Atrial ectopics
        D:-Permanent reciprocating junctional tachycardia
        Correct Answer:- Option-D

Question51:-Becks triad suggests the following diagnosis
        A:-Contrictive pericarditis
        B:-Cardiac tamponade
        C:-Sub aortic stenosis
        D:-Alcoholic cardiomyopathy
        Correct Answer:- Option-B

Question52:-Which is not a feature of cardiac tamponade?
        A:-Pulsus paradoxus
        B:-Prominent y descend in jugular venous pulse
        C:-Muffled heart sounds
        D:-Prominent x descend in jugular venous pulse
        Correct Answer:- Option-B

Question53:-Which is not a feature in the jugular venous pulse of constrictive pericarditis?
        A:-Elevated jugular venous pressure
        B:-Kussmaul sign positive
        C:-Prominent x descend
        D:-Prominent y descend
        Correct Answer:- Option-C

Question54:-"Annulus reversus" is an echocardiographic feature of
        A:-Constrictive pericarditis
        B:-Mitral annular calcification
        C:-Mitral stenosis
        D:-Hypertrophic cardiomyopathy
        Correct Answer:- Option-A

Question55:-Cholesterol rich pericardial fluid is a feature of pericardial effusion due to
        B:-Lipoma of pericardium
        C:-Hereditary hypercholesterolemia
        Correct Answer:- Option-D

Question56:-Prostate surgery is considered to a ________________ risk surgery with regard to perioperative risk
        D:-Extremely high
        Correct Answer:- Option-B

Question57:-Breast surgery is considered to a _________ risk surgery with regard to perioperative risk
        D:-Extremely high
        Correct Answer:- Option-A

Question58:-Cardio Vascular Risk Index (CVRI) is used to
        A:-Assess heart transplant recipient
        B:-Assess requirement for left ventricular assist device during percutaneous coronary intervention
        C:-Pre-operative risk assessment for non-cardiac surgery
        D:-Choose between coronary bypass surgery and multivessel angioplastry.
        Correct Answer:- Option-C

Question59:-Climbing one flight of stairs utilizes ______________ METS
        Correct Answer:- Option-B

Question60:-Most important side effect of intravenous propafenone
        A:-Precipitation of seizures
        B:-Precipitation of wheezing
        Correct Answer:- Option-D

Question61:-Among the following, which type of bacteria is commonly associated with native valve infective endocarditis
        A:-Gram positive Cocci
        B:-Gram positive Bacilli
        C:-Gram negative Cocci
        D:-Gram negative Bacilli
        Correct Answer:- Option-A

Question62:-Fungal endocarditis with Candida Spp. is common in the following subsets of patients except
        A:-Indwelling right heart catheter
        B:-Prosthetic heart valve
        C:-IV drug users
        D:-Native mitral valve
        Correct Answer:- Option-D

Question63:-Which of the following statements about infective endocarditis is FALSE
        A:-Stenotic valve lesions are predominantly involved
        B:-Native valves accounts for 2/3rd of infective endocarditis
        C:-Pulmonary valve is the least affected in IE
        D:-Tricuspid valve endocarditis is common in intravenous drug users.
        Correct Answer:- Option-A

Question64:-Fever is NOT a prominent symptom in infective endocarditis in the following clinical situations except
        B:-CIED (Cardiovascular Implantable Electronic Device) infection
        D:-Receiving a course of empirical antibiotics
        Correct Answer:- Option-C

Question65:-Structurally normal heart valves may be affected by infective endocarditis in some patients. The predisposing conditions DOES NOT include
        A:-Advanced age
        B:-Renal failure on dialysis
        C:-Infections by Staph. Aureus.
        D:-Associated Secundum atrial septal defect.
        Correct Answer:- Option-D

Question66:-A patient being treated for infective endocarditis presents with pleuritic chest pain and chest Xray shows a wedge shaped shadow. The most likely affected valve will be
        A:-Mitral valve
        B:-Aortic valve
        C:-Tricuspid valve
        D:-Post Mitral valve replacement with mechanical heart valve
        Correct Answer:- Option-C

Question67:-The most common congenital heart disease associated with infective endocarditis is
        A:-Unrepaired ventricular septal defects
        B:-Unrepaired secundum atrial septal defects
        C:-Unrepaired Sinus venosus ASDs
        D:-Repaired secundum ASD with no residual shunt
        Correct Answer:- Option-A

Question68:-Regarding prosthetic heart valve and pregnancy - What is NOT true.
        A:-Warfarin usage increases the risk of miscarriage
        B:-Warfarin < 5 mg / day in first trimester is relatively safe
        C:-Patient has to be started and to be continued on heparin throughout pregnancy.
        D:-The risk to fetus is maximum between 6-12 weeks of pregnancy
        Correct Answer:- Option-C

Question69:-A patient after mechanical heart valve replacement was advised an INR target of 1.5 - 2 plus Aspirin. The most likely prosthetic valve implanted is
        A:-TTK Chitra heart valve prosthesis in the aortic position
        B:-TTK Chitra heart valve prosthesis in the mitral position
        C:-on-X valve at aortic position
        D:-St Jude valve at the aortic position.
        Correct Answer:- Option-C

Question70:-The incidence of atrioventricular block necessitating permanent pacemaker implantation with balloon expandable valves in transcutaneous aortic valve replacement (TAVR) is nearly
        Correct Answer:- Option-A

Question71:-Cardioembolic stroke accounts for ______ % of ischemic stroke
        Correct Answer:- Option-C

Question72:-The scoring system used to assess patients with patent foramen ovale (PFO) and benefit from treatment is
        A:-RoPE score
        B:-CHADS2 Score
        D:-HAS-BLED Score
        Correct Answer:- Option-A

Question73:-A patient with severe mitral stenosis in sinus rhythm need to be given oral anticoagulation in which of the following situations
        A:-MS with tricuspid regurgitation.
        B:-MS in sinus rhythm with history of minor stroke.
        C:-MS with pulmonary hypertension.
        D:-MS with mitral regurgitation.
        Correct Answer:- Option-B

Question74:-Atrial fibrillation occurring for the first time and persisting continuously for more than 7 days is termed as
        A:-Paroxysmal AF
        B:-Persistent AF
        C:-Long standing AF
        D:-Permanent AF
        Correct Answer:- Option-B

Question75:-Regarding management of atrial flutter - all are true except
        A:-Anticoagulation is not required in atrial flutter as in atrial fibrillation.
        B:-Rate control strategy using betablockers may be tried.
        C:-Rate control strategy using verapamil / diltiazem may be tried.
        D:-Intravenous ibutilide may be tried for conversion to sinus rhythm
        Correct Answer:- Option-A

Question76:-Which of the following drugs should not be used in the management of atrial flutter
        B:-Metoprolol succinate
        C:-Metoprolol tartrate
        Correct Answer:- Option-A

Question77:-Atrial fibrillation is linked to all the following except
        A:-Cognitive decline
        B:-Heart failure
        C:-Sudden cardiac death
        D:-Aortic regurgitation
        Correct Answer:- Option-D

Question78:-67 years old female with history of diabetes mellitus and hypertension presented with a trial fibrillation of 2 weeks duration, normal renal function, echocardiogram shows normal valves and good ventricular function - The best management strategy would be
        A:-Aspirin 150 mg daily
        B:-Aspirin 75 mg daily
        C:-Apixaban 5 mg twice daily
        D:-Aspirin 150 mg + Warfarin with target INR of 2-3
        Correct Answer:- Option-C

Question79:-The drugs used in the "pill in the pocket" strategy in Atrial fibrillation include
        Correct Answer:- Option-C

Question80:-Regarding AF in patients with hypertrophic cardiomyopathy - Which of the following is NOT true.
        A:-AF occurs in 25% of patients with HCM.
        B:-AF worsens symptoms of HCM
        C:-Anticoagulation is indicated in all patients with AF and HCM irrespective of the CHA2DS2-VASC Score.
        D:-Anticoagulation is indicated in patients with HCM with AF only those with CHA2DS2-VASC score > 3
        Correct Answer:- Option-D

Question81:-The following about aortic aneurysms are true EXCEPT
        A:-Larger Aortic aneurysms have a faster annual growth rate
        B:-Dissected aneurysms grow faster than those without dissection
        C:-Aneurysms of Ascending Aorta grow faster than the descending Aortic aneurysm
        D:-Patients with bicuspid aortivalve have a faster growth rate of aoric aneurysm than those without BAV
        Correct Answer:- Option-C

Question82:-Commonest primary tumour of ascending aorta is
        A:-Fibrous tumour
        D:-Un differentiated sarcoma
        Correct Answer:- Option-D

Question83:-Which of the following is not correct regarding Aortic dissection
        A:-CECT has the highest sensitivity and specificity in diagnosis
        B:-Coronary angiography must be done before surgical repair in acute type A aortic dissection
        C:-Aortography is no longer used for acute aortic dissection
        D:-Intra mural haematoma may predispose to aortic dissection
        Correct Answer:- Option-B

Question84:-Deceleration injury of aorta commonly involve
        A:-Sino Tubular junction
        B:-Aortic isthmus
        C:-Junction of thoracic and Abdominal aorta
        D:-Aortic root
        Correct Answer:- Option-B

Question85:-Indications for Thoracic endovascular repair for type B Aortic dissection are all EXCEPT
        A:-Impending rupture
        B:-Haemhorragic Pleural Effusion
        C:-Refractory Hypotension
        D:-Refractory Pain
        Correct Answer:- Option-C

Question86:-The Features of thrombo angitis obliterans include all EXCEPT
        A:-Involvement predominantly of appedicular arteries
        B:-Occlusive thrombus with micro abscesses and giant cells
        C:-Inflammatory infiltration of internal elastic membrane
        D:-involvement of pulmonary arteris
        Correct Answer:- Option-C

Question87:-The drug that has shown reduction in limb events and mortality in peripheral occlusive arterial diease is
        Correct Answer:- Option-B

Question88:-The following findings are seen in peripheral arterial disease EXCEPT
        A:-Loss of type I oxidative slow twitch fibres
        B:-Delay in mitochondrial respiratory activity in affected muscles
        C:-Early shift and delayed persistence of anaerobic metabolism with Exercise
        D:-Loss of type II skeletal muscle fibres with decreased muscle strength
        Correct Answer:- Option-A

Question89:-All are true about Kawasaki disease EXCEPT
        A:-Predominantly affects medium and small arteries
        B:-Treatment with aspirin and immunoglobulin provides symptomatic relief but do not reduce incidence of coronary aneurysms
        C:-Incidence of coronary aneurysms can occur in upto 25% of affected children
        D:-Diagnostic coronary angiography is not recommended in acute phase
        Correct Answer:- Option-B

Question90:-Thoracic and abdominal aortic aneurysm can be a feature of
        A:-Wegener's Granulomatosis
        B:-Kawasaki disease
        C:-Churg strauss syndrome
        D:-Gaint cell arteritis
        Correct Answer:- Option-D

Question91:-Which of the following can be considered as a contra indication for pregnancy
        A:-Severe asymptomatic aortic stenosis
        B:-Fontan circulation
        C:-Mechanical prosthetic valves
        D:-Severe mitral stenosis
        Correct Answer:- Option-D

Question92:-All are TRUE regarding paripartum cardiomyopathy EXCEPT
        A:-Multiparity is a predisposing factor
        B:-LV Ejection fraction less than 30% predicts poor LV functional recovery post partum
        C:-Women with an LV Functional recovery to normal does not carry any risk of recurrence in subsequent pregnancies
        D:-LV end Diastolic dimension of more than 60 MM at diagnosis is a predictor of poor functional recovery
        Correct Answer:- Option-C

Question93:-Which of the following statements is CORRECT
        A:-Niemann pick type C disease is caused by mutations in sphyngomelin phospho diesterase 1 gene
        B:-Tangiers disease is an HDL deficiency syndrome caused by ABCA1Gene mutation
        C:-Familial hyper triglyceridaemia is characterised by corneal arcus, xanthomas and xanthelasma
        D:-Cognitive impairment can be associated with very low levels of LDL
        Correct Answer:- Option-B

Question94:-Fish eye disease is an entity associated with
        A:-Lecithin - Cholesterol Acyl transferase deficiency
        B:-Cholesterol ester transfer protein deficiency
        C:-Hereditary sitosterolemia
        Correct Answer:- Option-A

Question95:-Which of the following drug is useful in sitosterolemia
        A:-Fibric acid derivatives
        B:-Water soluble statins
        D:-PCSK 9 inhibitors
        Correct Answer:- Option-C

Question96:-Disseminated intravascular coagulation may be associated with pulmonary embolism due to
        D:-Amniotic Fluid
        Correct Answer:- Option-D

Question97:-The following statement is wrong regarding pulmonary thrombo embolism
        A:-Progesterone only oral contraceptive pill poses a high risk
        B:-Superficial venous thrombus can be a predictor of future venous thrombo embolism
        C:-Fall in systolic BP to less than 90 is used to distinguish between massive and sub massive pulmonary thrombo embolism
        D:-ECMO can be a treatment option for massive pulmonary embolism
        Correct Answer:- Option-A

Question98:-Which of the following does not cross react with heparin induced antibodies of hit
        Correct Answer:- Option-D

Question99:-Assertion:- Warfarin initiation must be overlapped with heparin in treatment of DVT
Reason :- Warfa in causes an intial rapid fall in antithrombin III causing initial hypercoagulability
        A:-Assertion is CORRECT but reason is NOT CORRECT
        B:-Assertion and reason are in CORRECT
        C:-Assertion is wrong but statement given as reason is factual
        D:-Both Assertion and Reason are wrong
        Correct Answer:- Option-A

Question100:-Which of the following statements is CORRECT
        A:-Recurrent venous thromboembolism is more common in females
        B:-Asprin offers significant protection in unprovoked venous thromboembolism
        C:-Rivaroxaban, Apixaban and Dabigatran are superior to warfarin in prevention of recurrent venous thromboembolism.
        D:-Systemic venous thrombolysis with Alteplase is a recommended treatment for sub massive and massive pulmonary embolism
        Correct Answer:- Option-B

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