1. Which of the following statement regarding Lp is incorrect

Increased Lp is less commonly seen in Indians settled in Europe

Increased Lp is associated with increased incidence of coronary artery disease

Elevated Lp levels cause premature atherosclerosis

Elevated Lp are associated with genetic predisposition

2. In Atherosclerosis early fatty streaks usually appear at what age?

25 years

40 years

50 years

10 years

3. In insulin resistance syndrome all the following components are seen except one:

Abdominal obesity

High HDL levels

High Triglyceride levels

Hypersecretion of insulin

4. All the following variables are included in diagnostic criteria of NCEP ATP III except one:

Blood pressure

HDL-C

Waist circumference

Total cholesterol

5. What is Barker hypothesis

Increased incidence of coronary artery disease in diabetic patients

Sedentary patients have high incidence of coronary artery disease

Lack of exercise has inverse proportion to increased incidence of coronary artery disease

Low birth weight in new borns have enhanced susceptibility to coronary artery disease in adults

6. Which of the following statement is incorrect regarding primordial prevention of coronary artery disease

Treating patients aggressively with statins irrespective of lipid levels

Primordial prevention is the most effective strategy in prevention of coronary artery disease

It is very difficult to motivate population

Needs massive education of population

7. Left ventricular hypertrophy is said to be present in women when left ventricular mass exceeds:

80

100

130

150

8. All the following factors have shown increased incidence of coronary artery disease except one:

Elevated homocysteine levels

Elevated vitamin D levels

Elevated LDL levels

Low HDL levels

9. What is the incidence of coronary artery disease in the population without any conventional risk factor

Less than 20%

Less than 10%

Less than 30%

Less than

10. 45 years male, chronic smoker, has diabetes mellitus and hypertension since 9 years, his total cholesterol is 285 mg/dl. What is the estimated coronary risk in 10 years period?

40%

100%

24%

35%

11. According to INTERHEART study in what percentage of population the coronary artery disease is preventable?

100%

80%

90%

70%

12. In INTERHEART study which of the following risk factor was shown as strongest predictor of Acute myocardial infarction

Waist to hip circumference

Central obesity

Elevated homocysteine levels

Abnormal Apo -B/Apo A ratio

13. Which of the following is newer risk factor for coronary artery disease?

Smoking

Central obesity

Left ventricular hypertrophy

Excess alcohol consumption

14. When do you say morbid obesity

When BMI is more than 20% ideal body weight

When BMI is more than 25% ideal body weight

When BMI is more than 35% ideal body weight

When BMI is more than 40% ideal body weight

15. All the following are biochemical risk factors for coronary artery disease except one:

Diabetes mellitus

Dyslipidemia

Smoking

Lipoprotein

16. What is the prevalence of rheumatic heart disease in India?

1.5/1000

3.9/1000

5.4/1000

6.9/1000

17. According to ATP III Triglyceride levels are said to be high at what levels?

More than 120 mg/dl

More than 1000 mg/dl

More than 150 mg/dl

More than 200 mg/dl

18. All the following are non pharmacological methods of control of hypertension except one:

Increased intake of fruits and vegetables

Reduction of salt intake

Moderate consumption of alcohol

Lower intake of saturated fat

19. In prevention of cardiovascular disease what is the ideal target of achieving blood pressure would be?

120/80 mmHg

130/70 mmHg

140/90 mmHg

110/80 mmHg

20. In HOPE study which of the following ACE inhibitor was used

Carvadelol

Ramipril

Lisinopril

Enalapril

21. Which of the following is a primary prevention trials using statins in coronary atherosclerosis?

CARE trial

Scandinavian Simvastatin Survival Study

WOSCOPS trial

Lipid trial

22. In insulin resistance all the following changes are seen except one:

Hypersecretion of insulin by pancreatic B cells

Increased glucose uptake by skeletal muscle

Increased release of fatty acids from adipose tissue

Over production of glucose by liver

23. Serum levels of Lp are influenced by what?

Diet

Male gender

Genetically

Smoking

24. Increased levels of homocysteine are seen in all the following conditions except one:

Folate deficiency

Vitamin B12 deficiency

Vitamin C deficiency

Vitamin B6 deficiency

25. In Indian population the recommended fat intake in the diet should be how much percent?

20%

30%

10%

40%

26. Monounsaturated fats are found in high concentrations in all the following diets except one:

Sun flower

Peanut

Olive oil

Canola

27. Dr. Pekka Puska has initiated life style changes by changing their food habits of the population in the province of which country?

Sweden

Finland

Russia

USA

28. High saturated fats are present in all the following oils except one:

Coconut oil

Palm oil

Hard margarine

Olive oil

29. Pathological effects of Lp in atherosclerosis are seen at what levels of Lp in the blood?

>2.5-5 mg/dl

>5-7.5mg/dl

>20-30 mg/dl

>7.5-10 mg/dl

30. All the following are non modifiable risk factors for coronary artery disease except?

Gender

Heredity

Age

Obesity

31. Atherosclerosis principally affects which of the component of the vessel wall

Adventitia

Media

Intima

Endothelium

32. The foam cell is lipid laden cell derived from:

Endothelium

Smooth muscle cell

Macrophage

Lymphocyte

33. The LDL -NCEP goal for treatment of lipids in patients with known CAD or CAD equivalent risk is:

180 mg/dl

160 mg/dl

100 mg/dl

130 mg/dl

34. 58 years old man was evaluated for risk evaluation. He has hypertension and abdominal aortic aneurysm. He never smokes. His HDL is 46 mg/dl. He has no family history of premature CAD. What is his LDL target?

180 mg/dl

160 mg/dl

130 mg/dl

100 mg/dl

35. 49 years male patient without documented heart disease, has the following lipid profile LDL­138 mg/dl, HDL -20 mg/dl, triglycerides -946. Which of the following drug is first line of treatment?

Atorvastatin

Simvostatin

Lovastatin

Fenofibrate

36. Which of the following is considered as CAD risk equivalent?

Hypertension

Smoking

Diabetes Mellitus

Obesity

37. The advantages of physical activities are all except:

Decrease in LDL

Increase in Insulin Sensitivity

Increase in Triglycerides

Increase in Cardiac Reserve

38. Which of the following diet has shown to decrease the risk of future cardiovascular events after acute myocardial infarction

Atkins diet

AHA step 2 diet

Mediterranean diet

Low fat diet 10% of total calorie intake)

39. All the following statements regarding plasma homocysteine are true except:

Elevated levels increase the risk of atherosclerotic vascular disease

Interventions to lower homocysteine levels, reduce mortality from coronary artery disease

Vitamin B12 deficiency tends to increase homocysteine levels

Vitamin B6 treatment, lowers homocysteine levels

40. According to NCEP adult program, all the following criteria are required to lable as metabolic syndrome except

Hs CRP 3 mg/dl

Serum glucose concentration> 110 mg/dl

HDL<40mg/dl

Serum TGL> 150mg/dl

41. What percentage of population have shown in primary prevention trail with aspirin to reduce vascular events and non fatal MI

10%

23%

52%

75%

42. In primary prevention trail with aspirin to reduce non fatal MI, what dose of aspirin was beneficial

Baby Aspirin

150 mg

250 mg

365 mg

43. Which of the following drugs were used in combination in polypills trail?

Clopidogrel, Angiotensin receptor blockers, Statins

Aspirin, Statin, ACE inhibitors

Betablockers, Aspirin, ACE inhibitors

Calcium channel blockers, Betablocker, Clopidogrel

44. All the following statements regarding HDL reduction are true except:

High dose of niacin supplementation has consistently shown reduction of HDL has reduced significant cerebrovascular events

AIM -HIGH trail has shown niacin supplementation resulted in increasing HDL cholesterol> 40 mg/dl

Increasing HDL cholesterol by niacin has not shown any beneficial effect on cardiovascular events

Cholesterol Ester Transfer Protein (CETP) has shown no benefit in reducing the cardiovascular events

45. 36 years old female obese, hypertensive since 4 years, diabetic since 1 year on metformin, came for routine evaluation of her lipid profile -Total cholesterol 180 mg/ dl; Triglyceride -750 mg/dl; HDL -28 mg/dl; LDL -69 mg/dl. Which of the following drug is recommended

Omega 3 fatty acid supplementation

Fenofibrate

Atorvastatin

Simvastatin

46. All the following statements are true regarding coronary artery disease in Indians except:

The process is severe, diffuse extensive involving multiple vessels

The disease manifest at a younger age

The rate of first myocardial infarction is five times lower in Indians than Europeans

The coronary artery size in Indians are small

47. Which is the earliest recognizable pathological lesion in atherosclerosis?

Atheroma

Fibrous plaque

Fatty streak

Soft plaque

48. The modifiable risk factor for coronary artery disease includes all except one:

Obesity

Psycho-social tension

Family history of coronary artery disease

Metabolic syndrome

49. Which of the following type of cholesterol in the diet is more atherogenic?

Saturated fatty acids

Poly unsaturated fatty acids

Monounsaturated fatty acids

Trans fats

50. Among the following risk factors for coronary artery disease, which is considered as coronary artery disease equivalent?

Dyslipidemia

Hypertension

Diabetes mellitus

Smoking

51. All of the following are newer risk factors for coronary artery disease except:

Lipoprotein

Homocysteine

C-reactive protein

Low HDL

52. Which of the following were the strongest predictors of acute MI Risk according to previous studies?

Waist hip ratio and obesity

Heart rate and blood pressure

Diabetes mellitus and dyslipidemia

Abnormal Apo BjApo A ratio and current smoking

53. Types of disease prevention includes all the following except one:

Primordial prevention

Primary prevention

Secondary prevention

Chemo prevention

54. The recommendation of sodium intake per day would be

5000mgjday

3000mgjday

2300mgjday

1600mgjday

55. Glycemic index of food is defined as

Highly processed carbohydrates

Energy rich with quick absorption

A type of starch

Indicative of how quickly and how strongly rises after carbohydrate food

56. Risk factors for Coronary Artery Disease in INTERHEART study were all except:

Psycho-social Impact

Fruits and Vegetable Consumption

Smoking

Family history of Coronary Artery Disease

57. All the following statements regarding hormonal replacement therapy are correct except:

Reduces CAD morbidity and mortality

Deleterious effect noted with it on primary prevention

HRT does not affect atherosclerosis progression in. women with CAD

HRT should be given for prevention of CVD in post menopausal women

58. The ideal body mass index to be desired is

18.5 -24.9 kg/m^2

25 kg/m^2

25 -28 kg/m^2

30 kg/m^2

59. The following statements about antioxidant supplements are true except:

Vitamin E and beta carotene are contraversial in preventing cardiovascular disease

Vitamin E and beta carotene and antioxidant supplements are recommended for cardiovascular protection

Plant derived foods rich in antioxidant nutrients are recommended for CVD prevention

Diet rich in antioxidants especially those that are deeply coloured should be consumed

60. Which of the following statement is correct about smoking cessation?

Risk of heart attack is reduced by 50% after 1 year of quitting

Lung cancer mortality reduces and is similar to that of non smokers after 5 years of quitting

Functional capacity does not improve after smoking cessation

There is no difference in the benefits of smoking cessation between both sexes

61. What is the ideal pharmacological way to reduce LDL cholesterol?

Fibrates

Statins

Ezetamide

Cholestyramine

62. The following statements are true about regular exercise except:

Prevents or retards atherosclerotic process

Produces weight loss

Exercise training after heart attack reduces morbidity and sudden cardiac death

Rhythmic aerobic exercise should be advised

63. Long term studies on the effect of life style change on CV disease risk and mortality was found in which study?

Nurses health study

WOSCOPS study

4S study

AFCAPS study

64. Dietary changes advocated by WHO for prevention of heart disease include all of the following except:

Reduction in fat intake to 20-30% of calorie intake

A decrease in complex carbohydrates

Consumption of saturated fats to be limited to 10% of total energy intake

Reduction of cholesterol to below 100 mg per kcal per day

65. Dyslipidemia in metabolic syndrome is characterized by

High triglyceride and Low HDL

High HDL and Low triglyceride

High triglyceride and High HDL

Low VLDL and High HDL

66. Significant family history of coronary artery disease is taken as age below in first degree male relative:

45 years

40 years

50 years

55 years

67. Annual stroke risk in India is

69/1,00,000

79/1,00,000

89/1,00,000

99/1,00,000

68. Prevalence of heterozygous familial hypercholesterolemia in general population is

1 in 50

1 in 500

1 in 1000

1 in 1500

69. If two risk factors are present without CAD/ equivalent, a patient can still be treated as risk equivalent if their 10 year risk is greater than:









70. Moderate alcohol consumption associated with reduction of cardiovascular events by the following mechanisms except

By raising HDL levels

By reducing LDL levels

By reduction of platelet aggregation

By improvement in fibrinolytic capacity

71. Reynolds risk score in calculating heart and stroke risk includes all the following criteria except:

Systolic blood pressure

LDL cholesterol

Hs CRP

Whether parents had MI below 60 years

72. All the following statements regarding coronary artery disease in women are true except:

Men suffer more than women from atherosclerosis and coronary artery disease

The risk of coronary bypass surgery in women is three times more than men

Women are protected to a greater extent by female sex hormones

Treatment with estrogens in post-menopausal women has shown significant reduction in cardiovascular events

73. The goal of INTERHEART study was all the following except:

To evaluate the association of risk factors for hypertension

The population attributable risk in the context of the prevalence of the condition with in a population

To evaluate the association of risk factors for acute myocardial infarction

To evaluate the association of risk factors in different ethnic groups

74. 35 years male, hypertensive, euglycemic, non-smoker, no family history of coronary artery disease. His LDL cholesterol was 142 mg/ dl. What is the recommendation according to NECP ATP III guidelines

Life style modification

Atorvastatin 20 mg/day

Rosuvastatin 10 mg/day

Gemfibrozel 300 mg/day

75. All the following are common risk factors for sudden cardiac death in young adults except:

Myocarditis

Valvular heart disease

Hypertrophic cardiomyopathy

Brugada syndrome

76. In JUPITER trials, all the following statements regarding statin use are correct except:

In JUPITER trials, the results have shown that, statin reduces Hs CRP

In JUPITER trials, reduced inflammation with statins have shown 80% reduction of coronarv events

In Jupiter trials, statins have shown that, reduced cardiac events are independent of LDL levels

In Jupiter trials, results have shown that atorvastatin was superior to rosuvastatin

77. According to several trials, what level of Hs CRP has predicted increased coronary events:

3 mg/liter

1 mg/liter

0.6 mg/liter

0.8 mg/liter

78. Increased Hs CRP levels are seen in all the following conditions except:

Metabolic syndrome

Endothelial dysfunction

Syndrome X

Long QT syndrome

79. All the following statements regarding Lp lipoprotein are correct except:

Lp consists of an LDL particle

Lp has sequence homology of plasminogen

This lipoprotein increases endogenous fibrinolysis

Lp lipoprotein binds and inactivates tissue factor pathway inhibitor

80. All the following statements regarding homocysteine are correct except:

Severe hyper homocysteine levels can predispose to premature atherosclerosis

Severe hyper homocysteine levels can predispose to venous thromboembolism

In HOPE trail, treatment with folic acid, vitamin B12 and vitamin B6 in patients with vascular disease, have shown that reduction homocysteine levels to normal levels have reduced cardiovascular events significantly

Plasma levels higher than 15 mol/litre are more common

81. Which of the following statement is wrong regarding novel imaging tests in predicting coronary atherosclerosis early?

increase in future vascular risk for each 0.1 mm increase in Carotid Intima Media Thickness (CIMT)

Absence of Coronary Artery Calcium Score (CACS) excludes the occurrence of future coronary events over long term follow up

CT coronary angiogram is expensive and radiation exposure, to apply for large population study

CT imaging does not detect the non calcified thin capped lesions that appear to cause most clinical events

82. 32 year male came for routine health check up. His blood pressure was 130/82 mmHg. His LDL was 196 mg/dl, triglycerides -105 mg/dl. His father had CABG at 54 years age. His fasting blood sugar was 112 mg/dl. Which of the following preventive intervention is recommended according to NCEP ATP III

Life style modification

High dose niacin

Rosuvastatin

Atorvastatin and fenofibrates

83. Non HDLC is routinely calculated by which of the following:

Total cholesterol -Triglycerides

LDL cholesterol -HDL cholesterol

VLDL cholesterol -Total cholesterol

Total cholesterol -HDL cholesterol

84. 44 years old female recently found to have hypertension and diabetes mellitus. Her elder brother had mycocardial infarction and on treatment. Her total cholesterol is 250 mg/dl and triglycerides 220 mg/ dl, LDL 116 mg/ dl. Her HBA1C 7.4%. According to NCEP ATP III which of the following drug is recommended?

High dose statins

Statins and fenofibrate

Ezetamide

Omega 3 fatty acids

85. Which of the following statin was studied in CARE (Cholesterol And Recurrent Events) trial?

Atorvastatin

Simvastatin

Pravastatin

Rosuvastatin

86. 40 years male normotensive, euglycemic, came for routine health checkup. His LDL cholesterol was 120 mg/dl and Estimated 10 years atherosclerosis, cardiovascular disease risk was 6.5%. What is your recommendation for this patient?

Gem fibrogel 300 mg

Life style modification alone

Fenofibrate 200 mg

Atorvastatin 20 mg

87. Which of the following drug reduces cholesterol absorption from dietary and biliary sources by preventing transport to the intestinal valve

Fenofibrates

Rosuvastatin

Ezetamide

Gem fibrogel

88. Which of the following trial, niacin was tested for increasing HDL will reduce cardiovascular events?

JUPITER trial

ASCOT trial

AIM -HIGH trial

LIPID trial

89. Framingham risk assessment tool for estimating 10 years risk of having a heart attack includes all the following criteria except:

Total cholesterol

Systolic blood pressure

LDL cholesterol

Age

90. According to International Diabetes Federation metabolic syndrome in women is said to be present with all the following criteria except

Raised triglyceride level> 150 mg/dl

Reduced HDLC 30 mg/dl

Raised systolic blood pressure> or equal to 130 mmHg or diastolic BP or equal to 85 mmHg

Raised fasting plasma glucose> or equal to 100 mg/dl