1. Lateral view of the chest X-ray is particularly useful in following situations except:

to demonstrate retrosternal region

to define interlobar effusion

to assess cardiothoracic ratio

to localize lung pathology to a lobe

2. Ventricular septal defect can be caused by all except:

deficient development of proximal conus swelling

failure of fusion of endocardial cushions

none of the above

both of the above

3. Tetralogy of Fallot includes all except:

Pulmonary stenosis

VSD

Overriding of aorta

None

4. In ASD the defect can occur due to deficient development of all except:

septum primum

septum secundum

endocardial cushion

none of the above

5. Transposition of great vessels is associated with all except:

Failure of growth of truncoconal swellings

VSD

ASD

PDA

6. All the following structures fuse with endocardial cushions except:

septum primum

septum secundum

none

both of the above

7. All are true about myocardial energetics except

FFA is used as a energy source in resting, fasting state

Glucose is utilized in high glucose state

Lactate is used during severe exercise

None of the above

8. All can modulate vascular tone except

Nitric Oxide

Prostacyclin

Thromboxane

None

9. Preload is influenced by:

venous return

ventricular compliance

atrial kick

all of the above

10. Following are true about the venous waves except:

a-wave is due to atrial contraction

x-descent is due to downward movement of tricuspid valve

v-wave is due to atrial filling during the latter part of systole of ventricular contraction

none of the above

11. Following are true about the role of calcium in cardiac contraction except:

myosin binding sites are blocked by tropomyosin when calcium level is low

number of cross bridges depend on available calcium molecules

during systole intracellular calcium rises by 50 times

none of the above

12. All of the following drains into the coronary sinus except

great cardiac vein

venae cordis minimae

small cardiac vein

none of the above

13. Left anterior descending artery supplies all except

anterior 2/3rd of intra-ventricular septum

a part of right ventricle adjacent to the septum

both

none

14. All are true about the conduction of impulse in the heart except:

impulses from AV node first reaches the papillary muscles.

impulses from the SA node reach the interatrial septum near the opening of the coronary sinus.

impulse from right ventricular posterior papillary muscle reaches the anterior one via septo-marginal trabecula.

none of the above

15. Moderator band is the muscle band joining right ventricular:

anterior papillary muscle to the IVS

posterior papillary muscle to the IVS

anterior to the posterior papillary muscle

none

16. All of the following drains into the right atrium except:

inferior vena cava

venae cordis minimae

right pulmonary vein

superior vena cava

17. A patient with myocardial infarction presented with syncope. ECG showed complete heart block. The coronary artery most likely to be involved is

Left anterior descending

Left circumflex

Right coronary

Obtuse marginal

18. A patient with inferior wall myocardial infarction had left circumflex occlusion in angiogram. Right coronary was normal. His posterior inter-ventricular branch arises from:

Right coronary

Left circumflex

Both

None

19. A stab injury in the left lower sternal area is most likely to hit:

Right atrium

Right ventricle

Both

None

20. A needle penetrating through the right atrium just above the septal cusp of the tricuspid valve will reach:

Left atrium

Pulmonary trunk

Right ventricle

Left ventricle

21. The cusp experiencing forceful blood-flow on both its surfaces is

Anterior cusp of aortic valve

Posterior cusp of aortic valve

Septal cusp of tricuspid valve

Anterior cusp of mitral valve

22. In constrictive pericarditis the structure not constricted will be

Ascending aorta

Inferior vena cava

Pulmonary trunk

Right upper pulmonary vein

23. During inspiration all the events happen except:

Blood flow increases through Inferior vena cava

Pulmonary valve takes more time to close

Blood flow increases in Left Atrium

Aortic valve closes early

24. An agent preventing dissociation of calcium in the sarcomere will cause all except:

Increased contraction

Increased number of cross-bridges

Increased relaxation

None of the above

25. Increase in preload can produce all except:

Increase in cardiac oxygen consumption

Decrease in sub-endocardial ischemia

Increase in resistance to ejection

None of the above

26. A patient with orthostatic hypotension can use all of the following maneuvers to increase venous return except

Calf muscle exercise

Lying down flat

Intake of plenty of fluids

All of the above MCC-001 5 p.T.a.

27. A patient with COPD with high pC02 and warm extremities will exhibit all the following except:

Stimulation of aortic and carotid chemoreceptors

Stimulation of medullary centers

Local vasoconstriction

None of the above

28. In a patient with sepsis all can happen except:

Decreased venous return

Arteriolar dilatation

Increase in heart rate

None of the above

29. In fetal life the blood is diverted from the pulmonary circulation to the systemic circulation by all except

Septum primum

Foramen ovale

Ductus arteriosus

None of the above

30. Abnormality of trunco-conal swelling is seen in

Tetralogy of Fallot

Transposition of great vessels

Persistant Truncus Arteriosus

All of the above

31. All are true about probe patency of foramen ovale except:

Foramen ovale is closed functionally

There is trans-septal flow

Seen in 25% of normal subjects

None of the above

32. A patient with severe mitral regurgitation will demonstrate the following in chest X-ray except:

Gross cardiomegaly

Extension of the cardiac shadow behind the barium filled esophagus

Hoffman Rigler sign

None of the above

33. An old lady who underwent recent hip replacement developed sudden severe dyspnea with RBBB in ECG.

Her chest X-ray will show all of the above except:

Enlargement of the pulmonary artery

Distal pulmonary oligemia

Triangular pleural-based infiltrate

Significant pleural effusion

34. A patient presenting with sudden severe chest pain with absent left upper limb pulses and normal ECG can show

Westermark sign

Ring sign

Hampton hump

Fleischner's sign

35. A patient with past history of rheumatic fever and middiastolic murmur can show:

Upper lobar pulmonary vein 3mm in first interspace

Carinal angle >90 degree

Both

None

36. A patient with history of valve surgery showing the prosthesis just left to the spine has undergone:

Aortic valve replacement

Pulmonary valve replacement

Mitral valve replacement

Tricuspid valve replacement

37. Kerley B lines suggest pulmonary venous hypertension of grade:

I

II

III

None

38. A patient with ascites, pedal edema, inspiratory distension of neck veins and loud S3 can show following features in X-ray except:

dense calcification in atrio-ventricular groove

calcification best seen in A-P view

calcification in arcs or oblique circles

none of the above

39. A patient with a pulmonary artery systolic pressure of 100 mm of Hg will show in X-ray all except:

Right descending pUlmonary artery>16 mm

Sharp pruning of peripheral vasculature

Increased convexity of pUlmonary conus

None of the above

40. A patient with ASD will show the following features in X-ray except:

Visualization of pulmonary branches beyond inner 2/3rd of the lungs

More dilatation of the upper lobar vessels

5 or more end on vessels in both lung fields

3 or more end on vessels in one lung field

41. All the following structures form the right border of heart in X-ray except:

right brachiocephalic vessels

right atrial appendage

superior vena cava

inferior vena cava

42. A patient with cannon A wave in the JVP and palpitation may show all of the following in the ECG except:

extreme left axis

double-peaked R in V1 with taller right peak

dressIer beat

none of the above

43. A patient with significant ST-depression with normal coronary angiogram may have all of the following except

ventricular hypertrophy

hypokalemia

mitral valve prolapse

none of the above

44. Following are true about the ECG leads except:

leads II and III detect a change in electrical potential between two points

leads aVR, aVL and aVF measure the electrical potential at one point with respect to null point

precordial leads are bipolar

none of the above

45. All of the following denotes normal axis in the ECG except:

both I and aVF +ve

lead II +ve

both of the above

none of the above

46. As compared to PA view chest X-ray, an AP view X-ray will show all except:

Magnified heart

Higher clavicle

Magnified vertebrae

Higher diaphragm

47. All the following are correct about CT ratio in chest X-ray except:

requires good centering

requires deep inspiration

requires a PA film

normal is less than 0.5 for all ages

48. Echocardiograms of patients with obesity may show all except:

Chamber enlargement

LA smoke

Separation of myocardium and parietal pericardium by echolucent space

PAH

49. The coronary sinus lies in the:

Posterior av groove

Anterior interventricular groove

Posterior interventricular groove

Anterior atrioventricular groove

50. Orthopnoea is unlikely in

Obesity

Diaphragmatic palsy

Restrictive cardiomyopathy

Pulmonic Stenosis

51. Dresslers Syndrome may complicate all the following except:

Beating heart coronary bypass surgery

Myocardial infarction

Surgery for coarctaton of aorta

Blunt trauma to chest

52. A patient of severe mitral stenosis develops hoarseness of voice. Investigations will show:

Severe PAH

Large LA clot

Bilateral vocal cords palsy

Elevated diaphragm on left side

53. FrankStarling law can be demonstrated in patients with ventricular ectopic beats in recordings made during

PET scan

Coronary angiography

Sistamibi Scan

Dobutamine echocardiography

54. Low mixed venous oxygen saturation will occur in all the following except

Cardiogenic shock

Anemia

Pink TOF

VSD with CHF

55. Echocardiographic features of hypertrophic obstructive cardiomyopathy include:

Increased E point-septal separation

Paradoxical motion of the posterior mitralleaHet

Notching in the m mode aortic valve motion

AC interruption

56. Cannon waves are likely in all the following except:

1st degree av block

Mobitz type 1 second degree av block

PSVT

Ventricular tachycardia

57. A nonpulsatile JVP may be present post op after:

pericardiectomy

Glenns shunt

arterial switch

cardiac transplant

58. A ruptured sinus of valsalva aneurysm will not produce a continuous murmur when it opens into:

Coronary sinus

LA

PA

LV

59. When measuring blood pressure at the wrist with home monitoring apparatus, accuracy is improved if the patient:

lies in bed with his arm resting by his side

keeps the arm up in the air and prevents it from touching anything

wraps the cuff as low in the wrist as possible

sits on chair with his arm vertically down

60. Down syndrome may have:

Left to right shunt

Myocarditis

PS

Coarctation

61. The normal T wave axis is

opposite to QRS axis

similar to ST segment axis

similar to QRS axis

at right angles to depolarization front

62. Ventricular activation time is likely to prolong in all the following except:

Severe hyperkalemia

RBBB

VT

WPW

63. Recording left atrial depolarization is improved by recording:

V3R, V4R

Oesophageal leads

Chest leads in intercostal space higher

Increasing paper speed and doubling amplitude

64. ST elevation is seen in all the following except:

Early repolarization

LV aneurysm

Subendocardial ischemia

Successfully resusication after cardiac arrest

65. U waves are usually most prominent in

II, III, aVF

aVR

V2,

aVL, V5, V6

66. In a patient with DVT and breathlessness, the following will be useful in excluding pulmonary embolism:

ECG

Echocardiogram

D-dimer

None of the above

67. In a tri-phasic pericardiaI rub, the third component is related to

T wave

ST segment

P wave

TP segment

68. Metabolic abnormality most likely to need temporary pacing is

Hypokalemia

Hyperkalemia

Hypocalcemia

Hypercalcemia

69. PAT with block occurs with digoxin because it

Increases automaticity

Increases QT interval

Is a vagolytic

Blocks I f current

70. Radionuclide myocardial perfusion imaging studies currently use radioactive:

Thallium

Technetium

Iodine

FDG

71. The following are true regarding TMT placement of limb leads on the chest instead of limbs as is done in conventional 12 lead ECGs except

Reduces movement artifacts

Reduces sensitivity for inferior wall ischemia

Reduces recorded voltages

Increases the ST depression as measured in milli-volts

72. In pacemakers, threshold is measured in

watts

ohms

milli-amperes

volts

73. Long QT with malignant ventricular arrhythmias:

Can improve with overdrive pacing

Are usually congenital

Treated with QT shortening drugs like lignocaine and mexilitene

Should be treated with ICD

74. The acoustic characteristics of musical murmurs can be described as

Wide range of decibels

Wide range of frequencies

Start as low frequency with gradual increase in frequency

None of the above

75. The right coronary artery:

Lies in the posterior av groove

Divides into RV branches at the crux

Gives the acute marginal branch to the LV

Gives anterior branches to RV and posterior branches to RA

76. In a person with nondominant right coronary:

The PLY territory is supplied by the diagonals

The last branch of the RCA is the PLV

The last branch of the left circumflex coronary is the PDA

All the septal branches come from the LAD

77. In a patient with multiple ASDs

The pulmonary VI;:InS will be anomalous

The defects are usually ASD primum with ASD secundum

Chromosomal anomalies are uncommon

PAH will develop earlier

78. In a patient with sinus venosus ASD

Venous anomalies are always present

RV volume overload is usually absent

Cleft mitral valve is common

Cyanosis occurs late

79. In a patient of PAH, the pulmonary regurgitation end diastolic velocity will be more than:

0.6

1.6

2.6

3.6

80. In tamponade the JVP will show a prominent

A wave

V wave

X descent

Y descent

81. In a patient with PDA Eisenmenger, systolic and diastolic murmurs will not originate at

Ductus

RV outflow tract

Pulmnnary valve

Aortic valve

82. Incorrect for Valsalva would be

Phase 1 and 3 are longer than phase 2 and 4

Phase 1 has increase in stroke volume

Phase 2 will show tachycardia

Phase 3 will show the lowest blood pressure

83. Ejection click in severe Valvar PS is inconstant because of

Ventricular interdependence

Fall in pUlmonary artery pressures with inspiration

Loss of atrial kick

Premature opening of the pUlmonary valve in inspiration

84. Investigation most useful for establishing constrictive pericarditis as the cause of anasarca and elevated jugular venous pressure is

PET scan

Chest CT

Angiography

3D echo

85. A pulmonary AV fistula will produce:

Continuous murmur

Abnormal ECG

Abnormal 2d and Doppler echocardiogram

Abnormal Cnest X-ray

86. In Ebstein's anomaly, bypass tracts:

are usually present

usually concealed

usually multiple

show incomplete RBBB on resting ECG

87. Measurements of blood troponins

Picks up evidence of myocardial injury

Is a test specific for myocardial infarction

Is usually positive in first 4 hours

All of the above

88. ECG criteria for diagnosing LVH are

Highly sensitive

Highly specific

Most useful for epidemiological studies

More accurate than echocardiography

89. Myocardial perfusion imaging in a patient with acute ST elevation myocardial infarction will show:

Patchy uptake

Increased uptake

A cold area

Reversible defect

90. Long term prognosis in chronic heart diseases correlates best with:

LV ejection fraction

Myocardial perfusion abnormalities

Functional class and exercise capacity

Heart rate variability