MCC-0041R

CARDIOLOGY (PGDCC)

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June, 2007 :

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' i"i mCC-OO4m : COMMON CARDIOTVASCULAR DISEASES'II ffip':2 hoars"'

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Note : (t) _ :.. (ii) TIwrc will be multiph choice types of questians in this ernmination.

NI qtcrstions are compulsory.

q!i) Each':rygstion will haue four options (1, 2, 3 and 4) which are true or false in nature.

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If anA cand,idate ticks both the options (trun or folse), then it will be'tahnn as the wrol8 ouswer and nn marhs will be award,ed for this. '

fut) Ouerwriting utill not be allowed and it will be tahen as if tlrc candid.ate has ticked both tlIE options. (uii) Thctz will be 30 questinn^s this poper and. each question con'ins equal marks. in (viiilTllerc.:will be no negative markin4 for wrong answen . ,.(t*) ; --. '
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it the question Cand;ifutes should drposit tlrc question pdper aft'er tIrc complztion of thc uamirtation. If q&y a nd.id,ate dnes not return thz question paper, it will be treoted as thc punishablc offeie and actinn will be taken accordingly.
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No cand,id,ate shall leauethe examinationhall ot least for oru hour aftcr the commcrrcement of thc exqrnination.

P.T.O.

1.

Polyarthritis with skin rasftresare commonly seen in patients with (1) (2) (3) (4) Tuberculosis Infective endocarditis Rheumatic fever Gonococcalarthritis

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Rheumatic fever often follows Group A Streptococcal (GAS) infection because (1) (2) (3) (4) M protein of GAS has structural characteristics similar to human heart tissue Epidemiological studies have shown that following GAS epidemic, incidence of rheumatic fever increases ASO titers less than 200 Todd units is seen in patients with rheumatic fever A negative GAS culture rules out acute rheumatic fever

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Aschoff nodules are (1) (2) (3) (4) Classic hallmark of rheumatic fever Often seen during the sub acute or chronic phase of rheumatic carditis IJncommon during the acute phase of rheumatic carditis Represent the cell mediated immunity response

4.

Acute infective endocarditis is characterized bv (1) (2) (3) (4) Marked toxicity Evolves in about 3 weeks time Occurs only in patients with pre-existing valve disease Metastatic infections are very common

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Infective endocarditis is uncommon in patients with (1) (2) (3) (4) Pulmonary stenosis Ventricular septal defect Atrial septal defect Bicuspid aortic valve

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\ilhich of the following statcments.about prosthetic valve endocarditis is trup ? (1) Incidmce is highest during the first 6 weeks after surgery \z)
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unset rqtJun t!t) days rrrg l year after surgery are nosocomial @ (3) During the initial months after surgery mechanical valves lffil are not prone to'develop infective endocarditis (4) prosthetic valves are less likely to tT",r"l {fuT tZ.-onths develop infection Methicillin resistant staphylococcalendocarditis should be treated with (1) Vancomycinalone

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(?) Vancomycin with Gentamicin (8)rftancomycrnl Gentamicin and Rif4mpicin ,(4) For mitrimum of 6 weeks

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Persistent fever in patients with Infective endocarditis on treatment with sensitive antibiotics may indicate (1) Always microbial resistance to treatment (2) Hypersensitivity to antibiotics (3) Catheter related infection " (4) Metastatic abscess
,iPerivalvar qrtension of infection in patients with infective endocarditis is indicated by (1) Heart block New murmurs Persistent fever

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Which of the following statements about rheumatic mitral stenosis is true ? (1) Nearly 307oof patiente with rheunatic fever go on to

'.;CZI !!Vo otn{i9nts with mitral stenosismay not recall any '1,:' 'r history of rheusratic fever ;. (3) Pat-iprrtswith. Carey Coomb'smurmur always develop

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stenosis about tn zsyears , takes zo to

develop after an attack of rheumatic fever

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11.

Which of the following statements about mitral valve is true ? (1) (2) (3) (4) Changes in the posterior Ieft atrial wall can distort the mitral valve Global as weII as the regional contraction of the left ventricle is important for normal mitral valve closure Impaired contraction of the papillary muscle causes mitral stenosis Normal motion and contraction of mitral annulus contribute to mitral valve function

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Dyspneain mitral stenosisis due to (1) Elevated pulmonary veno-capillarypressure (2) Reduced lung compliance (3) IncreasedLA Pressur" (4) Increased End diastolicpressure LV lTru"l 1T""" I I f"t"l lT.A

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BaIIoonmitral valvotornyis not the ideal treatment in mitral stenosiswhen (1) Commissuralcalcificationis sever" (2) Sub-valvarfusion is marked (3) Atrial fibrillation is present (4) Left atrial appendage body are free of thrombi or fT"tt lT""r lTt"" I Tt"A

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Mitral openingsnap is absent when (1) mitral leaflets are pliable (2) mitral leaflets are mlxomatous (3) Ieaflets and commissures calcified are (4) mitral regurgitation is signifrcant I T""" I fT"""l lTt"a lT"t"l

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Open mitral valvotomy is better than balloon mitral valvotomy because (1) It has better immediate and long term result. (2) It has less morbidity (3) It requires shorter hospitalization (4) It is useful in patients with clots in the left atrium I f"t" I

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16. hegnanry is tolerated by patients with mitral stenosisif t.,,., (r) Mitral stenosis is mild or moderate ' , (2) Close mddical supervision is available

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(4) Mitral valve area is < 1 sq.cm.
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Patients with tight mitral stenosis and symptoms have (1) 10 year mortality of 70-80Vo patients (Q) Mortalrty due to pulmonary edema in about 80Voof patients of (4) Mortality due to: thromboembolismin about 2AVo patients

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Mitral regurgitation is (1) Most conmon diseaseseen in cardiolory practice (2) Always.due to diseaseof the mitral leaflets : (3) Commonly associatedwith atrial fibrillation i (4) A diseasepeculiar to the tropical countries

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Acute mitral regurgitation is often due to " O) Acute myocardial infarction

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(2) Progthetic valve dehiscence

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(3) Rhcumstic heart disease (4) Dilefed cardiomyopathy

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(1) O&en oofllrs in about 2% ofindividuals 'l:1,' ' ' "!; " (2) *"1 be associatedwith coarctation of aorta .' *T .(3) Is tb!"ifrFnmonest congenital cardiac abnormality . . , {4) with ventricular septal defest Id;nnn Nssociated

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Congenital bicuspid aortic valve

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21.

Degenerative aortic stenosis ( 1) (2) (3) (4) Shares common pathogenetic factors with atherosclerosis Occurs in majority of patients with extensive coronary artery disease Is precededby phase of aortic sclerosis Is associatedwith coronary artery diseasein less than 50Voof patients

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Angina in aortic stenosis (1) (2) (3) (4) Occurs in approximately b0 - 60Voof patients Is often due to associated coronary artery disease Is due to severe LVH and resultant myocardial ischemia Is due to recurrent coronary embolism

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Aortic valve replacement in severe aortic stenosis is indicated for (1) (2) (3) (4) All symptomatic patients All patients with LV dysfunction Patients showing hypotensive response to exercise Elderly patients with stroke

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Systolic LV dysfunction in aortic regurgitation (1) (2) (3) (4) Develops in l.\c/o patients per year Precedes onset of symptoms in about 25Voof patients Occurs early in the natural history Indicates severity of the regurgitation

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Medical management of aortic regurgitation consists of (1) (2) (3) (4) Nitrates Hydralazine Nifedepine Papaverine

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28.

Pericardial friction nrbs

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of .', . (1) The presence reciprocalchanges (9) Its concaviWupwards . (3) ST elevation in a VR ': 28. (4) AssocirBted progressive changesin serum cardiac markers Pericardial tamponade is diagnosedby

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(1) Tach5rpnea (2) Pulsusparadoxus t

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Elevated bloodpressure

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Hypertrophic dardiomyopathy often presents with

(1) Dyspnea ' (2') a"sitta (3) Depende4t "a* (4) Ascitee
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Which one of the following is involved in the production of myocardial lmlemia and angina in hypertrophic cardiomyopathy?

(2) LV Diastolic dystunction (3) Marked LV wall thickness (4) Congenital coronary vascular anomalies lvlcc-004/R

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