1. The most common cause of cardiovascular deaths is

Atherosclerotic disease

RHD

CCF

Myocarditis

2. Which is not a manifestation of atherosclerotic disease?

CAD

Stroke

PVD

CRF

3. The term South Asians includes all except

Indians

Pakistanis

Russians

Sri Lankans

4. Which is an incorrect statement

South Asians are more prone to CAD.

Indians in USA are less prone to CAD.

CAD risk reduces over three generations in migrants.

South Asians have more diffuse CAD.

5. Which is incorrect about the pattern of CAD amongst Indians?

More severe disease

More extensive lesions

Less AMI

Small coronaries

6. Correct about CAD in Indians is all except

Males have greater risk

More prevalent in rural population

Urban population has more obesity

Hypertension is more prevalent in urban population

7. Cardiovascular diseases that impose major burden on India include all of the following except

CAD

Hypertension

Rheumatic Heart Disease

None of the above

8. Which statement about the development ofCAD is incorrect?

Incubation begins in early teens.

Presence of risk factors accelerates the process.

Disease may remain asymptomatic for long periods.

Angina is a clinical presentation which occurs in advanced stage.

9. The correct sequence of staging in atherosclerosis is

Atheroma Fibrous Plaque Fatty Streak Thrombus

Fatty Streak Thrombus Fibrosis Atheroma

Atheroma Thrombus Fibrosis Fatty Streak.

Fatty Streak Fibrous Plaque Atheroma Thrombosis

10. Which of the following is a modifiable risk factor for CAD

Age

Gender

Genes

Smoking

11. Modifiable risk factors for CAD constitute all except

Lipids

Diabetes

Smoking

Family history of CAD

12. Moderate alcohol intake has beneficial action by virtue of its action on

HDL

Platelets

Fibrinolysis

All of the above

13. Lifestyle-related risk factors for CAD are all except

High calorie diet

Vigorous exercise

Current smoking

Mental stress

14. The advantages of physical activities are all except

Decrease in LDL

Increase in insulin sensitivity

Increase in triglycerides

Increase in cardiac reserve

15. Correct statements about cigarette smoking are all except

Single most important preventable factor

Significantly increases morbidity and mortality

Causes vasoconstriction

Second-hand smoking is not injurious

16. Which of the following is incorrect?

Diet can determine cardiovascular risk.

Diet can affect lipid levels.

Saturated fats help in reducing CAD risk.

Salt intake contributes to hypertension.

17. About the role of mental stress in the development of CAD choose the incorrect statement.

Chronic stress in family contributes to CAD.

People with Type-B personality are more prone.

Stress affects the sympathetic nervous system.

Marital stress leads to poor prognosis.

18. With regards to systemic HT as a risk factor for CAD, which is statement?

Systolic BP is the more important risk factor.

Diastolic BP is of no importance.

HT is a risk factor for stroke and renal failure also.

Risk is progressive with increasing BP. an incorrect

19. Correct statement about the treatment of systemic HT is

No specific targets for treatment.

No impact on heart failure after treatment.

Diabetics should have much lower targets.

Stroke risk increases with tight control of HT.

20. The following statements about dyslipoproteinemia are incorrect except

High HDL protects against CAD.

Low LDL is a risk factor.

Triglycerides are of no consequence.

TCIHDL ratio is a weak marker for CAD.

21. Which of the following is an incorrect statement?

Insulin resistance is atherogenic.

Risk ofCAD is high in DM-2.

DM-1 does not increase the risk for CAD.

Pre-diabetes also increases the risk strongly.

22. Which is not a correct statement about CAD in type-2 Diabetes Mellitus?

More severe disease

Very poor collateral circulation

More left main involvement

Very little calcification

23. Mark the incorrect statement about DM-2.

Greater cardiovascular mortality

Increasing risk of mortality with duration

Higher risk of strokes

Protection against heart failure

24. Select the incorrect statement about obesity.

Obesity decreases the risk ofCAD by a factor of 2.

BMI is used to measure ideal body weight.

Distribution of fat is equally important.

Dyslipoproteinemia can be attributed to obesity.

25. All of the following statements are incorrect except

Visceral fat is an inert mass of cells.

'Apple'type obesity is more strongly associated with CAD.

BMI is a stronger predictor than WHR.

Greater WHR is protective against CAD.

26. All of the following are components of metabolic syndrome except

Systemic Hypertension

Impaired blood glucose

BMI less than 25

Abnormal lipid profile

27. In the presence of diabetes

Likelihood to develop CAD increases 3-5 times

Overall mortality from heart disease in women increases 4 times

Prevalence of CAD may be as high as 55%

All of the above

28. Which of the following is not considered a.s risk factor for CAD

Lipoprotein excess

Hyperhomocysteinemia

Infection

Right ventricular hypertrophy

29. Which of the following statements is incorrect?

Majority of people with CAD have conventional risk factors.

People with acute coronary event may have no risk factors at all.

People considered may still present with CAD.

No further risk factors have been identified for CAD.

30. Within six years of heart attack

18% of men will have another heart attack

of men will experience sudden death

of men will have a stroke

All of the above

31. Which is an incorrect statement about

More atherogenic than LDL

Biological markerfor familial CAD

Influenced by diet and smoking

Indians have higher levels compared to Chinese

32. Plasma fibrinogen levels are reduced by all except

Smoking

Weight loss

Regular exercise

Moderate alcohol intake

33. Which of the following organisms is not considered etiological in CAD

Chlamydia

CMV

H. Pylori

HIV

34. Which of the following is an incorrect statement

CAD is an inflammatory disease.

CRP levels are elevated.

Statins reduce inflammation.

Steroids reduce CRP levels and decrease CAD risk.

35. All of the following risk factors are more prevalent in South Asians as compared to Caucasians except

Truncal obesity

Low triglyceride levels

High

High PAI-1 activity

36. Important source ofOmega 3 is

Canola oil

Olive oil

Fish oil

None of the above

37. Which is not used as part of Framingham risk scoring system?

Gender

HDL cholesterol

Asian ethnicity

Systolic BP

38. Which is not a correct statement?

Angioplasty and stenting constitute tertiary prevention.

To inculcate healthy lifestyle is primordial prevention.

Identification and treatment of risk factors is primary prevention.

Minimizing the risk after a coronary event is secondary prevention.

39. .All are sources of trans-fats except

Margarines

Fried chips

Burgers

Corn-ear

40. Which is not a correct dietary recommendation?

Carbohydrates 60% of energy

Fruits 4 servings daily

Saturated fats 30%

Dietary fibres 40glday

41. Which of the following is not a benefit of smoking cessation?

Decrease work capacity in the first tWQ years

Improve in lung functions

Reduction in chance of lung cancer

Non-smoker equivalence after 10 years

42. Following are true about quitting smoking except

Within 1 year the risk of heart attack is reduced by 50%.

Lung cancer is reduced by 60% after 5 years.

Personality is adversely affected.

There is immediate decrease in angina episodes.

43. Correct statement about the benefits of physical exercise are all except

Frequency should be twice a week

Target heart rate of75% ofMPHR

30 -60 min/day

Continuous, involving all muscle groups

44. Which of the following interventions does not help in the reduction of hypertension

Regular physical exercise

Reducing weight

Reducing salt intake to less than 25 g1day

Discontinuation of smoking

45. Correct statement about HRT in women are all except

Menopause reverses the partial protection against CAD.

HRT should be started early rather than late.

Incidence of breast cancer is reduced.

Incidence of pulmonary embolism is increased.

46. Which is not afeature of unstable plaque?

More lipid core

Thin fibrous cap

Thick fibrous cap

Internal hemorrhage

47. Non-pharmacological management of blood pressure includes

Restriction of salt intake to less than 4 gm/day

Reduction of overweight

Regular physical exercise

All of the above

48. All of the following are "coronary heart disease equivalent" except

Risk 10 in 10 years plus two risk factors

Diabetes mellitus

Peripheral arterial disease

Dyslipidemia

49. Best predictor for future risk of the cardiovascular events, amongst the following is

hs-CRP

Lipoprotein(a)

Homocystine

Interleukin-6

50. Premature CAD is defined as -CAD and occurs before the age of

40 years in men and 50 years in women

55 years in women and 65 years in men

55 years in men and 65 years in women

40 years in women and 50 years in men

51. Mono-unsaturated fats are found in all except

Canola oil

Coconut oil

Peanut oil

Olive oil

52. Modifiable risk factors are all except

Improper Diet

Smoking

Alcohol

Age

53. The most powerful predictor of Atherosclerosis, a Total CholesterollHDL ratio> is associated with high risk ofCAD.

4·5

3·5

5·5

6·5

54. Type-A Behaviour is characterized as all except

Ambitious

Impatient

Competitive

More Passive

55. In secondary prevention according to AHA guidelines, the goal is to have BMI of .

15'5 to 20·5 kg/m^2

lS'5 to 24·9 kg/m^2

25·5 to 30·5 kg/m^2

30·5 to 40·5 kg/m^2

56. Most important risk factor for the development of CAD throughout India is

HTN

DLP

Smoking

DM

57. CARE study is based on

DM

HTN

Statins

Beta Blockers

58. False statement for Nicotine is

Agonist ofSNS

Decreases Coronary Tone

Release ofNorepinephrine

Provokes vasoconstriction

59. Which of the following is true?

I. Men should have aWHR equal to or less than 0.95, in women it should not be more than,0·80.

II. The waist circumference should not be more than 90 em in women and 100 em in men.

I

II

Both I and II

None of the above

60. Earliest recognizable pathologic lesions in the process ofAtherosclerosis is

Fatty streaks

Fibrous plaque

Atheroma

Complicated

61. High Glycaemic Index foods are all except

White Bread

White Rice

Whole Fruits

French Fries

62. Which statement is false?

Fat intake should be 30% of total calories.

Cholesterol should be less than 300 mg.

Saturated fat should be 10%.

Complex carbohydrate should provide 10 to 20% of calories.

63. Which of these is not a secondary prevention?

Smoking control

CABG

HTN control

Weight reduction

64. Regarding stress management in CAD, all are true except

Stress has been implicated in pathophysiology of Atherosclerotic process, HTN and stroke.

Stress-related hormones such as cortisol and catecholamines in excess cause body system dysfunction.

Meditation, Yoga and Biofeedback are useful methods.

Alcohol and smoking are included in stress management.

65. NCEP ATP-III stands for

National Cholesterol Education Programme Adult Treatment Panel-III

Newer Cholesterol Evading Programme Adult Treatment Panel-III

Non-Cholesterol Enzyme Producing Adult Treatment Panel-III

National Cholesterol Eradicating Programme Adult Treatment Panel-III

66. Omega 3 fat is found high in

Mutton

Salmon

Pork

Lamb

67. Relationship between low birth weight and enhanced susceptibility to CAD in adult life is

Barter's Hypothesis

Bayer's Hypothesis

Basker's Hypothesis

Barker's Hypothesis

68. Which is not a secondary prevention trial

WOSCOPS

4S

CARE

LIPID

69. Strongest Anthropometric measure associated with risk ofMI in inter heart study is

WHR

Height

BMI

Weight

70. Trans-Fats

iLDL

J.HDL

i LDL and J. HDL

i LDL and i HDL

71. Which statement is false?

The prevalence of CAD among immigrant Indians is about 3-fold lesser comparable to the indigenous population.

CAD tends to occur earlier in life among people of Indian descent.

Process is very severe, diffuse extensive often involving multiple vessels.

Mortality attributable to CAD is substantially higher among Indian
immigrants.

72. Which is not true in the IDF definition ofMetabolic Syndrome?

Elevated TGs 1·7 mmol/L or receiving specific Rx for this lipid abnormality.

HDLC level 1·03 mmol/L 40 mg/dl) in men.

Raised BP 130 mmHglDBP 85 mmHg.

Raised FBS 5·6 mmol/L or per diagnosed with type-2 diabetic.

73. ATP III goal to reduce the level ofLDLC in high-risk category is

160

130

100

200

74. According to inter-heart study, two strongest predictors of acute MI are

DM and HTN

Stress and Depression

Exercise and Diet

Apo B/Apo A1 ratio and current smoking

75. Benefits of smoking cessation are all except

Immediate benefit is a decrease in Anginal episodes and improvement of effort tolerance.

Only one year after quitting, risk of heart attack is reduced by 90%.

Ten years after quitting, male ex-smoker has same mortality rate as of non-smoker.

For female ex-smoker, the benefit is seen even early in 2 years.

76. Regarding CAD in women all are true except

CAD in women is both preventable and amenable to lifestyle changes and pharmacological intervention.

Statins are first line to reduce LDL level.

Premenopausal is benefited from HRT therapy.

HRT may even have deleterious effect on primary prevention.

77. False statement about HDL is

Called as good cholesterol

Inverse relationship between HDL and Risk of CAD

VA -HIT (Veterans Administration -HDL Intervention Study) -decrease in HDL reduces Major Coronary events

None of the above

78. Which of the following is a primary prevention trial

JUPITER

HOPE

4S

CURE

79. Controlling, Reversing and Treating the riskfactors that are already present in the individual or in the community before any damage/before any symptoms is called

Primordial prevention

Primary prevention

Secondary prevention

Tertiary prevention

80. Which is true in CAD for women?

Less severe than for men at any age

Less mortality

Infarct size smaller

More lethal

81. Which statement about is false?

Concentration of is elevated in South Asians irrespective of their immigrant status.

Low level is associated with CAD especially with concomitant elevation of LDL levels.

level is genetically determined.

There is structural similarity ofLp(a) and Plasminogen.

82. Drugs used for smoking cessation are all except

Nicotine chewing gum

Bupropion

Varenicline

None ofthe above

83. True regarding Fish Oil is

Thrombic effects

Inflammatory

Contraindicated in hypertriglyceridemia

Decrease VLDL synthesis

84. Syndrome X (angina with normal angiogram) is due to

Coronary emboli

Micro-vascular dysfunction

Coronary spasm

Atherosclerosis

85. Following drugs causing Dyslipidemia

Beta Blockers

Thiazide Diuretic

Retinoic Acid

CCB

86. Exercise does all except

Reduces Blood Pressure

Decreases insulin sensitivity

Reduces LDL

Increases HDL

87. In CHF, the following drugs are used except­

ARB

Aspirin

ACE-I

Beta Blockers

88. Secondary prevention are all except

Weight reduction

HTN control

CABG

Smoking

89. Obesity is defined as BMI

20

25

30

35

90. Atherosclerosis starts in

Childhood

Young adulthood around 24 years

Middle age about 30 to 50 years

None of the above