Medicine - CVS MCQs

SQUARE ROOT SIGN

This is done by cardiac catheterization study where we try to measure the pressure in r.v during the
diastolic phase.
We know that when the volume of a chamber increases the pressure within decreases . In patients
having partial rv diastolic failure the pressure tracing reveals a square root as during initial normal
phase there is a normal decline and during the latter part re- elevation miniking square root.
The conditions in which it is seen are:
1. C.C.P,
2. RCM and
3. RVMI

1.

Pentology of fallot includes

a.

TOF+ASD

b.

TOF_ Coarctation of aorta

c.

TOF+PDA

d.

TOF + Hypersleenism

2.

All of the following are signs of impending Eisenmengers complex, except:

a.

Increased intensity of tricuspid/Pulmonary flow murmurs

b.

Increased intensity of P2

c.

Development of single S2

d.

Appearance of Graham steele murmur

3.

Cardiovascular manifestations in HIV/AIDS include all of the following except:

a.

Pericardial tampoande

b.

Congestive heart failure

c.

Recurrent arterial embolism

d.

Aortic aneurysm

4.

All of the following are used in the treatment of pulmonary artery hypertension except:

a.

Calcium channel blockers

b.

Prostacyclines

c.

Alpha blockers

d.

Endothelin receptor blockers

5.

Murmur increased with Valsalva maneuvre in

a.

VSD

b.

HOCM

c.

MS

d.

AS

6.

Accelerated idioventricular Rhythm is seen in

a.

AV nodal block

b.

Reperfusion therapy

c.

Digitalis toxicity

d.

Metabolic derangement

7.

Most common cause of abdominal aorta aneurysm

a.

Atherosclerosis

b.

Trauma

c.

Fibromuscular dysplasia

d.

Retroperitoneal fibrosis

8. A 30-year-old female presented with complain of progressive breathlessness since 6 months. There was
history of intermittent chest pain and palpitation. On examination her heart rate was 88 per minute and BP was
140/80 mm of Hg and a late systolic murmur with midsystolic click at cardiac apex. Pathological examination of
heart is most likely to show:
a.

Fatty replacement of ventricle with thinning of RV free wall

b.

Hooding of mitral valve leaflet with myxomatous degenation

c.

Ischemia of pappilary muscles

d.

Elongated and ruptured chordate tendinae

9.

True about 3rd heart sound

a.

Loud in ASD

b.

Can be heard in Constrictive pericarditis

c.

Can be heard during rapid filling phase of ventricular diastole

d.

Soft in cardiac tamponade

10. A patient with atrial fibrillation developed weakness of upper limb which recovered gradually over a period
of 4 weeks. Lab studies did not reveal any significant abnormality. What is the diagnosis:
a.

TIA

b.

Ischemic stroke

c.

Hemorrhagic stroke

d.

Cerebral salt wasting syndrome

11. A 15 Year old boy died suddenly while playing in the field. On autopsy myocardial fiber hypertrophy, fibrosis
reticular pattern seen
a.

Dilated cardiomyopathy

b.

Hypertrophic cardiomyopathy

c.

Arrythmogenic heart disease

d.

Obstructive cardiomyopathy

12.

Drug not used in CHF

a.

NTG

b.

Spironolactone

c.

Nesiritide

d.

Trimetazidine

13.

Murmur which is increased with decreased after load

a.

MS

b.

AS

c.

HOCM

d.

AR

14. The treatment of acute myocardial infarction is thrombolytic therapy if the patient presents within ---- hours
of the onset of chest pain.
a.

6 hours.

b.

12 hours.

c.

18 hours.

d.

24 hours.

15. A 50 year old lady with a history of intolerance to cold, constipation and hoarseness of voice is found to have
cardiomegaly on the chest roentgenogram. The best investigation to identify the cause of cardiomegaly would
be:
a.

Coronary angiography

b.

Left ventricular angiography

c.

Right ventricular angiography

d.

Echocardiography

16. A 30-year-old female patient presents with dyspnea on exertion class III and palpitations. Electrocardiogram
reveals atrial fibrillation with fast ventricular rate. Echocardiography reveals evidence of severe mitral stenosis
and left atrial appendage clot. Which of the following is not recommended?
a.

Diltiazem treatment to control ventricular rate.

Warfarin therapy followed by repeat echocardiography assessment

c.

Elective cardioversion followed by percutaneous balloon mitral valvuloplasty

d.

Open mitral commissurotomy with left atrial clot removal.

17. A 70 year old man presented to emergency and was diagnosed to have acute transmural myocardial
infarction. Based on his ECG changes, he was started on thrombolytic therapy with streptokinase injection. After
more investigations, which of the following finding indicates that thrombolygic therapy is risky and should be
stopped?
a.

Pericardial friction rub

b.

Mobitz Type II block

c.

Significant pericardial effusion on echocardiography

d.

Venous thrombosis in lower limbs

18. Two patients presented with significant atherosclerosis. One has significant co-morbid diabetes, the other is
nondiabetic. The incidence of which of the following disease is likely to be increased 100 fold if we compare the
above two patients?
a.

Myocardial infarction

b.

Cerebral stroke

c.

Lower limb ischaemia

d.

Vertebrobasilar insufficiency

19.

Least chances of infective endocarditis is associated with?

a.

Mild MS

b.

Mild MR

c.

Small ASD

d.

Small VSD