8/2/2019 MCC-004-R

1/8

MCC-0041R

, . . 1 CARDIOLOGY (PGDCC)

. ,.. June, 2007 :I. : : ' ' . '

' i " i mCC-OO4m : COMMON CARDIOTVASCULAR DISEASES'I Iffip':2 hoars"'

r-. '*'*1 . . t 1 * " , i , c ; , : ' : . ,Note :

(t) TIwrc will be multiph choice types of questians in this ernmination._ (ii) NI qtcrstions are compulsory.:.. q!i) Each':rygstion will haue four options (1, 2, 3 and 4) which are true or false in nature.

l;.,., fu) 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.atehas ticked both

tlIE options.(uii) Thctz will be 30 questinn^sn this poper and. each question con'ins equal marks.(viiilTllerc.:will be no negative markin4 for wrong answen

it tlrc question pdper of thc uamirtation. If,.(t*) Cand;ifutes should drposit the questionpdper aft'er tIrc complztion; --. ' q&y a nd.id,ate dnes not return thz question paper, it will be treoted as thc punishablc

i ; l loffeie and actinn will be taken accordingly.(r) No cand,id,ate hall leaue he examinationhall ot least fororu hour aftcr the commcrrcemen

1 ! of thc exqrnination.

P.T .O

8/2/2019 MCC-004-R

2/8

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

2. Rheumatic fever often follows Group A Streptococcal (GAS) infection because(1) M protein of GAS has structural characteristics similar tohuman heart tissue(2) Epidemiological studies have shown that following GASepidemic, incidence of rheumatic fever increases(3) ASO titers less than 200 Todd units is seen in patients with

rheumatic fever(4) A negative GAS culture rules out acute rheumatic fever

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

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

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

lF"r*lIF"r";llF"illlF"illIF"r";lfF"''"'llF"r';l@IF"t""lF"r*llr"t'"]IF"t""l

tr"'"llr"'.ltr"'.lf'**tIr""' If'**t1r"""1r"".

lr""' Itr"".1r"""lr""' Itr"""1r.""tr"""llr"'Elr"""ltr""atr"""lr""'

lF"r';lIF"t';ltF"rAlF"ill

lF"illlF"t".ltF"r';lfF"r";l

MCC-004/R

8/2/2019 MCC-004-R

3/8

6. \ilhich of the following statcments.about prosthetic valve endocarditis is trup ?: (1) Incidmce is highest during the first 6 weeksafter surgery @

\z) unset rqtJun t!t) days rrrg l year after surgery are nosocomial @(3) During the initial months after surgery mechanicalvalves lffilare not proneto'develop nfectiveendocarditis(4) {fuT tZ.-onths prostheticvalvesare less ikely to tT",r"l1 develop nfection

I7. Methicillin resistant staphylococcalendocarditisshould be treated with

lF"r61|F-"GlEt",;ltr"illlF"is"lfr"trylfF"mlF"rill

(1) Vancomycinaloner (?) Vancomycinwith Gentamicin(8)rftancomycrnl Gentamicin and Rif4mpicin

,(4) For mitrimum of 6 weeks8. Persistent fever in patients with Infective endocarditis ontreatment with sensitive antibiotics may indicate

(1) Always microbial resistanceto treatment(2) Hypersensitivity to antibiotics(3) Catheterrelated infection

" (4) Metastaticabscess9.. ,iPerivalvar qrtension of infection in patients with infectiveendocarditis is indicated by

(1) Heart block-' ,...' . 1; (2) New murmurs

(3) Persistent fever

[F"t-*lb"illlF"il:llF"tArtrilll{?trytF"illfr"r';llTt't"'lI False I@t-tI False I

P.T.O.

fTcltG|fr"df""""1lTr_"4fr'.Flfrf,r*llq"!r"l1r"".fTy""lF". lfr'". I

' i ;10. Which of the following statements about rheumatic mitral stenosis s true ?(1) Nearly 307oof patiente with rheunatic fever go on to t.Tru" I

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

(4) iltfHTfi stenosisakes bouto n zsyearso , [rr..,'-ldevelop after an attack of rheumatic feverMCC-004/R

8/2/2019 MCC-004-R

4/8

11. Which of the following statements about mitral valve is true ?(1) Changes in the posterior Ieft atrial wall can distort themitral valve(2) Global as weII as the regional contraction of the left ventricleis important for normal mitral valve closure(3) Impaired contraction of the papillary muscle causes

mitral stenosis(4) Normal motion and contraction of mitral annulus contributeto mitral valve function

12. Dyspnea n mitral stenosis s due to(1) Elevatedpulmonaryveno-capillarypressure lTru"l(2) Reducedung compliance 1T""" I(3) IncreasedLA Pressur" I f"t"l(4) Increased V End diastolicpressure lT.A

13. BaIIoonmitral valvotorny s not the ideal treatment in mitral stenosiswhen(1) Commissuralcalcification s sever" fT"tt I(2) Sub-valvar usion is marked lT""r I(3) Atrial fibrillation is present lTt"" I(4) Left atrial appendage r body are freeof thrombi I Tt"A

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

15. Openmitral valvotomy s better than balloon mitral valvotomy because(1) It has better immediateand long term result. I f"t" I(2) It has less morbidity I T""" I(3) It requiresshorter hospitalization I T""rl(4) It is useful in patientswith clots n the left atrium fT"""l

lF"illlF"t."llF"r*llF"t'"-l

Ir""dfr"""lt'"".lft**l

lF"t".llF"illtF"t'.lF"t".ltF"t".llF"illlF"t";llF"t"eltF"t".ltF"t"IlF"illfF"te"llF"illfF"illl-F3il]lF"t";l

MCC-004/R

8/2/2019 MCC-004-R

5/8

16. hegnanry is tolerated by patients with mitral stenosis ft.,,., (r) Mitral stenosis s mild or moderate

' , (2) Closemddical supervision is available

(4) Mitral valve area is < 1 sq.cm.' ' l ( , 'tl, Patients with tight mitral stenosisand symptomshave

(1) 10 year mortality of 70-80Voi,

patients(Q) Mortalrty due to pulmonary edema n about 80Voof patients(4) Mortality due to: thromboembolism n about 2AVo f patients

18. Mitral regurgitation is(1) Most conmon disease seen n cardiolory practice

: (2) Always.due to diseaseof the mitral leaflets(3) Commonlyassociatedwith atrial fibrillationi (4) A diseasepeculiar to the tropical countries

19. Acute mitral regurgitation is often due to"O) Acute myocardial infarction(2) Progtheticvalve dehiscence(3) Rhcumstic heart disease. * . L : . .(4) Dilefed cardiomyopathy

m. Congenitalbicuspid aortic valve- ' (1) O&enoofllrs in about 2% ofindividuals'l:1,' ' ' "! ;.' " (2) *"1 *T be associatedwith coarctationof aorta

.(3) Is tb!"ifrFnmonest congenital cardiacabnormality. . , {4) Id;nnn Nssociatedwith ventricular septal defest

IT-"trAl'"ffir;ll-lI False I

[E'Alr"r'sltr"til@Iqqt$ltF"r*lh"tAh"tA

.:l'F"tr"l@h"tAFry'GII,T"t'"fry"t'..|tF"t-"l 1 - l

P.T.O.

lrr'".lfr"p"l@lr'"".lh"""Flqi" ltr"""ltr-ll-tlTrue Ir@llr'61lT'"9 |@[TIll.Itr4'qlfr""' I@@fTr,."

MCG-004/R

8/2/2019 MCC-004-R

6/8

21. Degenerativeaortic stenosis(1) Shares common pathogenetic actors with atherosclerosis(2) Occurs in majority of patients with extensive coronaryartery disease(3) Is precededby phase of aortic sclerosis(4) Is associatedwith coronary artery disease n less than50Voof patients

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

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

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

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

lF"r';llF"illl-F"il]lr"illtF"r";llF"t""llF"illlF"ill

lr"";lfr"".Itr"".1r.""1r"".lr"".lIr"""11r"""Ir"""11r"""Ir"""1fr'""1lrill1r"""lr"'"l1r"".1r"""lrilllr"A1r"".

IF"r.;ll-F"r';llF"r";lIF"ill

l-F"r";lIF"r'nlF"r';llF"illIF"r";llF"illIF"r".IIF"ilI

MCC-004/R

8/2/2019 MCC-004-R

7/8

28. Pericardial friction nrbs

: (3) Is always present in patients with pericarditis lffili i (4) Is a prognosticsrgn durins treatment of pericarditi @|

' 27, ElectrocardiographicST elevation of pericarditis could be diagnosedby.', . (1) The presence f reciprocalchanges lT.r"l

(9) . Its concaviWupwards lTruJl(3) ST elevation in a VR lr"".l

': (4) AssocirBtedrogressivechanges n serum cardiacmarkers lFl28. Pericardial tamponade s diagnosedby

(1) Tach5rpnea lffi'l(2) Pulsusparadoxus tT"rr.l

t ,t) Elevated loodpressure lTtite I.89. Hypertrophic dardiomyopathy often presents with -(1) Dyspnea I r".r. I' (2') a"sitta lTt".:l

(3) Depende4t"a* @(4) Ascitee l*"n80. Which one of the following is involved in the production of myocardiallmlemia and angina in hypertrophic cardiomyopathy ?

(2) LV Diastolic dystunction l Tt t"l(3) Marked LV wall thickness lTt".l(4) Congenital coronaryvascular anomalies lT"".l

@b"illITGIfF"r*|lr"tdtffittFdr*.ltF"t';lh"I;ltF"r'Tllr"6l1F"r";lfrdrilryIr"t"dllr"tr"l

Ir"t-"]Ir"t-.]tF"r*llr,rrgel

1 ,000vlcc-004/R

8/2/2019 MCC-004-R

8/8