1. The following statement about procainamide is false:

About 50% is metabolised to napa

Napa prolongs depolarisation

Napa competes with procainamide for renotubular secretory sites

Napa can increase procainamide's elimination half life

2. Treatment of bradyarrythmia due to suppression of SA node/ AV node by antiarrythmics is:

Stopping of the offending drug

Instituting temporary pacing

Both

Denervation of the heart

3. Which of these class IC drugs have the most proarrythmic potential?

Flecainide

Propafenone

Moricizine

Both and

4. The most well established use of parenteral magnesium is in treatment of

Torsades-de-pointes

Supraventricular Tachycardia

Ventricular fibrillation

Atrial fibrillation

5. Magnesium toxicity is evidenced by

Increased PR interval and QRS duration in ECG

Loss of deep tendon reflexes

Respiratory paralysis

All of the above

6. The following device may not interfere with a pacemaker:

Cellular telephone

Radiotherapy units for treating cancers

Arc welding equipments

Ultrasound machines

7. Lead failure in pacemakers occur due to trauma to the lead. The most common cause of which is:

Accidents

People twiddling with their pacemakers

Battery short circuit

Faulty pacemakers

8. External pacing

Done for stabilizing of the patient after implanting permanent pacemaker

Typically done by placing two pacing pads on the chest wall

It can be relied on for a long period of time

The heart is always well stimulated along with the chest wall muscles

9. True about the defibrillators are all except:

Both solid and wet gel electrodes are available

Solid gel electrodes are more convinient

Wet gel electrodes do not need cleaning of the patient's skin after removing the electrodes

Solid gel electrodes have a higher risk of bums during defibrillation

10. In resuscitation, the resuscitation electrodes:

Are placed in antero posterior scheme preferably

May be placed in anterior -apex scheme when anteoposterior scheme is unnecessary

The apex electrode is placed to the left side of the patient just below and to the left of the pectora muscle

All of the above statements are true

11. is the basic single chamber ventricular pacing mode i.e. it allows pacing only when the ventricular rate is below the programmed limit.

VVI

AVI

DOD

001

12. Regarding implantable cardioverters -defibrillators, true statement is

Dual chamber ICDS are better

Single chamber ICDS are better

Currently there is no consensus on the use of single V/S dual chamber reDS

All statements are false

13. In treatment of atrial fibrillation, false statement is

Dranoderone is approved for treatment of AF

After successful radio frequency catheter ablation, AF can recur in 2-3 years

Sotalol is ineffective in treating AF

Ibulitide is an agent which can be used in the acute termination of AF episodes

14. The following patients are considered for heart transplantation while evaluating potential recipient, except

Patients with cardiogenic shock requiring mechanical/high dose inotropic support

Chronic, refractory, progressive or stage D heart failure

Recurrent life threatening arrythmias despite maximal interventions

Refractory anginapatients awaiting CABG

15. Immunosuppressive drugs used after cardiac transplantation are:

Glucocorticoids

Calcineurin inhibitors

Antiproliferative agents

All of the above

16. Torsades de pointes, true statement:

Is a form of monomorphic VT with QT rolongation

Cisapride when given with cyto P450 inhibitor can cause TDP

Torsades de point means ballooning around a point

All are false

17. Which of these class of conditions does not produce heart failure in the newborn

Critical coarctation of aorta

AV malformations of the heart

d transposition with intact ventricular septum

Congenital mitral regurgitation

18. Following statements about intra aotic balloon pump are all true except:

Contraindicated in severe aortic regurgitation

Should be placed below the left subclavian artery

Reduces after load

Improves cardiac output by 30%

19. Haemofiltration during open heart surgery -statement which is not untrue is

During ultrafiltration blood is diluted and haematocrit is kept around 18-20

Haemofiltration reduces pre operative compliment activation

Haemofiltration causes blood destruction especially of platelets and coagulation factors

Haemofiltration preserves excess fluid in the body especially in renal failure patients

20. Internal mammary artery is an ideal conduit for CABG because:

Size matches the coronary arteries

Resistant to atherosclerosis

Has excellent long term patency rates

All are true

21. False about VSD surgical closure is

Results of VSD surgery are excellent

Mortality in a large series of patients was 1.6%

Complications like complete heart block can occur

Recurrent VSD is a rare complication of VSD surgery

22. Of the following, which one is a biological valve?

Njork Shiley

Omni Science

Chitra

Carpentier -Edward

23. Which of these valves has the largest effective orifice area for an aortic position:

Starr Edwards

Single leaflet

Bileaflet

Heterograft

24. In post mortem, incidence of rheumatic tricuspid stenosis is as high as

15%

50%



25%

25. Tricuspid stenosis is severe when the gradient across the tricuspid valve is

511M

10 MM

15 MM

12 MM

26. Alfieri repair is done in patients with mitral regurgitation of origin.

Rheumatic

MVP

Degenerative

Ischemic

27. 7 year old child is having elfin facies, mental retardation, multiple peripheral artery stenosis and hypercalcaemia and also supravalvular aortic stenosis. The most likely diagnosis is

Noonans syndrome

Williams syndrome

Downs syndrome

Klinefelteers syndrome

28. Approaches for pericardectomy usually include:

Right anterolateral thoracic approach

Median sternotomy

Both and

Interscapular approach

29. "Elephant trunk" technique is used in the surgical procedure for:

Aortic aneurysm

Aortic dissection

Coronary sinus ligation

SVC ligation

30. Hospital mortality for the ventricular septal rupture post M.I. is

30%

25%

20%

40%

31. Around 80% of VSD are

Membranous

Perimembranous

Muscular

Posterior

32. Circulation in congenitally corrected TGA is as follows:

Right atrium right ventricle pulmonay artery left atrium left ventricle aorta

Right atrium left ventricle pulmonary artery left atrium right ventricle aorta

Right atrium right ventricle aorta left atrium left ventricle pulmonary artery

None of the above

33. Notching of the ribs is a classical X-ray finding in

Coarctation of the aorts

Pulmonary stenosis

Aortic dissection

Pulmonary atresia

34. During embryological development, the morphogenetic abnormality of malalignment of the infundibular septum gives rise to which of the following congenital heart disease?

Ebsteins nomaly

Coarctation of aorta

Total anomalous pulmonary venous connection

Tetralogy of fallot

35. Parachute mitral valve results from:

Single papillary muscle

Split anteromedial papillary muscle

Split posteromedial papillary muscle

None of the above

36. Atrial switch operation is performed in

Truncus arteriosus

Tricuspid atresia

Transposition of great arteries

Tetralogy of fallot

37. Definitive indication for surgery in aortic dissection are all except:

All proximal dissections

Distal aorta dissection with rupture impending rupture

Distal aorta dissection with retrograde extension into ascending aorta

All of above are indications for surgery

38. True about adenosine is

It does not produce flushing, dyspnoea and chest pressure as side effect unlike other anti arrythmics

Transient side effects occur in 50% of patients with SVT

Ventricular ectopics, sinus bradycardia are common especially when SVT terminates abruptly

Atrial fibrillation is occasionally observed in 22% of the patients

39. Digoxin toxicity is enhanced by

High potassium levels

Low potassium levels

Both high and low levels are equally harmful

Potassium levels have no effect on digoxin toxicity

40. Beta blocker with intrinsic sympathomimetic activity is

Atenolol

Propranolol

Esmolol

Labetalol

41. Which of these are highly protein bound?

Lidocaine

Phenytoin

Mexelitine

All class IB drugs are equally protein bound

42. Fontan procedure comprises of

Redirecting all of RA blood into pulmonary circulation bypassing the RV

Switching the great arteries to restore the normal ventriculoarterial concordance

Outflow resection of RV and pulmonary valvulotomy

Release of papillary muscles

43. A surgery involving closure of VSD and establishing RV to PA connection with an external conduit is called:

Blalock procedure

Glenn shunting

Rastelli operation

Ross procedure

44. PDA has the tendency to close within period.

1-2 years

3-4 years

2-4 weeks

10-12 weeks

45. ASD are unlikely to close spontaneously.

8mm

15mm

10mm

3mm

46. All of the following drugs decrease the effect of quinidine (class IA antiarrythmic) except:

Phenobarbital

Phenytoin

Rifampicin

Ethanol

47. Cyanotic condition with normal pulmonary flow is

Pulmonary atrio-venous fistula

Left SVC to AN unroofed coronary sinus

Both and

None of the above

48. 33 year old female with mitral stenosis has a LAA clot and is in atrial fibrillation. Treatment of choice for her is

Closed mitral valvulotomy

Balloon mitral valvulotomy

Mitral valve repair

Open valvulotomy

49. Which of the following prosthetic valves has the highest effective orifice area at mitral aortic area

Starr Edwards

Free homograft

Heterograft

ST Jude Bileaflet valve

50. Unclassified drugs under Vaughen Williams classification are all except:

Bretylium

Adenosine

Magnesium

Digoxin

51. Cyanotic spells are seen in all of the following conditions except:

Tetralogy of fallot

Total anomalous pulmonary venous connection

Tricuspid atresia with pulmonary stenosis

Double outlet right ventricle with VSD and pulmonary stenosis

52. Which of the following can cause chemical sympathectomy like state:

Labetalol

Bretylium tosylate

Carvedilol

Adenosine

53. Following are the mechanisms for cyanotic spells;

Acute increase in the pulmonary blood flow

Decrease in the circulation catecholamimes

Both and

None of the above

54. In Down's Syndrome which of the following chromosomal abnormality is seen?

Trisomy 21

Trisomy 18

Trisomy 24

Trisomy 26

55. Dose of aspirin following device closure of ASD is

3-5 mg/kg/day

10 mg/kg/day

1 mg/kg/day

81 mg/day

56. All of the following statements regarding ASD are correct except:

ASD 8 mm are likely to close spontaneously

Ostium primum ASD do not close spontaneously

Fossa ovahs ASD have tendency to close

Sinus venosus ASD do close spontaneously

57. Neurological/central nervous system complications of congenital heart disease include all of the following except:

Acute global ischaemia

Chronic focal ischaemia

Brain abscess

Mycotic aneurysms

58. Which of the following class III antiarrythmics have the longest half life?

Amiodarone

Bretylium

Sotalol

Ibulitide

59. False statement about hypoxia test is

It is used to rule out critical congenital heart disease

It is based on the principle that administration of 100% O2 can raise the P02 of arterial blood to higher level in the absence of shunt

It requires estimation of PCO2 levels

All statements are true

60. Proximal aortic aneurysms include:

Debakey type I and II or Stanford type A

Debakey type I and Stanford type A

Debakey type I and II and Stanford type B

Debakey type III or Stanford type B

61. In complete transposition of great arteries, in relation to the pulmonary valve, the aortic valve:

Is placed more anteriorly, superiorly and to the right

Is placed more posteriorly, inferiorly and to the left

Is placed more anteriorly, inferiorly and to the left

Is placed more posteriorly, inferiorly and to the right

62. Cardiac rehabilitation is prescribed for patients who:

Have had myocardial infarction

Have undergone bypass grafting

Have chronic stable angina

All of the above

63. Correct statement about angiongraphic quantification of tricuspid regurgitation is

Grade I -partial RA quantification

Grade II -minimal systolic jet, clears rapidly

Grade III -opacification of whole RA

Grade IV -opacification of whole of RV

64. Potts shunt is between:

Left pulmonary artery and descending thoracic aorta

Left pulmonary artery and ascending thoracic aorta

Right pulmonary artery and ascending thoracic aorta

Main pulmonary trunk and ascending thoracic aorta

65. In pulmonary regurgitation, if the jet extends more than 2 em, then it is

Severe PR

Mild PR

Moderate PR

Normal finding

66. The percentage of survival ;It 10 years with patients undergoing medical treatment for triple vessel coronary artery disease is

20%

50%

70%

30%

67. In bidirectional glenn shunt hospital mortality is



10-15%

15-20%

20-25%

68. Differential cyanosis is seen in which of the following conditions?

Aorto Pulmonary Window

Coarcpation of Aorta with Aortic Stenosis

Tetralogy of Fallot

Right to Left shunt with Patent ductus arteriosus

69. In critically ill neonates with coarctation of aorta, the following drug is used:

Prostacyclin

Prostaglandin

Propranolol

Protamine

70. Congenital pulmonary stenosis, the treatment of choice for which is

Percutaneous balloon valvulotomy

Surgical valvulotomy

Pulmonary valve replacement

Aorto-pulmonary shunting

71. In acquired aortic stenosis of rheumatic origin, the aortic valve is

Predominantly regurgitant with some degree of stenosis

Predominantly stenotic with some degree of regurgitation

Equally stenotic and regurgitant

All of the above

72. All are surgeries for mitral stenosis except:

Mitral valve replacement

Open mitral valvulotomy

Closed mitral valvulotomy

Mitral valve repair

73. Chithra valve is a

Bileaflet valve

Tilting disk valve

Ball and cage valve

Bioprothetic valve

74. Which of the following statements is untrue with regard to dietary aspects in CABG patients?

Pre-operatively patients are given low calorie, low fat diet

Immediate post-operatively, patients are given strict dieting regimen

After a month patients are made to go back to their previously prescribed diet

Smoking is strictly prohibited

75. With respect to vein grafts in CABG, at the end of ten years post-operative:

50% grafts are patent, 50% have significant atherosclerotic changes

25% are patent with 75% having atherosclerosis

75% are patent with 25% having atherosclerosis

100% are occluded

76. Unture about false ventricular aneurysm is

Develops after acute rupture of infarct

Occurs more often on the anterolateral surface

The mouth is usually narrow

Resection is always recommended

77. Bental procedure is a technique used to repair aortic aneurysm involving:

Ascending aorta and aortic valve

Descending thoracic aorta

Descending thoracic aorta and arch

Ascending aorta below the innominate artery

78. All are true about constrictive pericarditis except:

Is usually the first stage of inflammatory process involving the pericardium

In developing world, infection with M. TB is still common

Non infective causes involve idiopathic, post radiation or post surgery

A few cases have been reported after insertion of implantable defibrillators

79. Cardiac rehabilitation involves:

Exercise training

Education, counselling and behavioural interventions

Both and

None of the above

80. True about cardiac rehabilitation are all except:

Phase I -begins in the hospital

Phase II -consists of planned rehabilitation programs

Phase III -consists of a lifelong program committed to encourage exercise and a healthful lifestyle

Phase IV -ends with the death of the patient

81. Ventricular septal rupture, true statement is

Correct terminology is post myocardial ventricular septal defect

The location is 60% anterior and 40% posterior

An anterior septal rupture is often associated with mitral regurgitation

Presence of a ventricular septal rupture is not an indication of surgery

82. Absent in the triad seen in PS with atrial right to left shunt (intact IVS) is

Cyanosis

Ischaemic lung fields in chest X-ray

Split 52

Cardiomegaly

83. Following statement about sotalolare true except:

L -isomer is responsible for the beta blockade

Effective in ventricular tachycardia

Prevents recurrence of wide range of SVT

It does not cause pro-arrythmia

84. Patient is fully heparinised before start of cardio pulmonary bypass, the baseline activated clotting time at 30 degree celsius should be

400 msec

450 msec

480 msec

420 msec

85. In left main coronary artery disease, stenosis more than is an indication for surgery.

50%

60%

70%

75%

86. Pediatric dose of adenosine is

0.1 to 0.3 mg/kg

0.5 to 0.7 mg/kg

1-3 mg/kg

5-7 mg/kg

87. Which of the following beta blockers has vasodilator property

Atenolol

Esmolol

Metoprolol

Propranolol

88. The most significant side effect of bretylium is

Proarrythmia

Dyspnoea

Orthostatic hypotension

Rebound hypertension

89. The following class of drugs is not effective in treating AV node dependent tachycardias:

Class IA

Digoxin

Class II

Class III

90. Class of antiarrythmic drugs which block the slow calcium channel and reduce the plateau height of the action potential

Class IV

Class IA

Class III

Digoxin