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NIZAMS INSTITUTE OF MEDICAL SCIENCES


Punjagutta, Hyderabad 500 082, A.P., India.



Question Booklet


Entrance Examination for Admission to DM Cardiology 2014


29 June 2014 Marks 90 Time: 01 Hour :30 Mins



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corresponds to your hall-ticket number

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Q1. The following device permits ultrahigh risk PCI



A) IABP device
B) Thrombectomy device
C) Impella device
D) Pig tail cather in left ventricle

Q2. Following is true about mammary souffl

1) Murmur is heard during late pregnancy and early lactation
2) Firm digital pressure could obliterate the murmur
3) Best heard in the supine position
4) Murmur peaks around S2

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

Q3. In Acute Aortic dissection, Endovascular therapy is NOT indicated in

A) Acute type B Aortic dissection complicated by limb ischemia
B) Acute type B Aortic dissection complicated by rupture or
impending rupture
C) Acute type A Aortic dissection
D) Acute type B Aortic Dissection complicated by aneurysmal
dilatation



3 of 30

Q4. Acute lung injury (ALI) is characterized by all except :

A) PaO
2
/ FiO
2
< 200 mm Hg
B) Bilateral interstitial infiltrates
C) PCWP < 18mm Hg
D) Normal left atrial pressure

Q5. The following figure showing the distribution of ventilation and blood flow
and the ventilation/perfusion ratio in normal upright lung.



A) 1= ventilation, 2 = perfusion, 3 = ventilation/perfusion ratio.
B) 1 = ventilation/perfusion ratio, 2 = ventilation, 3 = perfusion.
C) 1= perfusion, 2 = ventilation, 3 = ventilation/perfusion ratio.
D) 1= ventilation/perfusion ratio, 2 = perfusion, 3 = ventilation.
4 of 30

Q6. Simultaneous Right ventricular (RV) and Left ventricular (LV) pressure
recording as depicted below is seen in



A) Ebsteins Anomaly
B) Constrictive pericarditis
C) Hypertrophic cardiomyopathy
D) Dilated cardiomyopathy

Q7. Free wall rupture after acute MI. Pick up true statement

A) More often in elderly females
B) Common after 2 weeks of MI
C) Young age MI at higher risk
D) Incidence has increased in fibrinolytic era

Q8. Regarding evaluation of intracardiac or extracardiac structures by cardiac
CT appropriate indications are

1] Evaluation of pulmonary vein anatomy prior to radiofrequency ablation for
atrial fibrillation
2] Noninvasive coronary vein mapping prior to placement of biventricular
pacemaker
3] Evaluation of pericardial anatomy
4]Initial evaluation of cardiac mass(suspected tumor or thrombus)

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


5 of 30
Q9. Keshan disease is associated with deficiency of

A) Copper
B) Fluoride
C) Iron
D) Selenium

Q10. Correct option regarding electrophysiological abnormalities in ebstein's
anomaly

1) Intra-His or infra-His conduction abnormalities
2) Right bundle branch block
3) Supraventricular tachycardia
4) Deep Q waves in precordial leads V4-V6 and limb leads I and avL

A) Only 1,2 &3 are correct
B) Only 1&3 are correct
C) Only 2&4 are correct
D) Only 4 is correct

Q11. Non-Viable myocardium is characterized on MRI as having

A) No Late gadolinium enhancement (LGE)
B) 5-25 % LGE
C) 25-50 % LGE
D) > 50% LGE

Q12. Assertion: Risk of thrombosis of prosthetic valve is highest in tricuspid
location
Reason : Low pressure and low velocity of blood flow across tricuspid
valve

A) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true

Q13. The compensation formula for simple Acid- Base Disorders for Acute
respiratory alkalosis is

A) Change in HCO3 = 0.35 X change in PaCO2
B) Change in HCO3 = 0.6 X change in PaCO2
C) Change in HCO3 = 0.2 X change in PaCO2
D) Change in HCO3 = 1.2 X change in PaCO2
6 of 30
Q14. Assertion: ECG diagnosis of Q wave infarction is not affected by RBBB.
Reason : RBBB affects only early portion of the ventricular depolarisation.

A) Both Assertion and Reason are true, and Reason is the correct
explanation for the Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for the Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true

Q15. The correct statement regarding Rhabdomyomas of the heart is

A) Cardiac rhabdomyomas are the second most frequently
encountered primary cardiac tumor in infants and children.
B) Arrhythmias are an uncommon presentation for adult-type
rhabdomyomas.
C) Cardiac rhabdomyoma arises more commonly in the atrium,
although up to 30% of cases can involve either ventricles.
D) Prognosis of this disease is excellent

Q16. Regarding heart failure with normal ejection fraction

1) 50 to 70% of patients are women
2) Obesity is seen in 30 to 50%
3) Diabetes is seen in 30 to 50%
4) Atrial fibrillation is seen in 5 to 10%

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

Q17. STICH trial compared death and cardiac hospitalization in patients
undergoing

A) CABG vs. SVR (Surgical Ventricular Reconstruction)
B) CABG+SVR vs. CABG alone
C) CABG+SVR vs. SVR alone
D) CABG+ SVR vs. Optimum medical management
7 of 30
Q18. On Doppler echocardiography, Severe diastolic dysfunction is diagnosed by

A) Mitral Inflow E/A <1.5, Doppler tissue imaging of mitral annular
motion E/e' < 10, Pulmonary venous flow S>D
B) Mitral Inflow E/A >1.5, Doppler tissue imaging of mitral annular
motion E/e' < 10, Pulmonary venous flow S>D
C) Mitral Inflow E/A <1.5, Doppler tissue imaging of mitral annular
motion E/e'>10, Pulmonary venous flow S>D
D) Mitral Inflow E/A >1.5, Doppler tissue imaging of mitral annular
motion E/e' > 10, Pulmonary venous flow S<D

Q19. A Person working as a driver for a long time drives automatically. This type
of Memory is classified as

A) Episodic memory
B) Working memory
C) Semantic memory
D) Implicit memory

Q20. Which of the following is FALSE regarding management of acute heart
failure syndrome (AHFS)?

A) Severity of clinical presentation of AHFS does not always
correlate with long term outcome
B) Hemodynamic improvement should result from myocardial
stimulation (Inotropic therapy should be used liberally)
C) The implementation of current performance measures does not
always appears to improve post discharge outcomes
D) LV dysfunction and its progression are the main cause of the high
rehospitalisation rates and of mortality observed in heart failure

Q21. D- lactic acidosis is a feature of

A) Pyroglutamic acidosis
B) Intracellular inorganic phosphate depletion.
C) Short bowel disease.
D) Carbon monoxide poisoning.
8 of 30
Q22. Regarding occurrence of ventricular premature contractions during tread
mill testing

1. Increases with age
2. Repetitive forms can occur in some asymptomatic patients without
cardiac disease
3.VPCs suppression during exercise is a non-specific finding
4. Suggest bad prognosis in patients with chronic ischemic heart disease

A) Only1,2, and 3 are correct
B) Only1 and 3 are correct
C) Only 2 and 4 are correct
D) Only 4 is correct

Q23. One of the following elements is used in preparation of Cardioplegia
solutions during cardiac surgery

A) Helium
B) Potassium
C) Boron
D) Manganese

Q24. Some of the facts about Fabry disease are given below

1) X-linked dominant disorder that results in deficiency of alpha-
galactosidase A
2) Major clinical features result from the accumulation of glycolipid
substrate in the endothelium
3) Valvular involvement is extremely rare
4) Administration of recombinant alpha-galactosidase A provides clinical
and echocardiographic improvement

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

Q25. The following is not a feature of Purkinje cells

A) Long and broad cells
B) Diameter of 35-40 um
C) Plentiful T-tubules
D) Fast end to end transmission



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Q26. The drug tested in SENIORS trial on Heart Failure is

A) Irbesatan
B) Eplerenone
C) Nebivolol
D) Perindopril

Q27. Regarding digitalis effects on ECG
1. QT interval prolongation
2. Scooped ST,T complexes in precordial leads
3. ST,T changes gets accentuated with decrease in heart rate
4. Non paroxysmal junctional tachycardia indicate digitalis toxicity

A) Only1,2, and 3 are correct
B) Only1 and 3 are correct
C) Only 2 and 4 are correct
D) Only 4 is correct

Q28. Genome wide association studies (GWAS), a systematic method of
identifying disease-associated polymorphisms is used mainly to identify

1.Chromosomal disorders
2.Is a hypothetical model
3.Disorders related to mutations in single genes
4.Complex multigenic disorders

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

Q29. Regarding Wellens T waves on ECG

1. Seen in patients with high grade proximal LAD stenosis
2. Seen in leads II, III, aVF
3. Indicates unfavourable prognosis
4. Correlates with inferior wall hypokinesia

A) Only1,2, and 3 are correct
B) Only1 and 3 are correct
C) Only 2 and 4 are correct
D) Only 4 is correct




10 of 30
Q30. Which of the following is not true regarding BNP assays in the diagnosis
of heart failure

A) BNP levels are lower in obese patients
B) In heart failure with normal EF, BNP levels are less compared to
patients with heart failure having reduced EF
C) BNP is less specific for the detection of heart failure with normal
ejection fraction
D) Normal Plasma BNP concentrations decrease with age

Q31. What is the approximate "cold ischemia time" for hearts acceptable for
transplant

A) 30 minutes
B) 2 hours
C) 4 hours
D) 12 hours

Q32. Patent Ductus Arteriosus arises from

A) First Aortic arch
B) Second Aortic arch
C) Fourth Aortic arch
D) Sixth Aortic arch

Q33.The levels of two biomarkers in the first
3 days of STEMI in reperfused and non
reperfused patients are depicted in the
following figure. X-axis shows the days
since MI and y-axis shows multiples of
the 99
th
percentile control group of the
bio-marker. Pick the correct option

A) line A is Cardiac -Troponin in
a reperfused patient
B) line B is Cardiac -Troponin in
a non-reperfused patient
C) line C is CK-MB in non-
reperfused patient
D) line D is Cardiac Troponin in a
non-reperfused patient





11 of 30
Q34. The study of time, place and person distribution of a disease in human
population is known as:

A) Analytical Epidemiology
B) Experimental Epidemiology
C) Descriptive Epidemiology
D) Holistic Epidemiology

Q35. Regarding the role of Late gadolinium enhancement (LGE) in MRI in
assessment of CAD - Myocardial Infarction
Assertion :When LGE imaging (MRI) is performed early (within 5 min)
after contrast injection ,regions of microvascular
obstruction(no reflow) are visualised
Reason : LGE imaging can recognize subendocardial MI undetected by
SPECT or PET

A) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true

Q36. Which of the following AVP antagonists is given parentally

A) Sotavaptan
B) Tolvaptan
C) Lixivaptan
D) Conivaptan

Q37. In acute type A Aortic Dissection with Cardiac Tamponade

1. Cardiac Tamponade occurs in nearly 20% of acute type A Aortic
dissection
2. In hospital mortality increase by 5 folds as compared to acute type A
Aortic dissection without cardiac Tamponade
3. In relatively stable patient, the risk of pericardiocentesis likely
outweighs its benefits
4. In patients with refractory hypotension, conservative management with
intravenous fluids for initial 24 hours is the mainstay of treatment.

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

12 of 30
Q38.Choose the correct statement regarding Angiographic narrowing and
haziness (arrow) observed proximal to the site of stent deployment, where
as IVUS image shows



A) Malposition of the stent struts
B) Plaque rupture
C) Large atheroma with positive vascular remodeling
D) Large dissection with intramural hematoma

Q39. In UNOS (united network of organ sharing) donor allocation system,
patients temporarily unsuitable for thoracic organ transplant surgery are
allocated in

A) status IA
B) status IB
C) status 2
D) status 7

Q40. Use of nitrates in initial management of acute MI

Assertion: beneficial in reducing mortality

Reason: they cause non-endothelium dependent coronary vasodilatation

A) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true


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Q41.Following randomised controlled trial was done to see the effect of
Intracoronary administration of Bone marrow derived cells in patients of
Acute MI

A) BEAT
B) EMPHASIS
C) MOXCON
D) REPAIR AMI

Q42. Compared with a patient with LVEF40%, patients with LVEF < 20%
increases perioperative mortality during CABG by

A) 2.5 fold
B) 3.4 fold
C) 4.2 fold
D) 5 fold

Q43. True statements regarding prevention of coronary artery disease
1. Primordial prevention is difficult to implement on a population- wide
basis
2. Patient screening is not needed for primary prevention
3. JUPITER TRIAL was a primary prevention trial
4. Relative risk reduction is very low in secondary prevention

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

Q44. Regarding loop diuretics

1. They irreversibly inhibit the Na
+
-K
+
-2Cl
-
cotransporter on the apical
membrane of epithelial cells
2. Efficacy is dependent on secretory function of proximal tubule
3. Due to weak binding to plasma proteins, it is easily filtered from
glomerulus
4. Reduces the driving force for water resorption in the collecting duct by
inhibiting the concentration of solute within the medullary interstitium

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



14 of 30
Q45. Coronary angiogram in left anterior oblique projection, arrows indicates


A) Posterior descending artery from dominant right coronary artery
system
B) Posterolateral Branches from dominant left coronary system
C) Septal Branches from Left Anterior Descending Artery
D) Diagonal branches from Left Anterior Descending artery

Q46. Regarding Rheumatic fever
Assertion: Subcutaneous nodules are seen with severe carditis but occur
several weeks after the onset of cardiac findings
Reason : Erythema marginatum occurs early in course of rheumatic
fever and may lasts for months or years

A) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true

Q47. Redgarding MRI features of ARVD true statement is :-

A) Fat supressed LGE imaging of RV myocardium using short
inversion time has good correlation with endomyocardial biopsy
B) CMR has poor sensitivity in detecting ARVD
C) Fat infiltration of RV free wall is of high specificity for diagnosing
ARVD
D) Segmental perfusion defects are common
15 of 30

Q48. Following statement(s) are true about Transforming Infections
1. Caused by viruses: EBV, HPV, HBV, and HTLV-1
2. Implicated in brain hemorrhage and high fever
3. Implicated in the causation of human cancer
4. Implicated in meningoencephalitis

A) Only 1,2 and 3 are correct
B) Only 1and 3 are correct
C) Only 2 and 4 are correct
D) Only 4 is correct

Q49. Regarding ACC/AHA Guidelines for risk stratification of patients with
Unstable angina the high risk features are

1. Prolonged ongoing rest pain >20 min
2. Age >70 yrs
3. Bundle branch block new or presumed new
4. Pathological Q waves

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

Q50. X ray feature of ebstein's anomaly following option is correct

1) Box shaped heart
2) Wide vascular pedicle
3) Convexity of left heart border secondary to infundibular dilatation
4) Increased pulmonary vascularity

A) Only 1,2&3 are correct
B) Only 1&3 are correct
C) Only 2&4 are correct
D) Only 4 is correct
16 of 30
Q51. Regarding LV aneurysms in CAD

1. Most common location is anterolateral aspect of LV apex
2. Total occlusion of LAD is often seen lesion
3. Collaterals are poorly developed
4. Majority have single vessel 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 correct

Q52.


Overlap trace of Pulmonary artery and right ventricle depicts

A) Valvular pulmonary stenosis
B) Infundibular pulmonary stenosis
C) Pulmonary regurgitation in pulmonary artery hypertension
D) Congenital valvular pulmonary regurgitation

Q53. The normal right ventricular stroke work (RVSW) is

A) 60-80g-m/beat
B) 20-30g-m/beat
C) 2-5g-m / beat
D) 10-15 g-m / beat
17 of 30
Q54. Category A diseases/agents of bioterrorism include
1. Plague (Yersinia pestis)
2. Anthrax (Bacillus anthracis)
3. Smallpox (Variola major virus)
4. Brucellosis (Brucella 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 correct

Q55. Regarding ulcers of foot in vascular disease
1. Most ulcers due to PAD (Peripheral arterial disease) are due to non-flow
limiting stenosis
2. Venous ulcers usually have a pink base with irregular border
3. Venous ulcers are usually localised to the tips of the toes or the heel of
the foot
4. Venous ulcers produce milder pain than those caused by PAD

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

Q56. Regarding treatment of Neurally mediated syncope Class 1 indications are

1. Beta blockers
2. Cardiac pacing in the absence of documented cardioinhibitory reflex
3. Tilt training
4. Reassurance and education

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

Q57. The energy spectrum of thallium for myocardial perfusion is

A) 80 kev
B) 140 kev
C) 160 kev
D) 30 - 60 kev




18 of 30
Q58. The oxygen extraction ratio is in the range of

A) 32-42%
B) 12-15%
C) 45-50%
D) 22 - 32%

Q59. Regarding Bosentan

1. It is a selective ETA receptor antagonist
2. It reduces mortality in patients of Primary PAH
3. The usual dose is 5mg once daily which can be increased to 10mg
daily if tolerated
4. It may cause testicular atrophy and infertility

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

Q60. Following coronary artery revascularization, in patients with significant
viable myocardium( 25 to 30%), nuclear studies, PET and dobutamine
echocardiography predict an average improvement of LV function by
approximately

A) 4-5%
B) 8-10%
C) 14-16%
D) 18-20%

Q61. Assertion: In MVP during strain phase of Valsalva maneuver and sudden
standing click and onset of murmur occur earlier in systole
Reason : Left ventricular size increases during the strain phase of
valsalva and sudden standing

A) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true





19 of 30
Q62. During uptake of iodine into the thyrocyte

A) Each iodide ion is transported in along with 2 sodium ions
B) Each iodide ion is transported in, in exchange of chloride ion
C) Each iodide ion is transported in, along with one calcium ion
D) Iodide ions diffuse across the cell membrane

Q63. Ryanodine receptor abnormalities are characteristic of which one of the
following conditions

A) Long QT syndrome
B) Brugada syndrome
C) Catecholaminergic Polymorphic VT
D) Sick Sinus Syndrome

Q64. Pick up the correct choice from the following figure


A) Right (R) and left (L) Amplatz catheters
B) Right (R) and left (L) multipurpose catheters
C) Right (R) and left (L) Judkins catheters
D) Right(R) and left (L) NIH catheters
20 of 30
Q65. Immediately threatened viability category (2b) for Acute limb ischemia is
characterised by

1. Inaudible venous Doppler signals
2. Inaudible arterial Doppler signals
3. Major tissue loss
4. Mild to moderate muscle weakness

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

Q66. True statements regarding indication for permanent pacing after acute MI.
(Class 1 indication as per ACC/AHA guidelines)

1. Transient AV block without intraventricular conduction defects
2. Transient AV block with isolated LAHB
3. Transient second or third degree AV block at the AV node level
4. Transient second degree infranodal AV block and associated bundle
branch block

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

Q67. Regarding coronary blood flow

1) Systole contributes <20%of the total coronary blood flow during cardiac
cycle at rest
2) Total coronary blood flow to right ventricle is more than left ventricle
3) Fraction of coronary blood flow during systole is higher in right ventricle
compared to left ventricle
4) Increase subendocardial to subepicardial flow ratio is the hallmark of
myocardial ischaemia

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





21 of 30
Q68. Noncompaction of ventricular myocardium is characterized by

1) A distinctive spongy morphologic appearance of left ventricular
myocardium

2) Noncompaction predominantly involves the base of the left ventricle
chamber with deep inter/intratrabecular recesses (sinusoids) in
communication with the ventricular cavity

3) An end-systolic ratio of noncompacted to compacted layers higher than
2 on echocardiography

4) Complex congenital heart disease is seen in >90% of the cases

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

Q69. Regarding basis for using statins in acute myocardial infarction
Assertion: It is reasonable to start them early after the episode and aim at
achieving LDL < 70 mg/dl
Reason : statins have antiplatelet effects and reduce inflammation and
improve endothelial function

A) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true
22 of 30

Q70. The following systemic arterial pressure waveform from a patient with
IABP device suggests


A) IABP balloon inflation occurs too early before aortic valve closure
B) IABP balloon inflation occurs too late after the beginning of
diastole
C) IABP balloon deflation occurs too early before the end of diastole
D) IABP balloon deflation occurs too late after the end of diastole

Q71. Central sinus node lacks:

A) Connexin 43
B) Connexin 40
C) Connexin 45
D) Pacemaker cells

Q72. Assertion : One third of acute type A Aortic Dissection is associated with
Acute Inferior Myocardial Infarction
Reason : Acute Inferior Myocardial infarction in type A Aortic dissection
is due to the extension of dissection flap into the ostium of
RCA

A) Both Assertion and Reason are true, and Reason is thecorrect
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation of Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true



23 of 30
Q73. Regarding potential mechanisms contributing to the patho physiology of
heart failure with normal ejection fraction
1) There is neurohumoral activation
2) There is increased Extracellular matrix
3) There is concentric remodeling and other geometric changes
4) There is normal calcium homeostasis

A) only 1,2 and 3 are correct
B) only 1and 3 are correct
C) only 2 and 4 are correct
D) only 4 is correct

Q74. Takeuchi's procedure is devised for surgical repair of

A) Supravalvular Aortic Stenosis
B) Congenital Mitral Stenosis
C) Anamalous Left Coronary Artery from Pulmonary Artery
D) Cor Triatrium Dexter

Q75.


ECG shows

A) Lead reversal in normal person
B) Situs solitus with dextrocardia
C) Situs solitus with levocardia
D) Situs inversus with dextrocardia







24 of 30
Q76. Evidence of antecedent Group A Beta Hemolytic streptococci (GABHS) is
not required for diagnosis of acute rheumatic fever in the following
conditions

1. In patients with established RHD
2. In patients with chronic low grade carditis
3. In patients with recurrent rheumatic fever
4. In patients with rheumatic chorea

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

Q77. The course (arrows) of the anomalous left coronary artery from the right
coronary sinus is


A) Interarterial course
B) Retroaortic course
C) Prepulmonic course
D) Septal course

Q78. In acute mitral regurgitation
Assertion: the murmur is decrescendo rather than holosystolic
Reason : reverse pressure gradient between Left ventricle and left
atrium decline at end systole

A) Both Assertion and Reason are true, and Reason is the correct
explanation for Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C) Assertion is true, but Reason is false
D) Assertion is false, but Reason is true
25 of 30
Q79. True statements regarding Saphaneous vein grafts

1. About 10 to 20 % occlude in first 1 year
2. Late attrition rate (more than 5 years after surgery) is <2%
3. By 6 to 12 years only 55% are patent
4. Vein graft atherosclerosis is not much different from native
atherosclerosis

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

Q80. Regarding diet and fluid management of heart failure, the following is NOT
true

A) Dietary sodium restriction of 2-3 gm is recommended
B) Fluid restriction is recommended irrespective of serum sodium
levels
C) Calorie supplementation is recommended for advanced heart
failure
D) Dietary supplements should be avoided in symptomatic heart
failure

Q81. A 34 year old women who had two prior pregnancies with preeclampsia,
the magnetic resonance imaging scan showing



A) Tetralogy of fallot
B) Ebstein anomaly
C) Coarctation of aorta
D) Transposition of great vessels

26 of 30
Q82. Which of following chemokine receptors facilitate entry of HIV into the cell

1.CXCR4
2.CXCR5
3.CCR5
4.CCR4

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

Q83. A patients plasma osmolarity was 280mOsm/L, urine osmolarity was
140mOsm/L, with a urine flow rate of 2ml/min, then the free water
clearance is

A) 3 ml/min
B) -2ml/min
C) 0.5ml/min
D) 1ml/min

Q84. Assertion : Abnormal heart rate recovery following exercise cessation is a
normal phenomenon observed in patients who are on beta
blocker drug therapy
Reason :Abnormal heart rate recovery occurs due to decreased vagal
tone

A) Both Assertion and Reason are true, and Reason is the correct
explanation for the Assertion
B) Both Assertion and Reason are true, and Reason is not the
correct explanation for the Assertion
C) Assertion is true, and Reason is false
D) Assertion is false, and Reason is true
27 of 30
Q85. In a patient with RV infarction the ECG in VR3 is
shown in this figure below. Pick up correct answer

1. pattern A indicates proximal occlusion of right
coronary artery
2. pattern B indicates distal occlusion of right
coronary artery
3. pattern C indicates circumflex artery occlusion
4. both A and B suggest Obtuse marginal artery
occlusion

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

Q86. In the presence of Complete RBBB, the last portion of the right ventricle
to get activated is

A) Septum
B) Freewall
C) Outflow tract
D) Anterior wall

Q87. The following is true regarding Heparin induced Thrombocytopenia (HIT)

A) Antibodies against platelet factor 2 complexes are responsible for
the disorder.
B) Both arterial and venous thromboses are seen.
C) Warfarin is used as a treatment of HIT.
D) Platelet rich plasma is used for reversing the effects of
thrombocytopenia
28 of 30
Q88. In the daigram of HIV cycle given below, the drugs acting at step 1, 2 and
3 respectively are


A) enfuvirtide, elvitegravir, darunavir
B) darunavir, elvitegravir, enfuvirtide
C) elvitegravir, enfuvirtide, darunavir
D) darunavir,enfuvirtide, elvitegravir

29 of 30
Q89. In the figure given below the data given represents which of the fallowing
conditions

EDV: End diastolic volume TSV: Total stroke volume
ESV: End systolic volume FSV: Forward stroke volume
LAP: left atrial mean pressure RSV: Regurgitant stroke volume
EF: Ejection fraction

1. 2.


3. 4.

1. Figure 1 represents normal
2. Figure 2 represents acute MR
3. Figure 3 represents chronic compensated MR
4. Figure 4 represents chronic compensated MR

A) Only 1,2 and 3 are correct
B) Only 1 and 3are correct
C) Only2 and 4 are correct
D) Only 4is correct

30 of 30
Q90. On the basis of correlation of intravascular ultrasound, a plaque with
attenuation value of 15 to 50 HU on coronary CT, is classified as:

A) Fibrous plaque
B) Calcified plaque
C) Lipid rich plaque
D) Partially calcified plaque

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